Archive by Author

Conflicts of interest in vaccine safety research

7 Mar

When this abstract came out I had hopes, vain hopes, that it wouldn’t get discussed much online. It’s perfectly reasonable to discuss issues surrounding conflicts of interest in vaccine safety research, but the author has a track record of less-than-excellent publications. Prof. DeLong wrote A positive association found between autism prevalence and childhood vaccination uptake across the U.S. population, which was discussed here at Left Brain/Right Brain, Neuroskeptic and The Biology Files (to name a few). Again, not an excellent study.

Here is the abstract of the new paper:

Conflicts of interest (COIs) cloud vaccine safety research. Sponsors of research have competing interests that may impede the objective study of vaccine side effects. Vaccine manufacturers, health officials, and medical journals may have financial and bureaucratic reasons for not wanting to acknowledge the risks of vaccines. Conversely, some advocacy groups may have legislative and financial reasons to sponsor research that finds risks in vaccines. Using the vaccine-autism debate as an illustration, this article details the conflicts of interest each of these groups faces, outlines the current state of vaccine safety research, and suggests remedies to address COIs. Minimizing COIs in vaccine safety research could reduce research bias and restore greater trust in the vaccine program.

The introduction to the paper starts with “How safe are vaccines?” This for a paper whose purported subject is “Conflicts of interest in vaccine safety research”.

I was going to put off reading the paper until I found this line in Orac’s article on it. Prof. DeLong, former board member of SafeMinds, wrote about “advocacy groups” (which includes SafeMinds, NVIC and the Autism Research Institute) thus:

While these organizations are not as well-staffed or well-funded as government agencies or vaccine manufacturers, their main task is to generate information to refute agency or industry claims.

We hear over and over how these groups have the focus to provide accurate information, to allow for “informed consent”. But here we find that they are focused on generating “..information to refute [government] agency or industry claims.”

Which begs the question: what if/when the information from the government or industry is correct? Prof. DeLong appears to be assuming that the information is always in need of refutation. Not exactly what I want for in an “advocacy group”.

Which brings us to another point: why are “advocacy groups” only those who are in the business of “refuting” government and industry information? What about advocacy groups such as the Sabin Vaccine Institute, the Bill and Melinda Gates Foundation, CHOP’s Vaccine Education Center, Every Child by Two, to name a few. I know many vaccine skeptics dismiss these groups as “front groups” for the government or industry, which is a particularly hard argument to make for the Gates Foundation.

Prof. DeLong makes a passing attempt to include conflicts of interest for the advocacy groups she does include. I say “passing attempt” because while much of the paper is devoted to methods whereby public health decisions should be made without influence of COI’s, she only makes these suggestions for people from industry or government. For example, she says that we should “manage the influence of vaccine manufacturers on medical journals”. No mention of, say, Andrew Wakefield serving on the editorial board of “Autism Insights” when a paper supporting him was published by one of his employees. Or for less severe questionable activities such as people funded by “advocacy groups” serving as referees or editors of journals. She also has a section on how we should “prohibit agencies that promote vaccines from overseeing vaccine safety”. But no prohibition for members of “advocacy groups” which often include, as in her case, people who have filed claims in the vaccine court and are, thus, facing a significant financial COI.

Much of the paper is basically a Trojan Horse. Under the title of “Conflicts of interest in vaccine safety research”, the paper spends considerable space discussing vaccine safety (remember that first sentence of the paper?). We are left with the premise that “trust in vaccine safety is low”. Those two paragraphs are a good example of selective quoting of statistics. For example, we are told that 77% of people surveyed have at least one concern about vaccine safety. Count me in. Am I an example of “low trust” in vaccine safety? “Low” is a relative word. A counter example to those given in the paper: vaccine uptake is still about 90% (and more) for most childhood vaccines. People watching these numbers are concerned with fractions of a percent drop. “Low” is “low enough to potentially endanger public health by allowing for outbreaks”. That’s my definition of low. Not the implied, most people have low trust.

The paper is about 25 pages long, in published format. That’s a big effort. It is, in the end, largely a very long blog post. If you’ve been reading the online discussions for the past few years, you’ve likely encountered much of what she has to say. It ends up more of an opinion piece than a scientific paper.

Walker-Smith wins appeal

7 Mar

Prof. John Walker-Smith was one of Andrew Wakefield’s colleagues at the Royal Free and participated in the research there. Prof. Walker-Smith was struck off the medical register along with Andrew Wakefield by the General Medical Council. Prof. Walker-Smith appealed and the GMC’s decision has been quashed.

Here is the conclusion of the appeal decision:

For the reasons given above, both on general issues and the Lancet paper and in relation to individual children, the panel’s overall conclusion that Professor Walker-Smith was guilty of serious professional misconduct was flawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusion. Miss Glynn submits that the materials which I have been invited to consider would support many of the panel’s critical findings; and that I can safely infer that, without saying so, it preferred the evidence of the GMC’s experts, principally Professor Booth, to that given by Professor Walker-Smith and Dr. Murch and by Dr. Miller and Dr. Thomas. Even if it were permissible to perform such an exercise, which I doubt, it would not permit me to rescue the panel’s findings. As I have explained, the medical records provide an equivocal answer to most of the questions which the panel had to decide. The panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMC’s approach to the fundamental issues in the case led it to believe that that was not necessary – an error from which many of the subsequent weaknesses in the panel’s determination flowed. It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician. Its failure to address and decide that question is an error which goes to the root of its determination.

The panel’s determination cannot stand. I therefore quash it. Miss Glynn, on the basis of sensible instructions, does not invite me to remit it to a fresh Fitness to Practice panel for redetermination. The end result is that the finding of serious professional misconduct and the sanction of erasure are both quashed.

From The Telegraph’s MMR doctor wins battle against being struck off:

A doctor found guilty of serious professional misconduct over the MMR controversy has won his High Court appeal against being struck off.

And:

Chief executive Niall Dickson added: “Today’s ruling does not however reopen the debate about the MMR vaccine and autism.

“As Mr Justice Mitting observed in his judgement, ‘There is now no respectable body of opinion which supports (Dr Wakefield’s) hypothesis, that MMR vaccine and autism/enterocolitis are causally linked’.

Autism recurrence in half siblings: strong support for genetic mechanisms of transmission in ASD

5 Mar

Autism recurrence in half siblings: strong support for genetic mechanisms of transmission in ASD comes out of Dan Geschwind’s group at UCLA. They used the Interactive Autism Network database. Here is the abstract:

Current estimates of the heritability of autism spectrum disorders (ASD) derived from existing clinical twin studies1, 2, 3, 4 are potentially confounded by a number of factors, including low sample size, inconsistency in case definition and the role of de novo mutation (currently estimated to contribute to some 20% of cases), and the possibility that heritable causes of ASD in a twin could result in environmentally engendered affectation of a non-identical co-twin in utero, especially if mediated by humoral or immune mechanisms. To minimize these confounds, we compared autism recurrence in half siblings versus that in full siblings, using data (6 June 2011) from over five thousand families enrolled in the Interactive Autism Network (IAN), a national volunteer register for ASD, detailed characteristics of which have been previously described by our group. Recurrence rate among full siblings was observed to be approximately twice that among half siblings, providing strong evidence of genetic transmission of ASD.

The recurrence risk is the chance that a sibling has autism if another sibling does. The authors found the recurrence risk to be twice as high for full siblings, which is consistent with a primarily genetic model of autism risk.

This follows on a number of recent twin studies (here, here and here) have shown a lower concordance than previously estimated and the baby siblings study which showed a 19% recurrence risk for autism.

I wonder at how many half-siblings there are in the cohort. A small subpopulation could mean large error bars.

Roberto Marty, San Francisco School Bus Driver, To Stand Trial For Molesting Multiple Special Needs Students

5 Mar

This from the Huffington Post: Roberto Marty, San Francisco School Bus Driver, To Stand Trial For Molesting Multiple Special Needs Students. Obviously this is not yet proved. The story, however, tells of the possibility of more than one instance of abuse:

Long-time San Francisco Unified School District bus driver Roberto Marty stands accused of two counts of felony molestation–the first stemming from an incident occurring nearly a decade ago with the second allegedly happening last year.

Marty was investigated for inappropriate contact with a student in 2004; however, the San Francisco Police Department’s investigation found the claim to be without merit and Marty was allowed to continue driving buses for the district, a job he held since 1994.

Vaccine skeptic propogates harmful autism stereotypes…again

29 Feb

A major news story in the U.S. right now involves a school shooting incident in Ohio. Somehow when school shootings happen, someone always seems to float the speculation that the shooter is/was autistic. It’s happening again with people pointing to this article on
the Cafe Mom website:

40 Infallible Reasons Why You Should Not Vaccinate Infants

By Jagannath Chatterjee (Fighting Vaccines Since 1985)
August 30, 2008

“Fighting vaccines since 1985″….

The 40 “infallible reasons” include this one:

23. Autism is a permanent disability that affects the child physically, mentally and emotionally. It makes the child loose social contact. It impedes both the physical and mental growth of the child. It destroys the brain causing severe memory and attention problems. According to vaccine researcher Dr Harris Coulter, vaccines cause children to become pervert and criminal. All the school shootings by the children in the USA are by autistic children. Vaccines can cause more harm that even the medical community privately acknowledges.

Readers will likely not be surprised to read that Dr. Coulter is not a medical doctor.

Such statements as those above generally don’t need comment to anyone who has even a cursory knowledge of the facts. If I had made that statement up people would accuse me of going over-the-top in parody.

This isn’t a time for “generally”. We have a recent school shooting case in the U.S.. And we have people pointing to this article as part of that discussion. The logical train of vaccines cause autism which causes people to be “pervert and criminal” which leads to school shootings.

It’s worth noting that both Harris Coulter and Jagannath Chatterjee are featured favorably on the site Whale.to. For those who consider that to be an ad-hominem attack I’d ask: against who? Whale.to or Coulter and Chatterjee? Neither looks good in association with the other.

leaping science forward fundraiser for Autism Science Foundation

29 Feb

Today is a special fundraiser for the Autism Science Foundation. All the money will go towards the stakeholder travel grants they provide for people to attend IMFAR. Here are the details:

We need YOUR help to make the 2012 Leap Day a great day for autism science!

How often have you wished for an extra hour or extra day to get everything you need done? In 2012, we get a WHOLE DAY! At the Autism Science Foundation, we want to make the most of this special leap day by using it to help autism science leap forward.

All donations made on February 29, 2012 will go directly to our IMFAR Travel Grants program, helping us provide more scholarships for stakeholders – parents, siblings teachers, people with autism – to attend IMFAR 2012 in Toronto where they will share their real world autism experience with scientists. These stakeholders will then bring the latest autism science back into our communities helping the science take a giant leap forward.

We need YOUR help leaping science forward and sharing your love of autism research. We need YOUR help spreading the word about this 1-day fundraiser!

Please help us by writing a blog post, composing some tweets and/or posting an update to your Facebook page on Wednesday, February 29 after 8 am EST.

Do something special with this extra day of 2012 and help leap science forward.

Get all the details about the 1-day fundraiser here – http://leapscienceforward.causevox.com/

Call for Applicants: Leadership Training for Autistic College Students

28 Feb

This announcement from the Autistic Self Advocacy Network (ASAN).

What is the Autism Campus Inclusion (ACI) Summer Institute? The ACI Summer Institute is a week-long training for Autistic college students. The training is meant to prepare students to engage in self-advocacy and pro-neurodiversity activism on their college campuses.

Who is eligible for the ACI Summer Institute? Any current Autistic college student in the United States is eligible to attend. Students should have at least one more year remaining in college. Because of the support we are receiving from our partners, we are offering this institute at no cost to the students chosen for the program, including travel accommodations, room and board. The institute will take place August 12th through August 17th in Baltimore, MD.

What will participants learn at the ACI Summer Institute? With curriculum based on our collaboration with the Daniel Jordan Fiddle Foundation in the Empowering Disabled Leaders handbook and materials produced and developed with the help of University of New Hampshire’s Institute on Disability, the participants will learn how to engage in activism and advocacy activities on their college campuses.

Applications are due by March 30, 2012 with accepted applicants being contacted in May 2012. If you feel you would like to participate, please fill out the application and submit it with your responses to the essay questions and your resume to Melody Latimer at mlatimer@autisticadvocacy.org . All questions should also be directed to Melody.

We look forward to hearing from you.

Sincerely,

Melody Latimer
Director of Community Engagement
The Autistic Self Advocacy Network

APPLY NOW!

Normal concentrations of heavy metals in autistic spectrum disorders.

27 Feb

A recent study once again looks for metals in autistic children. Once again fails to find significant differences between lead, mercury, cadmium and aluminum levels in autistic and non-autistic children. The study is relatively small (17 autistic children, 20 non-autistic). This group tested hair, blood and urine.

Here is the abstract:

Normal concentrations of heavy metals in autistic spectrum disorders.
Albizzati A, Morè L, Di Candia D, Saccani M, Lenti C.
Source
Operative Unit Child Neuropsychiatry A.O. San Paolo Hospital, University of Milan, Milan, Italy – carlo.lenti@unimi.it.
Abstract
AIM:
Autism is a neurological-psychiatric disease. In the last 20 years we witnessed a strong increase of autism diagnoses. To explain this increase, some scientists put forward the hypothesis that heavy metal intoxication may be one of the causes of autism. The origin of such an intoxication was hypothesised to be vaccines containing thimerosal as antimicrobic preservative. This preservative is mainly made up of mercury. The aim of our research was to investigate the correlation between autism and high biological concentrations of heavy metals.
METHODS:
Seventeen autistic patients, between 6 and 16 years old (average: 11.52 DS: 3.20) (15 males and 2 females), were investigated, as well as 20 non autistic subjects from neuropsychiatric service between 6 and 16 years (average: 10.41 DS: 3.20) (15 males and 2 females). In both groups blood, urine and hair samples were analysed trough means of a semiquantitative analysis of heavy metal dosing. The metals analysed were Lead, mercury, cadmium and aluminium, since their build-up may give both neurological and psychiatric symptoms.
RESULTS:
The comparison of the mean values of the concentrations between the groups, performed with ANOVA test, has shown no statistically relevant differences.
CONCLUSION:
There wasn’t correlation between autism and heavy metal concentration.

This follows on the heels of a recent study published in the Public Library of Science, A Comparison of Urinary Mercury between Children with Autism., which found no differences in urine concentrations of mercury. This study was discussed here at Left Brain/Right Brain.

Looking back, what other studies have there been?

Heavy Metal in Children’s Tooth Enamel: Related to Autism and Disruptive Behaviors?

The current findings challenge the notion that perinatal heavy metal exposure is a major contributor to the development of ASDs and HDB [highly disruptive behaviors]

Lack of Correlation Between Metallic Elements Analyzed in Hair by ICP-MS and Autism.

A cross-sectional case-control study was carried out to evaluate the concentrations of metallic elements in the hair of 44 children with diagnosis of autism and 61 age-balanced controls. Unadjusted comparisons showed higher concentrations of molybdenum, lithium and selenium in autistic children. Logistic regression analysis confirmed the role of risk factor for male gender and showed a slight association with molybdenum concentrations. Unconventional chelation and vitamin-mineral supplementation were ineffective on elemental hair concentrations. A meta-analysis including the present and previous similar studies excluded any association of autism with hair concentrations of mercury, cadmium, selenium, lithium and copper. A slight association was found for lead only, but it was very weak, as strictly dependent on the worst data from one study.

Blood mercury concentrations in CHARGE Study children with and without autism.

After accounting for dietary and other differences in Hg exposures, total Hg in blood was neither elevated nor reduced in CHARGE Study preschoolers with AU/ASD compared with unaffected controls, and resembled those of nationally representative samples.

IMFAR (unpublished) abstracts:

Prenatal and Neonatal Peripheral Blood Mercury Levels and Autism Spectrum Disorders

Conclusions: Levels of total mercury in serum collected from mothers during mid-pregnancy and in blood collected from infants at birth were not associated with risk of ASD.

The Tooth Fairy Project: Heavy Metal Concentrations in the “Baby Teeth” of Children with Autism Spectrum Disorders (ASD)

Results: Initial analyses do not indicate higher concentrations of lead, manganese, or mercury in either prenatal or postnatal regions of the teeth among children with ASD as compared to matched controls. The presentation will include final analyses and interpretations on the full sample and on other elements.
Conclusions: Based on preliminary results, concentrations of heavy metals do not seem to be higher in children with ASD. The type of biomarker used may be important, and it is also possible that prenatal and early postnatal exposure to heavy metals contributes to the development of ASD in some children, but not others.

PS1.65 MERCURY LEVELS IN CHILDREN WITH PDDS AND THEIR MOTHERS: A CASE-CONTROL STUDY

Conclusion: There is no evidence that children with PDD have elevated levels of mercury or that they have deficiencies in mercury excretion. The findings do not support the use of chelation therapies as a treatment of autism.

PS3.36 A STUDY OF MERCURY LEVELS IN YOUNG CHILDREN WITH AUTISM USING LABORATORY ANALYSIS OF HAIR SAMPLES

Analysis of hair sample data by t-tests for equality of means and equal variance yielded no significant difference in mercury levels for the two groups. Despite the small sample size, results raise questions about the usefulness of evaluation for mercury exposure using hair samples, and about claims of mercury toxicity in children with autism.

PS6.4 NO AUTISM AMONGST INUITS FROM NORTHERN QUEBEC?

Conclusion: Autism appears to not exist amongst Inuits from Northern Quebec. If confirmed, it would have significant implications for the genetic understanding of autism. In addition, as Inuits are exposed through their fish-eating practices to high pre- and post-natal levels of mercury, it would also suggest that high mercury exposure in itself does not increase the risk of autism.

24-hour provoked urine excretion test for heavy metals in children with autism and typically developing controls, a pilot study.

RESULTS:

Fifteen autistic children and four typically developing children completed the study. Three autistic subjects excreted one metal in greater quantity during the provoked excretion than baseline. Two of these were very close to the limit of detection. In the third case, the provoked excretion of mercury was between the upper limit of normal and lower limit of the potentially toxic reference range. Fish was removed from this child’s diet for greater than one month, and the provoked excretion test repeated. The repeat excretion of mercury was within the normal range.
CONCLUSION:

In the absence a proven novel mode of heavy metal toxicity, the proportion of autistic participants in this study whose DMSA provoked excretion results demonstrate an excess chelatable body burden of As, Cd, Pb, or Hg is zero. The confidence interval for this proportion is 0-22%.

Yes, you can find papers claiming there are differences in hair, blood or urine concentrations of mercury. Many by father-son team Mark and David Geier. I won’t take the time to go into the lengthy discussion of why I don’t trust anything they do without corroboration. There is the old Amy Holmes “baby haircut” study that was taken apart at the autism omnibus proceeding (amongst other places). Plus a couple papers by James Adams. Yes, and a poorly done reanalysis of an existing dataset. Just not a strong body of evidence to support the idea that “autism is a novel form of mercury poisoning”.

In the end all of this evidence comes in a far second to the fact that multiple studies have shown no increased risk for mercury exposure from vaccines. For example:

[Lack of association between thimerosal-containing vaccines and autism].

Our study revealed no evidence of an association between TCVs and autism.

So much time spent. So much money spent. And it is still going on. It’s long past time to move on. The vast majority of the research community already has. Most parents have.

Vote for The Thinking Person’s Guide to Autism as best new special needs parenting book

26 Feb

Have you read The Thinking Person’s Guide to Autism? If so, consider a vote for The Thinking Person’s Guide To Autism as best new special needs parenting book. This poll is being held at SpecialChildren.about.com.

From about.com:

Five new special-needs parenting books have been selected to vie for a 2012 About.com Readers’ Choice Award, based on your nominations

And you can vote every day (for real):

You can vote once a day every day between now and March 21. Winners will be announced on March 30

Mark Geier: Cease and Desist

26 Feb

From the Baltimore Sun: ‘Cease and desist’ order issued against autism doctor

Dr. Mark R. Geier, a Rockville doctor accused of improperly treating children with autism, has been ordered by the state Board of Physicians to stop practicing medicine while his license is suspended.

The doctor’s license was suspended in April after the board concluded his hormone and chelation therapy endangered the children in his care. But the board in a new “cease and desist” order this week accused the doctor of refilling prescriptions for at least three patients in violation of the suspension.

The doctor has appealed the suspension of his license. His lawyer declined to comment on the newest claims.