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Here’s one part of Brian Hooker’s “reanalysis” that shows just how cynical the anti vaccine movement is

18 Dec

When my kid was diagnosed autistic I started reading research papers (I am a Ph.D. researcher by profession) and the raw data. One thing that struck me immediately was the fact that minority children are much less likely to get a diagnosis than white kids. And minority kids are diagnosed later.

This inequity really bothers me. Accurately identifying the needs of a disabled child can focus the appropriate therapies and supports on that child. The need to rectify this inequity is 100% accepted within the autism advocacy and research communities.

This inequity poses a problem to people who claim that autism is an “epidemic”. If we are not identifying all the autistics in any given group (we aren’t), autism prevalence numbers are inaccurate. Being inaccurate, how does one compare, say, one CDC prevalence number with one 2 years later and claim a “real” increase?

One can’t. Plain and simple.

So, for years, groups like those promoting the idea that autism is caused by vaccines have not only ignored this inequity, they have actively denied it. They are stuck between accepting that the data can’t show an epidemic, or accepting that minorities have some sort of protection from this supposed “autism as vaccine injury”.

When was the last time you read something from, say, the Age of Autism blog or Andrew Wakefield calling for efforts to end this inequity? You haven’t. They don’t do it. When have you heard from someone like Brian Hooker that we should study minority populations to see what “protects” them from “vaccine injury”? You haven’t.

Who is Brian Hooker? Brian Hooker is a parent of an autistic child. Brian Hooker strongly believes that vaccines cause autism. He can back this up with his observations of his child’s development. Observations which are contradicted by his child’s medical records. I discussed this before as Double checking Brian Hooker’s story in VAXXED. A Special Master (a judge in the vaccine court) put it very strongly:

After studying the extensive evidence in this case, I am convinced that the opinions provided by Petitioners’ experts in this case, advising the Hooker family that there is a causal connection between SRH’s vaccinations and either the initial causation or aggravation of SRH’s ASD, were quite wrong.

In the original, the Special Master emphasized “quite wrong“.

So, we have someone who believes vaccines cause autism to the point of ignoring the facts in front of him.

A few years ago Mr. Hooker “reanalyzed” some data from an old CDC study, suggesting that evidence showed that the MMR vaccine might increase risk in African American boys. That was discussed in great detail here and elsewhere. (for example: Brian Hooker proves Andrew Wakefield wrong about vaccines and autism and MMR, the CDC and Brian Hooker: A Guide for Parents and the Media).

Mr. Hooker’s study was retracted. In the research world thats a big deal. As in, embarrassingly bad.

Recently, as in 4 years after his original study, Mr. Hooker republished his “reanalysis”. In the Journal of American Physicians and Surgeons. I’d be completely embarrassed to have a paper in that journal, to be blunt. A lengthy discussion of this reappearance of the study can be found at Respectful Insolence as Brian Hooker’s antivaccine pseudoscience has risen from the dead to threaten children again.

Let me just focus on how Mr. Hooker, in my view cynically, abuses the African American community in order to attack vaccines. From the website of an organization Mr. Hooker belongs to (the ironically–to be polite–named “Children’s Health Defense”), we read this:

Main Points from Reanalysis:

The rate of autism diagnoses has increased alarmingly in the U.S., and is about 25 percent higher in black children. Boys are far more likely than girls to receive this diagnosis.

This is not only wrong, it’s wrong in a way that points to incredible dishonesty.

This first point is that autism is about 25% higher in black children. A “main point from the reanalysis”.

Tell me, when you read that did you think, “this study found that autism is more prevalent in African American children”? If so, you were misled. The 25% higher prevalence is from a different study than Hookers. And that other study says something completely different.

From the Hooker study:

However, one study showed that prevalence of autism in African-Americans was approximately 25% higher than that of whites when the data were adjusted for socioeconomic factors[7].

Reference [7] is Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a U.S. cross-sectional study.

The Socioeconomic Equality study states:

Also notable is that, although the overall ASD prevalence was higher among non-Hispanic White and Asian children than among non-Hispanic Black or African-America and Hispanic children, when the results were stratified by SES, we saw that the racial/ethnic differences in prevalence varied by SES (Table 3). The lower prevalence among non-Hispanic Black or African-American and Hispanic children was seen only in the low SES category, and the fact that more non-Hispanic Black or African-American and Hispanic children live in poverty contributed to the lower overall prevalence among these groups.

Emphasis mine. Overall ASD prevalence was lower for African American children. Not 25% higher. This lower prevalence was due to lower socioeconomic status. I.e. poverty.

Want to see this a different way? Here’s a figure from the paper (click to enlarge):

The overall prevalence in White non-Hispanic kids was 6.9/1000. For black non-Hispanic kids it was 5.7/1000. About 20% lower. Not 25% higher as Mr. Hooker claims.

Fewer African American kids are getting autism services. Not because they aren’t autistic, but because their poverty keeps them from getting a diagnosis.

This is something we should be working towards fixing. No question. But don’t look to the anti-vaccine community to care or act. It’s an inconvenient fact for their epidemic story.

I guess he has such a low level of respect for the people in his own community (those who believe vaccines cause autism), that he thought no one would check this.

By the way, this paper isn’t the only one that shows a lower autism prevalence among African Americans. You know those CDC autism prevalence reports that come out every two years? Every single one has reported a lower prevalence among African Americans. Every one.

Here’s a line from the latest report:

Previous reports from the ADDM Network estimated ASD prevalence among white children to exceed that among black children by approximately 30% in 2002, 2006, and 2010, and by approximately 20% in 2008 and 2012.

When I saw the claim on Hooker’s organization’s website I figured he must have cherry picked a study that shows what he needed to make his story work. It’s just such common knowledge in the autism community that African Americans get diagnosed less frequently. It’s in every CDC report. I didn’t know he wasn’t cherry picking, he was just misrepresenting the study entirely.

I discuss this as a scientist. He “misrepresented the study”. My father had a word for that sort of behavior: lying.

OK, Brian. You’ve read the studies and decided to do nothing about the fact that many autistic African American kids aren’t getting identified and getting appropriate services. I get that, you have your own cause. But, really, is that community so much of a nothing to you that you can just use them like this? I ask rhetorically. You and your community have always acted with callous disregard.

I once had hope that as it because completely obvious that you and your community were wrong (and that was many years ago), you’d join the actual autism community and put your advocacy to use. I now know that will never happen. And, frankly, we don’t need dishonest people.


By Matt Carey

Double checking Brian Hooker’s story in VAXXED

7 Jul

One of the arguments so often given for “vaccines cause autism” is that of “then why do so many parents tell exactly the same story?”

Well, they don’t. As we saw with JB Handley (Which is it, Mr. Handley?) even a single parent can shift and change stories over time. And he’s just one example. But we have also seen many times that once the stories we are told are compared to the facts, like say the medical records or videos in vaccine court, parent recollection is shown to be wrong.

Well, now we have Brian Hooker’s two stories. We have what he says in Vaxxed, and we have his recent vaccine court case. An in-depth legal analysis is provided by Prof. Dorit Reiss as BRIAN HOOKER’S VACCINE INJURY CLAIM DENIED BY NVICP.

From the video from Vaxxed, we hear Brian Hooker describe his son’s story starting at 3:26.

My son [SRH] was born in [month] of [year].

(home video with Brian Hooker saying: “[SRH] what does the cow say?”).

(second home video: Brian Hooker: “tweet tweet”, SRH vocalizes which parents interpret as “doggie”).

“Two weeks after his 15 month vaccines, then he lost all language. He lost all eye contact. You would pick him up and he would just hang limp.”

That’s pretty dramatic. And the sort of story that convinces many that, yes, indeed, vaccines might cause autism.

But ask this question, if this happened, why doesn’t Brian Hooker’s son’s medical record say anything like that?

From the Court’s decision, we see that the medical records show that Brian Hooker’s son was already delayed at 15 months. In fact, he was already showing signs of delays at 4 months. First, to be clear: Brian Hooker’s argument before the Court changed with time, and this can lead to some confusion. He first argued that one set of vaccines caused his child’s autism. When the Court informed Mr. Hooker that his cases was filed after the statute of limitations (filed more than 3 years from when the alleged vaccine injury occurred), Mr Hooker amended his complaint to add the claim that the 15 month vaccines (the ones he appears to be referring to in Vaxxed) “aggravated” the ASD as well. Since this event was later, it was not “untimely filed”.

In the end the court found that Mr. Hooker’s claims failed on their merits, so timely or untimely filed didn’t matter.

That all said, here’s an excerpt from the Court’s decision that discusses the 15 month vaccinations:

SRH received his 15-month well child examination on [DATE], and was found to be “healthy.” (Ex. 35, p. 13.) However, at this visit his developmental progress chart indicates that SRH had not achieved most of the expected milestones. (Id., p. 24.) His Denver II developmental progress chart indicates that he could not speak six words, could not run or climb stairs, could not remove garments or use a spoon, and could not stack two cubes, — indeed, he failed all but one of the developmental milestones for 15 months. (Id.) Following a physical examination of SRH, Dr. Heller-Bair administered the usually recommended vaccinations — i.e., DTaP #4, Hib #4, and OPV. (Id., pp. 13, 26.) (These vaccinations of [DATE], were the vaccinations that Petitioners now allege to have “significantly aggravated” SRH’s autism.)

OK, that’s the 15 month vaccination visit. But as to “two weeks after his 15 month vaccines” that Mr. Hooker describes in Vaxxed? What does the record show happened? The Court transcript reads:

Nineteen days later, on [DATE], both parents accompanied SRH to the pediatrician’s office, where she recorded that his temperature was 101.8°, and that both tympanic membranes appeared normal. (Ex. 35, p. 14.) She included the following description.

One-year-old with 1-day history of low-grade fever, irritability, decreased appetite, nasal congestion. Child has a history of recurrent ear infections. Is scheduled for typanostomy tube placement by Dr. Fong in about 4 days’ time. Mom is concerned that he may have an ongoing ear infection prior to surgery.

(Id.) No other recent symptoms were noted. Dr. Heller-Bair determined that SRH had a viral upper respiratory infection — in other words, “a cold” — and reassured the parents that he did not have an ear infection. (Id.)

Emphasis added. And now repeated: no other recent symptoms were noted. Not “he lost all language”. Not “he lost eye contact”. Not “he was hanging limp”.

As to signs of autism before the vaccines in question, we read this (Dr. Leventhal was an expert witness for the government):

Also included in Dr. Leventhal’s list of early symptoms of developmental disorders was another symptom particularly indicative of ASD — “evidence of language delay and reports of social interaction problems” at age 12 months. (Ex. C, p. 30, para. g.) Language delay and social interaction problems, are classic symptoms of autism.

Of course, many will discount this as coming from the government’s expert (even though he’s reporting the medical record).

So, what did the parents have to say?

Third, several representations by the Petitioners themselves indicate that SRH was suffering from developmental problems, likely early symptoms of his ASD, well prior to [DATE–about 15 months]. For example, SRH’s parents reported that at one year of age (about [DATE]), he seemed “delayed in interactive skills.” (Ex. 2, p. 46.) On [DATE], SRH’s parents reported that they had been worried about developmental delays “for about 6 months,” which would put the onset around [DATE–about 13 months]. (Ex. 6, p. 19.) And on occasions, SRH’s parents identified the onset of SRH’s developmental problems as occurring about the time of his MMR vaccination, which took place on [DATE–about 12 months]. (See Ex. 5, p. 30 (SRH lost eye contact “after his MMR shot”); Ex. 14, p. 38 (“delays, deterioration of verbal skills coincidental [with] MMR”)).

Emphasis in the original.

Parents reported loss of eye contact at about 12 months. But in Vaxxed Brian Hooker says his child lost eye contact two weeks after the 15 month vaccinations. So again we see that the stories don’t match up. And recall that Brian Hooker apparently didn’t mention this loss of eye contact to the doctor nor did the doctor notice 19 days after those 15 month vaccines.

Finally, it’s worth noting that pretty much the time that Vaxxed has been touring, Brian Hooker and the rest of those doing personal appearances have known that the Hooker case failed. And let’s not downplay this, the case was not even close. The Court decision includes in the conclusion:

After studying the extensive evidence in this case, I am convinced that the opinions provided by Petitioners’ experts in this case, advising the Hooker family that there is a causal connection between SRH’s vaccinations and either the initial causation or aggravation of SRH’s ASD, were quite wrong.

emphasis in the original.

The experts were quite wrong. The science was the same as was extensively argued in the Omnibus Autism Proceeding, and which failed to come close to being convincing then. The case history showed no sign of vaccine injury or developmental regression. On every count, Brian Hooker’s case failed. But we don’t hear that in the public talks. Why would Brian Hooker, Andrew Wakefield and the rest want to tell the public that not only are the “facts” in Vaxxed wrong, but the science had also been tested yet again and failed yet again? I mean, it’s not like they are calling this a “documentary” or anything. Except that’s precisely what they claim.


By Matt Carey

The Brian Hooker/William Thompson conversations

24 Aug

A year ago we learned that a CDC researcher (William Thompson) had reached out to Brian Hooker (of all people!) and was talking about his (Thompson’s) view of what goes on inside the CDC. Most especially, Thompson appears to have guided Hooker towards a spurious result one can obtain from an old CDC dataset: that if one avoids controlling for any possible confounding variables one can claim that in a small subset of the study population, there is a calcluated risk of autism from the MMR vaccine.

There are so many strange aspects of this story. So many. One that has wracked my brain for the past year is this: why did Thompson reach out to Brian Hooker? Brian Hooker is not an unknown quantity. In the world of people claiming vaccines cause autism, far from it. Brian Hooker is a fixture in the community that promotes the idea that vaccines cause autism. His claim to fame for years was that he was constantly placing freedom of information act (FOIA) requests for documents from the CDC. His family are petitioners to the Court of Federal Claims (i.e. they have a claim in about a family member whose autism they believe was caused by vaccines). Mr. Hooker even spoke with CDC vaccine researchers–including William Thompson–many years back.

In the end, Brian Hooker published a paper (now retracted), teamed up with Andrew Wakefield, totally misused their spurious result in an ugly, race-baiting attack on the CDC, and betrayed Thompson’s trust by outing him.

And pretty much all of that was predictable, if you had any idea who Brian Hooker is.

Given that, there were two possibilities in my mind as to why Thompson reached out:

1) William Thompson was so stressed by what he thought was an unreleased result that he reached out to someone, anyone outside of CDC to get the result out. That he wasn’t aware of who he was working with.

2) William Thompson either didn’t care about the harm that would be cause by his actions, or wanted to cause harm. Let’s face it, Thompson chose the precise person who could make the most damage with the information. It wasn’t a strong result, or even a good result. But it was something that an intellectually dishonest person could sensationalize.

(2) Was very hard to believe. Thompson has spent many years working on public health. He was the lead author on one paper that showed no risk of neurodevelopmental disorders from thimerosal in vaccines. The idea that he would willingly ally with someone whose efforts are very much, let’s say, vaccine antagonistic, is difficult to accept.

As noted above, Brian Hooker betrayed the trust of William Thompson: Hooker not only outed Thompson, but Hooker secretly recorded at least 4 phone calls. And purported transcripts of those calls have been gathered together in a book. The forward is by Robert Kennedy Jr. (who has a long history of claiming he’s “pro vaccine” while acting completely the opposite) and is filled out by a someone named Kevin Barry. It’s a thin book and the material by Kennedy and Barry is basically filler, so you are left with transcripts from 4 phone calls.

From the conversations in the book we see that Thompson is angry. Angry at people. Not as much angry about science or omitted data. You can read more about that at Science Based Medicine.

Was Thompson aware of who he was dealing with in Brian Hooker? Yes. He says, “I see a lot of your stuff online. I saw that you interviewed Congressman Posey, is it?”

There’s a lot of talk of Posey and Congressman Issa. It seems like Hooker’s connections with congress were a big draw for Thompson.

Here’s one exchanges. Not about congress, but we get an idea of Thompson at work.

Dr. Hooker: I’m afraid of those people. I’m afraid of Kevin Malone. I’m afraid of Deborah Tress, I mean, these people, ya know, they don’t like me.

Dr. Thompson: They’re scumbags. But here’s the deal. She is like a twenty-five-year-old and I apologize as I am saying this, she’s like a twenty-five-year-old bimbo that they have do their dirty work. So her sending this email, the fact that they didn’t come from someone with a lawyer. It came from this woman who’s just out of school and just doesn’t know her head from her ass. This is the type of stuff they do. They don’t say who it’s from, they just say OGC.

Here’s a quote attributed to Mr. Thompson:

“But I also have to say these drug companies and their promoters, they’re making such a big deal of these measles outbreaks and they are now, they’re making a big deal that polio is coming back and polio comes back all the time in third world countries. It’s like a never- ending thing where the press loves to hype it and it scares people. It scares the crap out of people when they hype those two types of outbreaks”

Really? A vaccine researcher at CDC thinks it’s “hype” to talk about polio coming back?

Here’s the thing–we want to eradicate polio. That’s what vaccine researchers at CDC are supposed to be helping. Polio is really bad. If it weren’t for people like Brian Hooker, Thompson’s new friend, we might have done that by now. Any outbreak is a big deal. But not to William Thompson.

Boggles the mind.

In discussing the MMR paper–the one where Hooker claims a large risk for MMR in African American boys who are vaccinated late (by not controlling for any confounding variables)–Hooker notes in his conversation:

“I mean, whites are getting diagnosed twice as much as blacks”

That’s a pretty key observation. If you are going to claim a large risk for African American’s, you have to discuss in your paper the fact that this doesn’t mesh with the actual prevalence. The raw prevalence has African American’s not getting counted as much as caucasians.

Does Brian Hooker bring this up in his paper? Address it? No. He ignores a significant result of the analysis. That’s right, he does exactly what he claims is fraud. Well, not exactly–he compounds his error. Let’s look at his (now retracted) paper:

It should be noted that a recent publication has shown that the prevalence of autism in African Americans is nearly 25% higher than that of whites [15].

Yes–even though the data he is analyzing says exactly the opposite, he claims a higher than average prevalence of autism in the African American population.

Let’s belabor that one step further–if he actually believes a higher prevalence in this population, there is a huge issue with the data he’s analyzing. He doesn’t account for this, controlling for any socioeconomic factors, for example. He doesn’t even mention it. It appears that he intentionally omitted significant findings from his paper.

Hooker at one point notes, “I am not an epidemiologist by training”.

Got that right.

You can read more about the conversations at Science Based Medicine as
Vaccine Whistleblower: An antivaccine “exposé” full of sound and fury, signifying nothing

And I’m sure there will be more.


By Matt Carey

Andrew Wakefield and Brian Hooker complain. Not honestly, but they complain

23 Oct

Andrew Wakefield and Brian Hooker have lately been trying to manage a “cdc whistleblower” story. The idea has been covered a lot recently, here and elsewhere. So, rather than go into more introduction, let’s take a look at the complaint they recently filed with the CDC office of research integrity. It’s long, so I’ll bring up a few glaring problems with the complaint letter. These problems have for the most part already been discussed here at Left Brain/Right Brain.

The basis of their arguments has been that allegedly the CDC found a statistically significant result suggesting that the MMR was associated with a higher odds ratio for autism in African American boys. They argue that the CDC then changed their protocol (analysis plan) to avoid reporting on this result. Mr. Wakefield and Mr. Hooker have since added a similar argument for “isolated autism”–autism without comorbid conditions like intellectual disability. They claim the CDC hid those results as well.

So, what does the complaint say in specific? It’s long, but here’s an interesting and key part and a good place to start. Under the section titled “The Georgia Birth Certificate Cohort (GBCC): what was its stated purpose?“, Hooker and Wakefield quote the

[Exhibit 2, page 7, emphasis added] The Analysis Plan, “Statistical Analyses” states that “race” data were available for the entire sample:

The only variable that will be assessed as a potential confounder using the entire sample will be the child’s race.

[Exhibit 2, page 8, emphasis added]. Thus, “race” data came explicitly from the “school record” and not from the Georgia birth certificate/Georgia birth
records and was available for the “entire sample”.

The funny thing is that quote, “The only variable that will be assessed as a potential confounder using the entire sample will be the child’s race” doesn’t match what’s in the screenshot of the analysis plan that Wakefield included in his recent YouTube video (click to enlarge).

Draft Plan 2

The plan actually states:

The only variable available to be assessed as a potential confounder using the entire sample is child’s race.

emphasis added.

See how “available to be assessed” in the actual plan has been changed into “that will be assessed” by Mr. Wakefield? Mr. Wakefield would like us to believe that the analysis plan called for a study to be reported broken down by race using all the kids in the study. He’s been arguing that since his first ugly “It’s like the Tuskegee experiment!” video. The thing is that the plan didn’t call for that. As I recently discussed, the sentence Mr. Wakefield misquotes was a statement of the limitations of the dataset they had (MADDSP) and explains why the CDC needed to get the birth certificate data to do a more thorough analysis.

As I also noted, the full paragraph references table included in the analysis plan made it clear that race was to be analyzed for the birth certificate sample, not the total sample as Mr. Wakefield is leading us to believe.  The title of the table shows us that they were planning to report detailed data on the birth certificate group, not the entire sample.

What I find interesting is that Wakefield and Hooker are not just misinterpreting the statement as I originally thought. In the complaint they clearly changed what the statement said. Besides being wrong all on it’s own, this change tells me they know that phrase they latched on to ( “The only variable that will be assessed as a potential confounder using the entire sample will be the child’s race”) doesn’t come close to fitting in with his story. I don’t see this as an honest mistake.

The complaint also includes the “isolated autism” argument Mr. Wakefield recently put into another YouTube video. In this, Mr. Wakefield claims that all sorts of methods were used to hide an association observed for MMR and autism without other conditions like intellectual disability, cerebral palsy, etc.. In his complaint and video, Mr. Wakefield claims one of the methods used to hide this association was by limiting “other conditions” to only “MR” (mental retardation/intellectual disability). In the video Mr Wakefield gives us a fragment of an audio attributed to Mr. Thompson of the CDC saying, “the effect is where you would think it would happen. It is with the kids without other conditions, without the comorbid conditions.”

Mr. Wakefield even went on to say

But that didn’t seem to happen. They deviated further from the analysis plan by limiting the isolated group to only those with no mental retardation. Even changing the age categories and composition of the isolated subgroup may not have achieved the desired effect. Since, in the end, they simply omitted the relevant findings from the paper altogether

Emphasis added.

As I said before, I found this odd in that the CDC did report an apparent association in the raw data. The total sample/unadjusted data. To repeat a quote by Mr. Thompson, “It’s all there!”

Destefano_table_4 highlighted

It’s numerically almost the exact same result as Mr. Wakefield says was concealed. So, if it’s the same, how is it concealed? How is it omitted? Answer: it isn’t.

Remember that quote attributed to William Thompson from the video? Here’s a more full quote that’s from the complaint:

You see that the strongest association is with those [autistic cases] without mental retardation. The non-isolated [sic], the non-MR [mental retardation]…the effect is where you would think it would happen. It is with the kids without other conditions, without the comorbid conditions.

Mr. Wakefield wanted us to believe that by switching to autism without MR instead of autism without MR and/or other disabilities, the CDC were covering up the result.  Not only did the CDC report on the result, this isn’t what Mr. Thompson was saying.  Thompson is not saying, “hey look, we only used MR as a way to conceal the result.” He’s saying, in effect: when we looked at autism without MR, we saw this effect. It looks to me like Thompson is drawing Mr. Hooker’s attention to a result in the paper. Not describing an omitted result hidden from the public.

So, what is it? Did the CDC “simply omit the relevant findings altogether” as Mr. Wakefield stated in his video? No, they didn’t. Don’t take my word for it, take the word of Andrew Wakefield and Brian Hooker. In their complaint they state

2.7. The Group further deviated from the Analysis Plan by limiting the “isolated” group to only those without mental retardation, as published in The Paper.

Emphasis added.

So, we in the autism communities get one story in the video (the result was omitted), but in a legal document he puts the truth (the result was published in the paper).

And, how did the CDC accomplish all this alleged cover up in the story told by Mr. Wakefield and Mr. Hooker? Well, in part the CDC supposedly did this by creating a “revised analysis plan”. From the complaint:

Over the ensuing months and in contravention of the CDC’s own policies,10 they deviated from the Analysis Plan and introduced a “revised analysis plan”11

Wakefield and Hooker can’t provide us with that revised analysis plan. Here is reference 11 noted in the quote above:

11 See original notes of Dr. William Thompson of 9.6.2001: “Get revised analysis plan from Tanya.” Tanya Bashin – a relatively junior member of The Group – was the second author named on the DeStefano 2004 paper. [Exhibit 8] The revised analysis plan itself is not available

I discussed this recently as well. It’s not after “ensuing months” that Mr. Thompson wrote about the “revised” plan. It’s not after the data were analyzed (which the earliest dates given by the complaint are in November).  The comment attributed to Mr. Thompson is dated September 6, 2001, the day after the plan was finalized.

Or, to put it another way: Mr. Wakefield and Mr. Hooker–the revised analysis plan is indeed available. It’s the one you are working from, dated Sept. 5, 2001.

In their complaint, Mr. Hooker and Mr. Wakefield disclose private details about Mr. Thompson which frankly have no real bearing on the complaint and should not have been disclosed.

The complaint is long, but it all hinges on the three major claims: (1) The CDC was supposed to do an analysis of the total group (not just the birth certificate group) by race, (2) that the CDC hid results on “isolated” autism and (3) that they deviated from their analysis plan, introducing a revised plan, to do this.

All three claims are false. And not false as in “I interpret them differently” but false as in “the very data Wakefield and Hooker depend on show them to be fabricated claims”.


By Matt Carey

note– I made significant changes for clarity after this was first put online.

ABC News covers Brian Hooker’s study: Hooker “manipulated the data and manipulated the media in a very savvy and sophisticated way.”

10 Oct

A recent ABC story (How a Now-Retracted Autism Study Went Viral — Again) discussed Brian Hooker’s flawed and retracted study.  Here are the first few paragraphs:

An autism study that was slammed by experts and retracted this week by its publisher is still alive and well on the Internet, thanks to what critics are calling a perfect storm of lax publishing standards.

Experts say the lone study author played fast and loose with statistics to show a link between autism and the MMR vaccine for measles, mumps and rubella, some experts going as far as saying that the author deliberately did this, but the dubious results took off online anyway, quickly going viral.

“There are always going to be those people at the edges of science who want to shout because they don’t want to believe what the data are showing,” said Dr. Margaret Moon, a pediatrician and bioethicist at Johns Hopkins Berman Institute of Bioethics. She said she thought the study author “manipulated the data and manipulated the media in a very savvy and sophisticated way.”

“It’s not good. It’s not fair. It’s not honest. But it’s savvy,” Moon said.

Good to see this coming from outside the blogOsphere. Let’s pull one sentence out for emphasis, shall we?

She said she thought the study author “manipulated the data and manipulated the media in a very savvy and sophisticated way.”

When people ask about data manipulation and the MMR/Autism story, there it is.

The story continues at ABC: How a Now-Retracted Autism Study Went Viral — Again. Included in the story is a CDC statement that I’ve seen before but warrants quoting here.

Centers for Disease Control and Prevention statement regarding Brian Hooker’s reanalysis of its 2004 study Aug. 27, 2014

There was no cover up. The study did not find any statistically significant associations between age at MMR vaccination and autism. In the CDC paper, similar proportions of case (children with autism) and control children (no autism) had been vaccinated before 18 months or before 24 months. While slightly more children with autism (93.4%) than children without autism (90.6%) were vaccinated between 24 and 36 months, this was most likely a result of immunization requirements for preschool special education program attendance in children with autism.

As this topic was so sensitive and complex, the CDC study published in Pediatrics in February 2004 underwent clearance at CDC, the usual process of internal review for scientific accuracy that all CDC papers undergo. In addition, before submission to the journal, the manuscript was reviewed by five experts outside of CDC and an independent CDC statistician (see acknowledgements section of the paper for specific names). Finally, all reputable journals undergo peer-review of all submitted papers before final publication.

The 2004 CDC study was designed as a case-control study. This means, children with autism (cases) were specifically identified, and children without autism (controls) were identified to be similar to the children with autism in other respects. When data are collected in a specific way for a specific type of statistical analysis (a case-control study in this instance), using those data in a different type of analysis can produce confusing results. Because the methods in Dr. Hooker’s reanalysis were not described in detail, it is hard to speculate why his results differed from CDC’s.

Since the 2004 Pediatrics paper, CDC has conducted additional studies of vaccines and autism. In 2004 the Institute of Medicine reviewed published and unpublished findings from the US and other countries and concluded that there was no association between MMR vaccination and autism. In 2011, another IOM committee reviewed additional research, and once again found that evidence favored rejection of this association.


By Matt Carey

Harpocrates Speaks on: MMR, the CDC and Brian Hooker: A Guide for Parents and the Media

8 Sep

Todd W. over at Harpocrates Speaks has put together a FAQ like guide on the questions that come up with regards to recent research by Brian Hooker and the allegations Mr. Hooker has made about the CDC. That article is an excellent resource for people looking for some answers on this story. The article starts:

The anti-vaccine community has been in a tizzy lately over a supposed “CDC whistleblower”, Dr. William W. Thompson, who, according to them, revealed fraud at the United States Centers for Disease Control and Prevention (CDC). To bolster their claim, they point to a new study from one of their own, Brian S. Hooker, that purports to show evidence of an increased risk of autism among African American boys who receive their first MMR vaccine late. However, the claims appear to be hollow and unfounded, and so they have chosen to rely on emotional arguments that may sound convincing to those who are not familiar with the issues and people involved. In a truly egregious fashion, they have erroneously and cynically compared this whole thing to the Tuskegee syphilis study, and equated the CDC with Adolf Hitler, Josef Stalin and Pol Pot, combined.

With that in mind, here is a brief FAQ for parents, news media and others to help them understand what the claims are and what the evidence actually says. The questions below have been raised or implied by anti-vaccine activists. Hopefully, this will prevent inaccurate reporting and help parents feel reassured about the MMR vaccine.

That FAQ can be found at MMR, the CDC and Brian Hooker: A Guide for Parents and the Media


By Matt Carey

Andrew Wakefield betrays another “whistleblower” with Brian Hooker helping

28 Aug

Probably the biggest story in years for the groups claiming that vaccines cause autism was when last week vaccine antagonistic activists Andrew Wakefield and Brian Hooker announced that they were in contact with an “informant” at the CDC who guided them to do a re-analysis of an older dataset. Andrew Wakefield has a history of not respecting the responsibility that one has when speaking with a whistleblower, having first threatened then actually outed a whistleblower who trusted him. As the recent story has unfolded, I’ve been asked and I’ve told many people that in my view, Brian Hooker sees himself as an honest person and, as such, he would not be a party to the sort of deception that would be involved in secretly recording someone while acting as his “priest”, then betraying him.

Apparently I was wrong.

When Wakefield and Hooker first released their story, they claimed that their “informant” wanted to remain anonymous. It says so right in the press release dated August 18. The (disgustingly race-baiting) video they put out was censored as if they wanted to protect the anonymity of the informant. But by the night of August 21st, 3 days later, the video had been changed without announcement. Mr. Wakefield (he owns/runs the Autism Media Channel that is putting out these videos) apparently uploaded the noncensored version. In it, Mr. Thompson is named early and repeatedly. His voice is no longer obscured. Mr. Thompsons’ anonymity (weakly veiled to begin with) was no more.

From the start many people questioned whether the “CDC Whistleblower” as he has been dubbed had agreed to be recorded, knew about the video that was made, or agreed to let his identity be known. Or if he ever had any intention that anyone would even disclose that there even was help from someone at the CDC on this.

My read on the press release Mr. Thompson has put out is that Mr. Thompson never intended for his role to be made public. That Mr. Hooker would just present the study as his own work and use that to advocate for a follow on analysis. Much less that his name would be revealed.

But, as we see, that didn’t happen. He was outed. His participation was revealed immediately. His name was revealed in a few days. His conversations with Mr. Hooker were edited for effect and put on the web.

How did Mr. Hooker describe his interaction with Mr. Thompson? From the video we hear:

“Dr. Thompson had appointed me his priest. And when he appointed me his priest, then he started confessing.”

Apparently Mr. Hooker is unaware that the secrecy of confession is absolute. Priests, real ones, not self appointed ones like Mr. Hooker, have been known to go to jail rather than divulge what they’ve been told in confession. Real priests don’t record confessions so they can betray another.

I once thought that perhaps Mr. Hooker and I were at a very basic level similar. That we were focused on doing what was best for our kids. I no longer think that way. At a basic level one either has integrity or one doesn’t. A person who takes on the role of a confessor in order to secretly tape and betray another has no integrity.

Mr. Hooker will no doubt be the hero of parent conventions in the future. It’s a very low price for one’s integrity in my opinion.

For whatever it is worth: Mr. Hooker lives in a state with a very clear two-party rule. It’s against the law there to record someone without his/her knowledge. Mr. Thompson also lives in a two-party state.

Below is that press release again.


By Matt Carey

August 27, 2014 Press Release, “Statement of William W. Thompson, Ph.D., Regarding the 2004 Article Examining the Possibility of a Relationship Between MMR Vaccine and Autism”
FOR IMMEDIATE RELEASE-AUGUST 27,2014

STATEMENT OF WILLIAM W. THOMPSON, Ph.D., REGARDING THE 2004 ARTICLE EXAMINING THE POSSIBILITY OF A RELATIONSHIP BETWEEN MMR VACCINE AND AUTISM

My name is William Thompson. I am a Senior Scientist with the Centers for Disease Control and
Prevention, where I have worked since 1998.

I regret that my coauthors and I omitted statistically significant information in our 2004 article published in the journal Pediatrics. The omitted data suggested that African American males who received the MMR vaccine before age 36 months were at increased risk for autism. Decisions were made regarding which findings to report after the data were collected, and I believe that the final study protocol was not followed.

I want to be absolutely clear that I believe vaccines have saved and continue to save countless lives. I would never suggest that any parent avoid vaccinating children of any race. Vaccines prevent serious diseases, and the risks associated with their administration are vastly outweighed by their individual and societal benefits.

My concern has been the decision to omit relevant findings in a particular study for a particular sub­ group for a particular vaccine. There have always been recognized risks for vaccination and I believe it is the responsibility of the CDC to properly convey the risks associated with receipt of those vaccines.

I have had many discussions with Dr. Brian Hooker over the last 10 months regarding studies the CDC has carried out regarding vaccines and neurodevelopmental outcomes including autism spectrum disorders. I share his beliefthat CDC decision-making and analyses should be transparent. I was not, however, aware that he was recording any of our conversations, nor was I given any choice regarding whether my name would be made public or my voice would be put on the Internet.

I am grateful for the many supportive e-mails that I have received over the last several days.
I will not be answering further questions at this time. I am providing information to Congressman William Posey, and of course will continue to cooperate with Congress. I have also offered to assist with reanalysis of the study data or development of further studies. For the time being, however, I am focused on my job and my family.

Reasonable scientists can and do differ in their interpretation of information. I will do everything I can to assist any unbiased and objective scientists inside or outside the CDC to analyze data collected by the CDC or other public organizations for the purpose of understanding whether vaccines are associated with an increased risk of autism. There are still more questions than answers, and I appreciate that so many families are looking for answers from the scientific community.

My colleagues and supervisors at the CDC have been entirely professional since this matter became public. In fact, I received a performance-based award after this story came out. I have experienced no pressure or retaliation and certainly was not escorted from the building, as some have stated.

Dr. Thompson is represented by Frederick M. Morgan,Jr., Morgan Verkamp, LLC, Cincinnati, Ohio, http://www.morganverkamp.com.

The Brian Hooker article “…has been removed from the public domain because of serious concerns about the validity of its conclusions”

27 Aug

The paper recently published by Brian Hooker, Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data has been pulled. Currently the journal’s website has this in place of the article:

This article has been removed from the public domain because of serious concerns about the validity of its conclusions. The journal and publisher believe that its continued availability may not be in the public interest. Definitive editorial action will be pending further investigation.

I wish they had thought this through before publishing it. Be that as it may, my own view (as an author and one-time editor) is that the revelation that this is not an original work by Mr. Hooker should have warranted some action. Mr. Hooker has discussed how the idea to do this study came from someone else and the analysis is a recreation of a previous analysis. Minor point, I know. And I know my online friends did not agree with me on that.

I do appreciate the journal taking this step. While Mr. Hooker, Andrew Wakefield and their team try to make as much political hay out of this paper as they can.

More discussions of this paper

Autism, Atlanta, MMR: serious questions and also how Brian Hooker and Andrew Wakefield are causing damage to the autism communities

Here’s the press release for the recent reanalysis study

Here’s a discussion of that study by an epidemiology grad student:
Directed Acyclic Graphs and the MMR vaccine doesn’t cause autism

And another discussion of that study from The Poxes Blog:
Andrew Jeremy Wakefield plays video director while African-American Babies die, or something

And Surgeon/Scientist Orac takes on the study and more here:
Brian Hooker proves Andrew Wakefield wrong about vaccines and autism

Educator and Advocate Liz Ditz discusses the PR approach that has been taken by those promoting the study here:
L’affaire CDC-MMR: Hooker, Wakefield, and Focus Autism Accuse African-American Senior CDC Researcher of Being A Race Traitor

And the CDC have a simple statement here:
CDC Statement Regarding 2004 Pediatrics Article, “Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-matched Control Subjects: A Population-Based Study in Metropolitan Atlanta”


By Matt Carey

Autism, Atlanta, MMR: serious questions and also how Brian Hooker and Andrew Wakefield are causing damage to the autism communities

26 Aug

The groups promoting vaccines causing autism have been handed probably their biggest story in a decade. They are claiming, and it seams likely, that a senior CDC epidemiologist came to them with information that a statistically significant result of possible increased autism risk from the MMR in a specific subpopulation was not reported.

I’ll go into a lot of background below, but if you wish to read up about these events:

Here’s the press release for the recent reanalysis study

Here’s a discussion of that study by an epidemiology grad student:
Directed Acyclic Graphs and the MMR vaccine doesn’t cause autism

And another discussion of that study from The Poxes Blog:
Andrew Jeremy Wakefield plays video director while African-American Babies die, or something

And Surgeon/Scientist Orac takes on the study and more here:
Brian Hooker proves Andrew Wakefield wrong about vaccines and autism

Educator and Advocate Liz Ditz discusses the PR approach that has been taken by those promoting the study here:
L’affaire CDC-MMR: Hooker, Wakefield, and Focus Autism Accuse African-American Senior CDC Researcher of Being A Race Traitor

And the CDC have a simple statement here:
CDC Statement Regarding 2004 Pediatrics Article, “Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-matched Control Subjects: A Population-Based Study in Metropolitan Atlanta”

Even with multiple press releases and no doubt other efforts to gain media attention, this story has yet to break out into a mainstream news story. Some alternative news sources and many parent supporters of the vaccine/autism idea have discussed this lack of media attention. And there’s a YouTube video by Andrew Wakefield that I’ll embed below. That video deserves and probably will get it’s own article here on Left Brain/Right Brain. It is remarkably bad.

It has often been said that the parents promoting the idea that autism is a vaccine-induced epidemic are their own worst enemies. As the parent of a multiply disabled autistic child I can say without reservation that these groups are no friends to the majority of the autism parent community either. Nor are they friends to the real majority of our community: autistics. The vaccines-caused-an-autism-epidemic parents have refused to support any research which goes against their idea that autism is a vaccine-induced epidemic. They don’t support research into the prevalence of autism in adults. Likely because they worry that this will show that their epidemic idea is false. In the process we lose the chance to learn from the previous generations of autistics about what has worked and what has not. Information which is critical to this autism parent. These groups have failed to accept that the lower prevalence of identified autism in racial and ethnic minorities indicates that the prevalence numbers we so often hear are not the a true count of the fraction of our population that is autistic. Because to admit that is to admit that they are misusing the numbers they rely upon to claim an epidemic. Their lack of support has hindered attempts to improve identification and get appropriate services for autistics in racial and ethnic minorities. This is a point that is incredibly ironic given the way these groups are framing their recent news as you will see (or have seen if you read Ms. Ditz’ article linked above). On top of this they have produced a way over-the-top PR campaign about their news, demonstrating their deep hatred for the CDC. If I were to tell you that Andrew Wakefield is claiming that the CDC are worse than Adolf Hitler, Josef Stalin and Pol Pot (because, you see, in Mr. Wakefield’s eyes at least those dictators were sincere), would you believe me? Would you think I was making this up? If I said that Mr. Wakefield has played the race card in a disgusting way, claiming that the U.S. vaccine program is a new Tuskegee experiment, would you believe me? You can skip down to the bottom if you want to see that discussion and video. I’ll start with the science.

About 10 years ago a team from the CDC published a study: Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta (full paper here). They took data from the CDC’s Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). In order to control for potential confounding variables–like mother’s age, birth weight and more, the authors of the MMR follow-up study pulled birth certificate records. They only pulled them for kids born in Georgia. Could be there was a logistics issue (trying to track down records across the country) or if birth records were not consistent across the US. Also, they would have had to find control kids for those born outside Georgia, and that would have been a big logistics issue. In the end there were two analyses presented–one on the raw data with all the kids, and one with a more detailed analysis done with this smaller “birth certificate” cohort.

Here’s an example of one of those analyses (click to enlarge):

DeStefano table 3

This is a good table to review this study. What did they find? The general result is that time of MMR vaccine receipt was similar between autistic kids and non autistic kids, but was statistically more common among autistic kids. In the table above we see that for the most part, the sub groups reported had generally no increased risk of autism with MMR. I.e. in most examples the 95% confidence intervals encompass 1. The unadjusted sample “all cases” and “boys” do not encompass 1. If those were all the data we had, we’d say “let’s look more closely at these”. We’d start with exactly what the authors do–check for confounding variables and see if the effect gets bigger or smaller. In the adjusted data, all the odds ratios encompass one. Some are high enough to warrant a closer look: kids aged 3-5 and boys. Combining these two I’d probably ask, “what about boys aged 3-5”, but the authors take on the age 3-5 question in general in the discussion citing that the 3-5 age group autistics were mostly in special ed preschool and were thus required to have MMR.

If you look at Table 5 (click to enlarge) you see an interesting and very strange trend. It was in the other data but it’s really clear here. The odds ratio is much larger for kids who got MMR before 36 months than for kids who got it before 24 months. The odds ratios still encompass 1, but there is something going on in the data for the kids who got vaccines between 24 and 36 months. And by “something going on” we always have to consider social factors. But take a look:

DeStefano table 5

Take, for example, maternal education. Kids with mothers who had more than 15 years of education had an odds ratio of only 0.61 if their kids got the MMR before 24 months, but that odds ratio jumps up to 2.76 if their kids got the vaccine before 36 months. In both the confidence intervals encompass 1, so we can’t say “MMR before 24 months is protective but MMR before 36 months increases risk”. But that difference is striking. Even if these results were statistically significant, it doesn’t make sense to say, “the MMR vaccine causes autism in kids when it is given between 24 and 26 months if their mothers are well educated. And, by the way, it’s protective if given before 36 months.”

While not as striking, the differences between the unadjusted and adjusted analyses in table 3 are notable. Odds ratios change when you take into account other factors. I’m no epidemiologist, but if this isn’t covered in epidemiology 101 I’ll be stunned. In physics (the field of my Ph.D.) we talk about “hidden variables”. You see one thing correlated with another but in reality a third, “hidden”, variable is actually causing the association.

That said, the CDC MMR paper is not a study without limitations (no study is). One major limitation was the need discussed above–to argue why the 3-5 age group kids had a higher prevalence.

At this point researchers (both the study authors and those reading this paper) and advocates can take a number of approaches. Here are 4:

1) They can say, “yep, that’s plausible enough. We’ve worked this dataset enough. This tells us that MMR doesn’t cause autism. Let’s move on from MMR.”

That didn’t happen and rightfully so. This isn’t a particularly strong study. It’s not the final word and I don’t think it was intended to be. It was a relatively quick study using an existing population. In the end there were more studies on autism and MMR.

2) Advocates and researchers could take the approach: “There’s an association there, but these data are too limited to really answer the question of causation. Can we do a study to nail down if there’s something about those kids born in those specific years (the 3-5 year olds) who got the MMR between 24 and 36 months? Maybe look at further subsets?” And, while it’s easy to say with hindsight, this is the approach that should have been taken in my opinion. I am unaware of work by this team of researchers or external researchers which addressed this question. I am also unaware of calls by the autism community to do such a follow up, by the way.

3) Advocates and/or researchers could say, “I think we can tease more out of these data. Hey, CDC, can I have that dataset to review myself?” Because the CDC did make these data available for serious researchers to review. CDC researchers moved on to other topics in autism and vaccines, but other researchers or qualified advocates could have taken this up.

4) Advocates (not so much researchers I suspect) could say, “I don’t trust the CDC to add 1 and 1. Give me those data and I’ll do the analysis myself. Even those areas where you show a lack of association are probably wrong.” And, yes, there are advocates like that. Well, except that no one asked for the data back then. More recently, though someone did. Which leads us to:

An autism parent and strong proponent of the failed mercury hypothesis, Brian Hooker, recently published a study re-analyzing that old CDC dataset on MMR and autism. His financial backers put out a press release claiming that not only does this study show that vaccines cause autism in a specific subgroup, but that this study was prompted by a CDC “whistleblower”. I.e. someone who was inside CDC and knew about the details of the CDC study was in contact with Mr. Hooker.

That’s a pretty dramatic press release. Let’s take some time on it.

Focus Autism Releases Findings on 2003 CDC Autism Study – Higher Autism Rate Among African-American Boys Receiving MMR Shot Earlier than 36 Months
Focus Autism releases their findings of a possible reduction in the sample size of a major 2003 study conducted by the Centers for Disease Control and Prevention. This sample size reduction negates statistically significant findings from the study.

This title is why I jumped to the press release before talking about Mr. Hooker’s paper. With this title we know (a) that Mr. Hooker is claiming an association among a specific subgroup only (African American boys) and (b) he’s claiming that there was some sort of sleight of hand by the CDC where they reduced the sample size.

Well we already know from the CDC study that autism rates were higher in kids who got the MMR before 36 months. It’s right there in the conclusion statement of the abstract. But not so much before 24 months. And we know autism rates were higher in boys. We didn’t see the analysis narrowed down to African American boys.

The press release states:

“However, CDC researchers did not include any children that did not have a valid State of Georgia birth certificate – reducing the study’s sample size by 41% . Dr. Hooker explains that by introducing this discretionary criteria into the analysis, the cohort size was sharply reduced, eliminating what would have been a higher statistical finding. ”

This is a rather odd statement. And by odd, I mean so obviously false that I wonder why it was written. See for yourself above, the study includes *both* the group with the birth certificate data and the raw data. Mr. Hooker’s explanation is, well, lacking. Sure, it is “discretionary” to try to account for confounding variables. It’s the sort of discretion I expect from epidemiologists. It’s like saying, “the engineers designing the Tacoma Narrows bridge decided against including the discretionary criteria of wind”. Also, consider that a result can be both statistically significant and wrong as is often the case when one finds something “statistically significant” without looking for or correcting for hidden variables.

In another press release Mr. Hooker calls the birth certificate data “irrelevant and unnecessary”. Again, why put out statements that anyone familiar with epidemiology would know to be false?

Elsewhere Mr. Hooker has even challenged the fact that one can obtain the stated data from birth certificates. He is in effect stating that not only is there no point in controlling for such factors, but that the CDC just lied and didn’t even have those data from the birth certificates.

Despite your assertions and the assertions of Destefano, Birth Certificates do not contain the information on the covariates you cite: birth weight, maternal age, maternal education, parity, etc. If you had read my paper, you would see that I repeated the analyses of the CDC and obtained the same results that they obtained in both what was published originally and what was withheld. Also, the birth certificate restriction was NOT applied to other race categories outside of African Americans.

Readers interested in whether Mr. Hooker is correct can take a look at the U.S. Standard Certificate of Live Birth. While this is the revised version, states standardized on birth certificates back in the 1990’s.

Epidemiologists are aware that the piece of paper a parent takes home isn’t necessarily the same birth certificate data that is in the full record.

And “Also, the birth certificate restriction was NOT applied to other race categories outside of African Americans”. Here we see the race card being played. A card that we will soon see was played with a very heavy hand. But to address the assertion made by Mr. Hooker, I wonder how he explains that there are 333 white autistic kids in the “total sample” and 199 in the “birth certificate sample”. Which is to say, his statement is false.

In one of the press releases, Mr. Hooker states

When asked if there could be any scientific basis for excluding children born outside of Georgia, Hooker responded, “I know of none, and none has been provided by the authors of the DeStefano study.”

Again, children born outside of Georgia were not excluded as Mr. Hooker asserts. Analyses were presented on both those born within Georgia (including adjustments for vital statistics found on the birth certificates) and a total sample including those born outside Georgia (the unadjusted analysis). If Mr. Hooker is “unaware” why people would do such an elementary epimiological task as adjusting data with covariates, I suggest he was a poor choice to perform Focus Autism’s study. Another thought would be that Mr. Hooker could read his own paper where he states:

It should be noted that a recent publication has shown that the prevalence of autism in African Americans is nearly 25% higher than that of whites. This value was obtained when CDC data were appropriately analyzed based on socioeconomic status

Mr. Hooker notes that when one does an analysis “appropriately” one includes socioeconomic status (such as with data found in the full birth certificates).

If Mr. Hooker would like to ask why the CDC team didn’t look for birth certificate data on kids born outside of Georgia, that’s would be a better place to start. Then we can discuss whether the CDC would then need 3 controls for each non-Georgia born kid, controls from the same place of birth as the study team did with Georgia born kids. And we could discuss how difficult that would be. And whether that would introduce more problems than it might solve. That’s a reasonable discussion. Claiming there’s no reason to gather important data is not.

Enough of the inconsistencies in Mr. Hooker’s recent statements. What was Mr. Hooker’s method and what did Mr. Hooker find in his analysis? The Poxes Blog and
epidemiologcal.net discuss this with more expertise than I can. Mr. Hooker does not recreate the CDC’s case-control study. That would require that match autistic kids and non autistic kids on the parameters he says aren’t available, and adjust for those same parameters. Instead he does a cohort study without adjustments. As discussed elsewhere, this is a much weaker approach. His main result is as the press release states “Higher Autism Rate Among African-American Boys Receiving MMR Shot Earlier than 36 Months”. He does not note in his press release “no risk for MMR and autism in everyone else”. Here is table 2 from his paper showing that.

hooker table 2

He states a relative risk that is statistically significant for African American boys who get the vaccine before 24 months (RR=1.73) and before 36 months (RR=3.36). No increased risk for African American girls. And, as Table 3 shows, no increased risk for non African Americans.

Mr. Hooker says his results are statistically significant. Others have questioned whether his analysis is really appropriate to say this, but for now let’s just benchmark this by checking how large his sample group for that large relative risk is anyway. Just so we know. The high risk group are kids vaccinated before 36 months. Here’s a figure from Table 2 of DeStefano et al.:

DeStefano table 2

There are 45 autistic kids vaccinated between 24 and 36 months. African Americans account for 40% of the total population, but let’s say about 1/2 of this 24-36 age group are African American. Or about 22 kids. 22 kids and Mr. Hooker is doing no adjustments for factors such as those found on birth certificates. The sort of socioeconomic parameters that he notes are important to get an accurate prevalence in the African American population.

Which is to say: this is not a strong finding by any stretch of the imagination.

Mr. Hooker took a subgroup–African American males–and found that there was in the unadjusted data a statistically significant relative risk. An increased relative risk is not the same thing as showing causation, especially when you are working with unadjusted data and many other limitations in this. This is enough to raise the question of whether we should do more studies to show if this increased risk holds up to further scrutiny. This is how Mr. Hooker concludes his paper:

Routine childhood vaccination is considered an important public health tool in reducing the morbidity and mortality associated with infectious diseases. However, consideration should be made in the current United States vaccination schedule for genetic subpopulations that may be associated with vaccine adverse events. Additional research is required to better understand the relationship between MMR exposure and autism in African American males.

A study relying largely on a small group of subjects (about 20) with the conclusion that more work is needed. Sounds vaguely familiar. And, as we will see, Mr. Hooker has teamed up with Andrew Wakefield to put out a video where they jump past the whole this indicates more research is needed through this is absolute evidence of MMR causing autism directly to the CDC are engaging in a racist experiment sacrificing children to autism. It’s like the events around Mr. Wakefield’s 1997 Lancet paper cranked up to 11.

Even though Mr. Hooker’s analysis is quite limited, as in it would be (and you will see is) incredibly irresponsible to jump from this to say “MMR Causes Autism in African American Males”, I’d like to see either more data or a good explanation why someone shouldn’t do it. If for nothing else, precisely to head off the sort of irresponsible and damaging PR campaign that Mr. Hooker and Mr. Wakefield have engaged in. There are a lot of data on MMR and autism since DeStefano first published (especially Hornig et al.) showing that MMR doesn’t increase autism risk. And Mr. Hooker himself has shown that autism risk is not raised in everyone other than African American boys. One can easily argue (and should) that the MMR/Autism/African American Boys result is spurious. But I’d like to see more evidence to support that. I don’t see evidence so far that this is fraud, but I don’t agree with the scientific decisions made.

All this said, can reasonable people really raise a concern about autism risk given how inflammatory that discussion can be? Yes. Here’s an example of how a study found a possible risk factor and follow up studies answered the question. The Price study was one of the largest studies on thimerosal exposure and autism risk. As part of that study they considered folic acid intake in mothers as one confounding variable for thimerosal exposure. They reported that there could be an increased autism risk from taking folic acid. The calculated risk for mothers who reported taking folic acid was about double that of those who didn’t. Keep in mind that folic acid supplementation for pregnant women is a major public health program as it reduces the risk of some developmental disabilities, so the possibility that it was increasing autism risk has major public health implications. This is a good parallel to the question of vaccines (public health program) and autism.

After the Price study, multiple studies were performed looking folic acid intake and autism risk (I can’t say that these were prompted by Price et al., but it seems reasonable to think they might):

Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (CHildhood Autism Risks from Genetics and Environment) case-control study.

Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children.

How can we summarize the folic acid history? A possible risk factor was found. It wasn’t plausible since folic acid seems to be protective for birth defects. But people did a second check (and even a third) and found that not only is folic acid not a risk factor, it may even reduce autism risk. Which even though this is what people would have said was biologically the most probable outcome at the start, this was a needed exercise.

Can we draw a parallel? Well, DeStefano et al. and later Hooker found a possible risk for MMR and boys (with Hooker citing African American Boys) getting the MMR vaccine late but before 36 months. It doesn’t seem plausible or even self consistent with the other results of the study dataset as has already been discussed. Reasonable people could move forward on this and see if existing data could answer this or if a new study is warranted.

Reasonable people could. As I’ve alluded to, we aren’t really dealing with a “and reasonable people” scenario. And here’s where we get into the “these people are their own worst enemies” part of the discussion. We’ve already seen how Mr. Hooker has made incorrect statements about the birth certificates of the DeStefano study. Let’s look another of Mr. Hooker’s statements and ask, “is this the statement of a reasonable person”?

He added, “The exclusion is reminiscent of tactics historically used to deprive African-Americans of the vote by requiring valid birth certificates.”

And here we see Mr. Hooker and Focus Autism playing the race card for sensational effect. One can’t even say this is a stretch. It’s just ridiculous. There was no exclusion and certainly people didn’t say, “let’s exclude African Americans and deny them their rights.” Maybe some will say this still within the realm of what a reasonable person might say. I would then ask you to watch this video produced to promote this study and the events surrounding it. The really inflammatory statements are made by Andrew Wakefield, but this looks to be a joint effort between Mr. Wakefield and Mr. Hooker. If Mr. Hooker would like to explain that he disagrees with the approach Mr. Wakefield took, I’ll be quick to rewrite this. But for now, here’s what team Wakefield/Hooker has prepared for you:

As promised above here are Andrew Wakefield and Brian Hooker claiming that the CDC are running a Tuskegee like experiment, where in Mr. Wakefield’s view African American boys are allowed become autistic by MMR for some nefarious and unexplained reason (because there are so few autistics that we need to create some for study?). I suspect Mr. Hooker will take offense at me stating that he is claiming this as it’s Mr. Wakefield who says the words. OK. Go ahead and put out a statement distancing yourself from this irresponsible attack Mr. Hooker. And, yes, I wasn’t exaggerating when I said that Mr. Wakefield thinks that the CDC are even worse than Hitler, Stalin and Pol Pot. The dictators, you see, were sincere. (8:40 into the video).

No one has yet responded in the mainstream media to the press releases and the Hooker study. And many of Mr. Wakefield’s supporters online are noticing this and asking why. Here are some possibilities:

1) The press has been burned by 17 years of bad science and unethical behavior by those promoting the vaccine/autism link.

2) perhaps the most famous person in that bad science and unethical behavior is your spokesperson on this new media campaign: Andrew Wakefield.

3) members of the press are not generally attracted to stories where people who have devoted their lives to preventing infectious diseases and to understanding developmental disability are called worse than Hitler.

4) after years of a campaign to instill fear about vaccines, we are in the midst of outbreaks of multiple vaccine preventable diseases. The founder of the blog where Mr. Hooker chose to release and discuss his new results famously once bragged that his groups was going to bring the “U.S. vaccine program to its knees

Mr. Wakefield and Mr. Hooker probably (and some of their followers certainly) have been wondering why their news of a CDC “informant” hasn’t garnered media attention. If you read the press releases and have followed the online discussions, you know that the idea for this reanalysis of the DeStefano data came from documents obtained by Congressman Issa and from phone conversations Mr. Hooker had with a CDC epidemiologist.

In their first press release, Mr. Hooker’s team noted that

According to Dr. Hooker, the CDC whistleblower informant — who wishes to remain anonymous — guided him to evidence that a statistically significant relationship between the age the MMR vaccine was first given and autism incidence in African-American boys was hidden by CDC researchers.

That was released on a Tuesday. The video came out the Monday previous, but was censored and the voice of the “informant” was obscured. On that same Monday, Mr. Wakefield noted on his Facebook page “He will be identified very soon” (referring to the “informant”). In other words, they had no intention of keeping this man’s identity secret. And a few days late, on Thursday night, the video was changed so that the censoring was gone and the voice was not obscured.

So, we have an informant who was obviously working with the Hooker/Wakefield team for months who wanted to remain anonymous. The Wakefield/Hooker team left clues about who this person was: they noted that he works for the CDC and has for some number of years and Mr. Hooker spoke of the informant as “him”. There are only two males who worked on that paper: W.W. Anderson Thompson (who has been named as the informant) and a statistician in the acknowledgments. Which of those two are on record within CDC as having voiced a strong opinion about the African American boy data? Heck, I nearly called Mr. Thompson myself to ask if he was working with Mr. Hooker. I wouldn’t be surprised if people at the CDC figured it out and that’s why his name was so quickly divulged by Mr. Wakefield. Why keep his name secret if you’ve already given out enough information to his superiors for them to break his cover?

And with that let’s get back to the “these guys are their own worst enemies” discussion. When you have someone you consider a whistleblower, it is your duty to protect that person. Not out him/her. Mr. Wakefield doesn’t seem to understand that. Years after having ignored the information given to him by a whistleblower in the UK, Mr. Wakefield not only outed that whistleblower, he first threatened the man with disclosure:

If Mr. Thompson intended to stay anonymous, and I have no reason to suspect otherwise, he chose poorly in his confidants.

Mr. Thompson had many options of to whom he could reveal his information. Many people would have taken him seriously and not taken the highly irresponsible approach that Brian Hooker has with the race-baiting video and more. I’ve read a number of people speculate that Mr. Thompson didn’t know what he was getting himself in to. If he really chose to work closely with Mr. Hooker, I can’t see how he didn’t see the extremes this information would be put to.

Mr. Hooker has had much communication with the CDC over the past decade and more. Here is some of that communication (about 3MB worth), selected by Mr. Hooker himself as an exhibit in his FOIA case with the CDC.
People at the CDC, likely Mr. Thompson included, would know of Mr. Hooker’s very strong opinions of them. A letter sent to then CDC Director Julie Gerberding is entitled “War Crimes in Your Fight Against Infectious Disease and recommends: “I would personally urge you to review the Book of Matthew 18:6 and consider your own responsibility to all children of the U.S. including my own son.” Italics in the original. Here is one version of Matthew 18:6:

But whoso shall offend one of these little ones which believe in me, it were better for him that a millstone were hanged about his neck, and that he were drowned in the depth of the sea.

Former CDC director Gerberding almost certainly did not share this with Mr. Thompson. But Mr. Thompson may have had similar exchanges with Mr. hooker in the past. As I’ve noted above, Mr. Hooker had at least some contact with Mr. Thompson previously. Also, one need only google Mr. Hooker’s name to see that he tends to exaggerate the importance of his CDC FOIA findings, his critiques of vaccine safety science are heavily biased, he is a board member of Focus Autism (Focus Autism was born out of Barry and Dolly’s desire to put an end to the needless harm of children by vaccination and other environmental factors.) and more.

Brian Hooker and Andrew Wakefield present at parent conventions such as AutismOne, where other presenters are selling their goods and services with faux autism treatments. Treatments such as bleach enemas and drinks (MMS), Lupron (a drug which shuts down sex hormone production. Essentially chemical castration), chelation, megadoses of “supplements” and more. They are sold largely on the promise of healing “vaccine injury”. By handing the Hooker/Wakefield team this PR win, Mr. Thompson will be feeding that industry.

This all said, we only have a few sentences on a video purporting to be Mr. Thompson. I have no reason yet to doubt that his his voice. I also don’t have the full conversations in context. Nor do I have evidence that Mr. Thompson agreed to be outed. Nor do I have evidence that Mr. Thompson agreed to have his phone conversations recorded. Nor do I have evidence that Mr. Thompson continues to communicate with Mr. Hooker. In fact he’s been silent since this story broke and no new quotes from him have been passed by Mr. Hooker or Mr. Wakefield.

What’s more, and rather odd, is that MMR is not really either Mr. Thompson nor Mr. Hooker’s primary interest. Mr. Thompson was author on a number of major thimerosal papers. First author on one. Mr. Hooker’s primary focus on the vaccine/autism discussion has been on thimerosal. I have been reading people online claiming that these events are what they’ve expected and hoped for: someone from CDC exposing that all the vaccine/autism work is fraudulent. But this isn’t the case at all. Nothing so far on thimerosal. One re-analysis of some MMR work that, while important to discuss, is not very strong at all. And while I have written what is possibly my longest article yet (out of something like 2000), there isn’t, as they say, much there there when it comes to anything substantial about vaccines and autism. What we do have is a public relations mess. A story that will be exploited by unethical people to frighten parents and try to revamp their own image and take some revenge.

More recently, at least one (non reliable) site is reporting that Mr. Thompson has spoken through his attorney. The message (and I paraphrase): in getting the preliminary result on African American boys out, he did what he set out to do.

In the end, it is once again public health and autism families that will pay the price. People will use this in their attempt to “bring the U.S. vaccine program to it’s knees”. More autism parents will be dragged into the self blame and guilt that comes with the vaccines-cause-autism beliefs. And disabled children will be subjected to abusive faux therapies in attempts to heal their “vaccine injury”.


By Matt Carey

The Hooker/Thompson conversations: were significant analyses omitted from Hooker’s paper?

27 Aug

As a few people have written about recently, a book was recently published in which we get to read transcripts of conversations between Brian Hooker (a vocal advocate of the idea that vaccines cause autism) and William Thompson (a researcher at the CDC).

The basic story we have been told is that supposedly the CDC team (of which Thompson was a member) saw a “statistically significant” association between MMR vaccination and autism in African American boys. Specifically for boys who got the vaccine late, but before age 3. The story then goes on to claim that he CDC team worked furiously to bury this association. William Thompson, wracked with guilt over this, finally reached out to Brian Hooker to guide him towards this result.

This story is full of holes, as has been discussed here and elsewhere. Rather than go through that again, just take this backstory and ask yourself: given this claim that significant results were omitted by the CDC, wouldn’t Brian Hooker make damned sure that nothing important was left out of the “reanalysis” paper? After all, the main criticism Hooker levied against the CDC team was omission.

You’d think so, wouldn’t you. But you’d also guess that I wouldn’t go through this long introduction if that was the case.

Brian Hooker sold his reanalysis as strong because he took a simple approach. I.e. he didn’t control for any confounding factors. Epidemiologists will tell you the opposite–a raw data analysis is suspect.

In the conversations, we hear that Brian Hooker was well aware that he would get criticism for not making corrections:

Dr. Hooker: Right. Right. Well, what would happen…Okay, so let me play this out … My paper gets published; my MMR paper gets published. They…I get heavily criticized, because I haven’t corrected for scioeconomic factors or maternal education. Yeah. I’ll take my hits, and then eventually it gets published. And then there’s a piece of information that I receive from the CDC, but I don’t source. Is that going to be a red flag?

OK, he knows that a “simple” approach is not considered strong. This begs the question: how important are socioeconomic factors and maternal education he’s worried about? I could tell you that they are huge factors for the conclusion he’s trying to make. But don’t take my word for it, because Hooker and Thompson did discuss the importance of maternal education in the recorded calls. And this discussion is very telling. Consider this exchange:

Dr. Hooker: Right. Right. Well, it does…You know, it does kind of play backwards.

Plays backwards–as in this goes against the story they are trying to tell. Going on:

Dr. Thompson: yeah.

Dr. Hooker:… in terms of: Will those kids that got vaccinated later; then you would expect less healthcare-seeking behavior; so they would be less likely to get an autism diagnosis.

Dr. Thompson: yep.

Yep?!? That’s all he can say? This is KEY to the entire argument that there is an increased risk in African American boys.

Let’s step back a moment and look at this issue. Brian Hooker’s reanalysis is based on very few subjects (seven–African American autistic boys who got their MMR vaccine late). Implicit in his “simple” analysis is the assumption that these boys were in every way similar to the other boys in the study, aside from autism and when they got their MMR vaccine. Let’s say that there’s a reason why these autistic kids were vaccinated late–like their parents didn’t have insurance so they didn’t go to well baby checks. This would correlate with the education of the mother and, thus, this variable could help control for this “health-care seeking behavior”.

This leaves us with a HUGE potentially confounding variable in Hooker’s analysis, and in precisely the population they are most interested in–the kids who got vaccinated later. But he don’t address it in the “reanalysis”. He sweeps it under the rug.

Which is to say, this is a very ironic conversation Hooker and Thompson are having. Hooker appears to be doing exactly what he claimes the CDC was doing: crafting a story around the results he wants to report and omitting important information to make that point.

The conversation goes on.

Dr. Hooker: But if you had maternal education, then you could correct for that.

Dr. Thompson: Right. But …

Dr. Hooker: So, I don’t think I have it.

Dr. Thompson: You could argue the most important confounder was not included in that study. So, why would you even consider the results valid?

Dr. Hooker:Valid.Right. Right, you can’t say either way.

Dr. Thompson: Exactly.

Dr. Hooker: Essentially.

Dr. Thompson: Yep.

Dr. Hooker: You can’t…

Let’s repeat one line for emphasis: You could argue the most important confounder was not included in that study. So, why would you even consider the results valid?

The most important confounder being maternal education. They know this is a big deal.

And this wasn’t just a passing thought in that conversation. Later in that same call, Hooker asked again about how strong an effect one could see from maternal education. In this case, from Thompson’s experience from his 2007 thimerosal paper. And again Thompson tells him that maternal education is a strong factor that should be included in an analysis.

Given this repeated discussion of the need to adjust your results for external variables, you’d expect Hooker to explore maternal education in his own paper, wouldn’t you? As in, do the math and see how much this factor affects his calculated relative risk for MMR in African American boys, right? At the very least, you’d expect a discussion similar to the one above–how this is a potential confounding variable and how exactly it could affect his results (it could go “backwards”).

You’d expect that of an ethical researcher. I would.

Here’s the thing: Brian Hooker did not include maternal education in his re-analysis. the closest he gets in in the final paragraph of his reanalysis paper. This is where he focuses on the weaknesses of his study. He goes into detail about age of diagnosis and how that might affect his results, for example. When it comes to maternal education the closest he says:

In addition, socioeconomic factors were not assessed in the current analysis. Thus, any differences in “healthcare seeking behavior” among individuals vaccinated ontime versus late could not be assessed.

Sorry to be so repetitive, but no word about how important maternal education or other socioeconomic factors are to precisely the conclusion he’s trying to draw. Just a statement that amounts to “controlling for socioeconomic factors can’t be done because I didn’t do it.” The data were available to Hooker in the birth certificates. Hooker even used the birth certificate data elsewhere in his paper (from the paper: “Georgia state birth certificate information was used to further obtain each child’s birthweight”). So he can’t say he didn’t have it.

This is ironic in the extreme: after complaining that the CDC left out a “statistically signficant” result, Brian Hooker doesn’t include a factor which he knows is a major without which one can’t consider the results valid.

I’ll go beyond ironic. This is in my opinion scientifically unethical. And, since his study is really more political than scientific, I consider this politically unethical. Frankly, if someone working for me did something like this as part of his work, he’d be fired.

But, wait, the story is even more strange. Recall how Thompson was bashing the original study (DeStefano, et al.) for being invalid due to not controlling for maternal education (“You could argue the most important confounder was not included in that study. So, why would you even consider the results valid?”). DeStefano et. al did control for maternal education. And not only should William Thompson and Brian Hooker have known this if they were reanalyzing the paper, William Thompson was a coauthor on the DeStefano paper!

One does have to wonder if Hooker did the analysis using maternal education and chose to not report it. Given the discussions he had with Thompson, my opinion is that either Hooker did the analysis or he’s incompetent.

Bottom line, though, if you are going to make some public relations/political hay claiming some group omitted a result, you shouldn’t be omitting important analyses yourself.

Were significant analyses omitted from Hooker’s paper? In my opinion, yes. And from his conversations with William Thompson, we see that Hooker was aware of the importance of factoring in maternal education.


By Matt Carey