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New National Autism Clearinghouse In The Works

7 Oct

Disability Scoop has an article, New National Autism Clearinghouse In The Works, which states:

A handful of disability organizations are joining forces to establish a national resource center to assist people dealing with autism and other developmental disabilities.

The new initiative known as Autism NOW: The National Autism Resource and Information Center will be established by The Arc in collaboration with the Autistic Self Advocacy Network and Self Advocates Becoming Empowered with the help of $1.87 million awarded by the Department of Health and Human Services this week. Autism NOW will be tasked with helping people connect with services and interventions in their own communities.

Here is the press release from The Arc:

Washington, DC – The Administration on Developmental Disabilities (ADD), within the Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services, announced yesterday that The Arc would receive an award of $1.87 million for fiscal year 2010 to establish a national resource and information center on Autism Spectrum Disorder (ASD) and other developmental disabilities.

The Arc, in collaboration with several key partners will implement an innovative and dynamic initiative, called Autism NOW: The National Autism Resource and Information Center to engage and leverage a national network of disability, aging, military, and family organizations to deliver information and resources relevant to individuals with ASD and other developmental disabilities.

“The Arc and our partners are primed and ready to build a dynamic resource to address the needs of people with ASD and other developmental disabilities through this national network. We are proud to have the opportunity to launch Autism NOW, a much needed resource. It is especially significant that self-advocates will have a meaningful role in leading, implementing and realizing the goals of this innovative project,” said Peter V. Berns, CEO of The Arc.

Other partners include the Autistic Self Advocacy Network (ASAN), and Self Advocates Becoming Empowered (SABE) to provide expertise from the self-advocate perspective. For research expertise in key areas across the lifespan in ASD and other developmental disabilities, The Arc has partnered with members of the Association of University Centers on Disabilities (AUCD) Network, also referred to as UCEDDs (University Centers on Excellence in Developmental Disabilities), the Institute for Community Inclusion from the University of Massachusetts, the Developmental Disabilities Institute from Wayne State University, and the Center for Community Inclusion and Disability Studies from the University of Maine.

First Autistic Presidential Appointee Speaks Out

7 Oct

Wired Magazine has an interview with Ari Ne’eman, Exclusive: First Autistic Presidential Appointee Speaks Out. Mr. Ne’eman has been appointed by the Obama administration to to positions: a seat on the Interagency Autism Coordinating Committee (IACC) and a seat on the National Council on Disability (NCD).

The author of the Wired piece, Steve Silberman, also blogs at PLoS. His piece there is No More Pity: The First Openly Autistic White House Appointee Speaks Out.

The Wired piece does touch on the opposition to Mr. Ne’eman’s appointment. I am grateful that this an other side issues are also met with a real discussion of what Mr. Ne’eman’s views are. I wish there even more of that discussion. Here is a small sample:

Very few of us wake up in the morning and think, “Have they developed a proper mouse model for autism yet?” Instead, autistic people and their parents worry about finding the educational and support services that they need.

As a parent, I appreciated this question and answer:

Wired.com: What advice would you give to neurotypical people who want to become effective allies of the autistic community?

Ne’eman: At the political level, watch where your money is going. There are a lot of well-meaning people who think they’re helping us by donating to Autism Speaks or other groups looking for a cure. It would be better for people to get involved in their local communities and ask tough questions like, “Is my school inclusive? Is my workplace willing to hire autistic people and other people with disabilities?”

Given Mr. Ne’eman’s recent appointments, I felt this was probably the key question of the interview:

Wired.com: What do you hope to accomplish in Washington?

Ne’eman: All across the country, we have hundreds of thousands of people on waiting lists for access to community services. People with disabilities don’t have the support we need to live independently, be employed, and participate in civic life. Instead, because of a bias in the way Medicaid is structured, many of us are segregated in institutions, which offer a much lower quality of life to disabled people at the same time that it works out to be much more expensive. It’s easier to get states to pay for an institution than to get them to allow people to access services in their homes. Making community services more accessible would be a huge game changer for all kinds of people with disabilities.

Passing one particular piece of legislation — the Community Choice Act — would accomplish that. The Community Choice Act would make it so that states would be required to pay for supports and services at home or in the community, but it would actually save money, because institutional placements are very expensive. There’s no reason not to do this.

Katie Wright demonstrates AoA mentality

30 Sep

Over at the Clown Blog, Katie Wright pens a sulky screed targeting Peter Bearman. Lets go through it.

Dr. Peter Bearman, a professor of sociology at Columbia University, recently released a research paper alleging that half of the meteoric rise in ASD cases is an artifact. You know- “better diagnosis” and “greater awareness.” A blind, non-medical professional, could have diagnosed my son. Nevertheless in the case of HF ASD and aspergers (which comprise a small % of overall ASD) certainly greater awareness has played a role in the increasing number of those diagnoses. Still- 50%? Ridiculous.

And why ridiculous? Well….just because. Wright offers no evidence to counteract Bearman’s. No science is referenced to challenge Bearman’s work. It simply is ridiculous apparently. One can almost hear the foot stomp of a poor little rich girl out of her league intellectually.

After Dr. Bearman concludes that 50% of the increase cannot be attributed to greater awareness Insel asks what Bearman believes is driving the other 50%. Bearman answers: “genes, old parents and possibly a virus.” This is the best he has got? The NIH gave this guy millions to come with that?

Well no Katie, thats not what the NIH gave him his research money for. According to _you_ Insel asked Bearman what he _believed_ was driving the other 50%. He gave his answer as to what he _believed_ . But these beliefs were just that – beliefs. He presented the science he had done and then shut up on the evidence and opined and on what he was asked to opine on by Insel.

And even his opinion, his beliefs, are rooted in science. There _is_ a genetic component to autism, thats simply a fact. There _is_ research that links ASD to older parents. Katie Wright’s beliefs revolve around one extremely unscientific thing. Vaccines.

Yes, Bearman does acknowledge the possible role of some kind of toxin. Bearman is not sure what that toxin is but he is sure what it isn’t. Take a guess.

See what I mean. If it ain’t a vaccine, it ain’t worth considering according to Katie Wright.

…unbelievably Bearman says: “it isn’t autism that parents are worried about. They know they can deal with that, they know they can help their child, (and he would know this a non parent of an ASD child?) but it is autism organizations scaring parents!” I had no idea that a bunch of stay at home Moms with no money, no federal backing, no million dollar grants- who are already busy parenting autistic kids- have this kind of extraordinary power! Wow, what’s next for us? Ending the recession, solving the mortgage crisis, creating electric cars?

And hot damn Katie Wright, guess what? In my opinion he _is_ right! I’m not scared of autism. I’m scared of one note zealots stealing away research monies, scaring away legitimate researchers with their threats of violence and scaring the public into believing that autism is some kind of tsunami of evil ready to engulf them all in a tide of social security claims.

As for Katie Wright personally, it makes me sick to think of this little rich girl, who’s children will want for nothing, playing the ‘poor little me’ card. There are families out there struggling to get by on a day to day basis and she has the temerity to liken herself to a ‘stay at home mom’. Feh.

As far as blaming the parents for the national crisis of confidence in vaccine safety- grow up Dr. Bearman. The problem is the problem- not people talking about the problem.

Nice quote from that intellectual giant Jim Carrey there. Oh and guess what Katie Wright? You and people like you *are the problem* . Whilst you play offended at legitimate science, there’s a whooping cough outbreak in California that is killing children. You do know that don’t you Katie Wright?

Here’s what you need to do Katie Wright. You need to accept the fact that the science is against you. You need to accept the fact that you are a small scaremongering minority of the autism community. Sounding off about stuff that you clearly have absolutely zero knowledge about (science) makes you look foolish and all it does is show you to be frightened. You are behind the times. Get out of the way of progress.

The Age of Autism before thimerosal

28 Sep

Dan Olmsted and Mark Blaxill have written a book, The Age of Autism. It expands on Mr. Olmsted’s UPI series of the same name and uses the same logic: build a narrative that links mercury to illnesses and claim this as proof that mercury is the cause.

One can download the first 46 pages of the book for free on iTunes, buy the book, wait for it to come to your library or used book story (don’t count on the used bookstore route. Last report I got was only about 600 books sold in the opening time for this book). Or, one could just not read it ever.

If you want just an idea of what the book is about you can read a short excerpt on the publisher’s website. It starts with this simple statement:

We believe that autism was newly discovered in the 1930s for the simple reason that it was new.

Why was it new? If I understand the logic, the idea is that a new mercury compound was invented and tested around that time: thimerosal. From a recent interview, here are Dan Olmsted’s words:

What we did really was try to trace the rise of autism and that led us to look at the first eleven families who had children diagnosed in the 1930’s .. in the famous paper. We were able to identify seven of those first eleven kids, who were only known by their first name and last initial. When we did, we found what we thought was significant exposure of the family to mercury, in particular a new kind of mercury that came on the market .. that was used in fungicides for agriculture and in vaccines. So, we think as that happened, the first cases appeared. Then it seemed reasonable to believe that when the vaccine schedule that included much more mercury exploded in the 1990’s and so did autism .. there’s probably a connection that has been missed here.

First eleven kids? First studied or first with autism? They seem to be asserting that these are, indeed, the first autistics ever.


Thimerosal was invented in 1927. What strikes me odd about the position of Mr. Blaxill and Mr. Olmsted is that ten years before the invention of thimerosal, someone was born who would later be diagnosed with autism and receive support from the California Department of Developmental Services (CDDS) under the label “autism”. I know this because the data are publicly available. The CDDS data have been used for years to promote the idea of a vaccine-induced autism epidemic. Of course Mr. Olmsted and Mr. Blaxill are aware of these datasets as their colleague David Kirby made use of them many times over the years in his promotion of autism as vaccine injury, starting with his book “Evidence of Harm, Mercury in Vaccines and the Autism Epidemic: A Medical Controversy.”

Here is a list of the birth year and the number of people for each birth year who were getting services from the CDDS (note that these data were from the 1990’s. Some or all of these autistics may have passed on):

Birth-year number of CDDS consumers under the autism label
1930 1
1929 2
1928 3
1924 1
1923 1
1922 3
1917 1

There were not a lot of autsitics born before 1930 and still alive receiving services in the 1990’s, this is true. But, the oldest person in that group was 78 at the time. That’s one year older than Donald T. is this year, for those following that story. .Be that as it may, there are a number of CDDS consumers who were born before thimerosal was invented. It would be unwise to assume that these are all the people born before 1930 who were diagnosed autistic. They are but an example.

From what I’ve read, Mr. Olmsted and Mr. Blaxill spent about five years looking for the origins of autism (the time since Mr. Olmsted’s original UPI series of articles). They traveled internationally and, from their description at least, appear to have left no stone unturned in their search.

I wonder, did they ever challenge their assumption that autism was new? Did they seek out autistics who predated thimerosal and/or those who weren’t research subjects of Dr. Kanner? Or did they merely rework and expand on Mr. Olmsted’s previous work on Kanner’s subjects?

In their statement attempting to distance themselves from anti-vaccine groups, Mr. Olmsted and Mr. Blaxill state:

We don’t want crops to wither, or houses to rot, or children to die of vaccine- preventable illnesses. We simply want to stop an autism epidemic whose origin we believe can be discerned from a careful examination of its environmental history.

“Careful” examination. I wonder.

Donald Triplett – Autism’s Patient Zero

27 Sep

Donald Triplett is (for he is still alive) Kanner’s Case 1. Recently the story in a lovely portrait in The Atlantic, Donald has also had the sad misfortune to slowly but inexorably become a poster child for the autism/anti-vaccine movement. As one of the leading autism/anti-vaccine proponents, Ginger Taylor, writes:

While Kanner’s other cases had poor outcomes, Donald did not. It turns out Donald received a medical treatment that Kanner never recorded when, as a boy, he fell victim to crippling juvenile arthritis. Donald was treated with gold salts and his brother reported that as a result, Donald not only recovered from the arthritis, but “the proclivity to excitability and extreme nervousness had all but cleared up.”

Donald began to recover from “autism.”

This is highly relevant to the autism debate because gold has an extreme affinity for mercury and pulls it from the body. It is also significant because arthritis links his “nervous disorder” to his autoimmune disorder. It is historical evidence that the claims that parents have been making, that their children with autism had regressed after their mercury-containing vaccines, and that treating them for their autoimmune symptoms makes their “autism” better.

Sigh. And so we see the same old merry-go-round that has engulfed Hannah Poling – a determination to see one end and one end only for causing autism – vaccines.

And yet…theres no evidence Donald Triplett was ever vaccinated with anything. Certainly not thiomersal. Indeed, those who ‘discovered’ that Donald was treated with gold salts – Messers Blaxill and Olmsted, had to find another method of Donald being exposed to mercury. They claim that Donald:

…lived in an area where a water-soluble form of mercury was first used in forestry.

Bit of a stretch much?

There are a few reasons I really think this is debatable at best.

1) Why was Donald Triplett the _only_ person in Forest, Mississippi to ‘get’ autism from pesticides used in Forestry?

2) The only person who has suggested Gold Salts could theoretically chelate mercury is one Boyd Haley. In fact as Prometheus said way back in 2005:

The gold used to treat Donald T’s RA was a salt – the gold was an ion and not able to amalgamate with metallic mercury. In addition, mercury in animal tissue is also either ionized or chemically bonded with organic groups (e.g. methyl, ethyl, phenyl…) and also not able to form an amalgam.

3) Lets say that the gold salts performed the impossible and chelated the mercury. Why didn’t Donald Triplett simply ‘get’ autism straight away since mercury continued to be used in the Forestry industry? Chelation is not a preventative.

So here is this young boy who’s exposure to water soluble mercury seems in extreme doubt to me, who’s vaccination record seems to be zero but who was also autistic.

I’m afraid that only points one way to me.

Safeminds comments on the latest thimerosal-autism study

21 Sep

SafeMinds is an organization which has long promoted the idea that thimerosal caused an autism epidemic. They may be the single greatest force that got the idea into the public’s eye, and got research funding focused on looking at the question.

SafeMinds has shown themselves to be very resistant to the very research they called for. Studies which show a lack of association between thimerosal containing vaccines (TCV’s) and autism are always rejected by SafeMinds. They are not alone in this, groups such as Generation Rescue and the National Autism Association (NAA) have also refused to accept the science.

So it was with no surprise that I read that SafeMinds had issued a statement against the study. The statement starts by pointing out that the study was funded and performed by those with conflicts–the CDC, Abt (an organization which does contract research for groups including the CDC), and HMO’s “which receive substantial funding from vaccine manufacturers to conduct vaccine licensing research”.

If we can’t use the HMO’s to work on such project, that sort of takes away the VSD as a tool. It certainly takes away the opportunity to do anything more than passive surveillance of the VSD data. One of the strengths of the Price study was the effort to do more than just review the medical charts. They worked with the children, both cases and controls, to verify that the autism counts were accurate. I bring this up because groups like SafeMinds frequently request access to VSD data.

SafeMinds also discusses the study methodology:

The study sample did not allow an examination of an exposed versus an unexposed group, or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates.

There is much wrong with the above statement. Let’s start with where they are close to correct. The study sample did not allow for a direct comparison (with good statistics) of exposed vs. unexposed. This is true. This is because there are few unexposed kids (unexposed=no thimerosal exposure in this study. Unexposed does not mean no vaccines). If you look at exhibit 9.1.4 from the technical reports by Abt associates (the detailed reports on the study), you will see about 20-30 “unexposed” children. I.e. children with no thimerosal exposure. Of those, about 3-4 (out of 1,000) had no HiB, HepB or DTP vaccine vaccine at all (MMR isn’t listed as it is not a source of thimerosal). This is in line with estimates by the CDC of how many children are unvaccinated (typically about 0.4%). (as an aside–this points out how difficult it would be to do a good study of vaccinated vs. unvaccinated children using the VSD. Seriously, with 99.6% of kids receiving at least one vaccine, you would need a huge number of kids to get the number of unvaccinated needed for good statistics).

Here is that exhibit, with the no-exposure kids circled. (click to enlarge)

It would appear to this reader that the issue of unexposed vs. exposed isn’t so much one of “study design” as the limitations of the VSD itself. There just aren’t that many autistic kids to make a good statistical comparison of unexposed vs. exposed populations.

And, it should be noted, an unexposed vs. exposed comparison wasn’t the purpose of this study. One big question posed by SafeMinds and later picked up by groups such as Generation Rescue was simple: did the increase in thimerosal exposure from vaccines in the 1990’s result in an “epidemic” of autism? This is the question this study addressed.

I am at a loss as to why SafeMinds wrote this: “….or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates”. Contrary to SafeMinds’ assertion, there is a large variation on thimerosal exposure in the study subjects. One of the surprising facts from this study was the number of children receiving thimerosal-free vaccines. This, together with variations in the number of vaccines administered, led to a much larger distribution in thimerosal exposures than one would expect based on the vaccine schedule alone.

Thus, the study was not on “timing” at all. It was, as advertised, on variation of exposure of thimerosal. The question is (at least to me), does the range of exposure amount to significant number of kids having “low” levels of exposure by SafeMinds’ definition?

The answer, it turns out, is yes.

Safeminds has the following statement on their website:

[Autism] remained rare (1 in 10,000) until the rapid escalation of vaccines beginning in the late 1980’s (from 10 shots of 7 antigens in 1983 to 36 shots of 15 antigens). Vaccines are a likely candidate to explain some, if not most of the rise in autism cases and possibly other chronic childhood disorders linked to immune system malfunction.

In one of the seminal papers on the thimerosal was co-written by SafeMinds founder Lyn Redwood Autism: a novel form of mercury
poisoning. In it, the authors state:

The discovery and rise in prevalence of ASD mirrors the introduction and spread of TMS in vaccines. Autism was first described in 1943 among children born in the 1930s (123). Thimerosal was first introduced into vaccines in the 1930s (7). In studies conducted prior to 1970, autism prevalence was estimated, at 1 in 2000; in studies from 1970 to 1990 it averaged 1 in 1000 (124). This was a period of increased vaccination rates of the TMS containing DPT vaccines among children in the developed world. In the early 1990s, the prevalence of autism was found to be 1 in 500 (125), and in 2000 the CDC found 1 in 150 children affected in one community, which was consistent with reports from other areas in the country (126). In the late 1980s and early 1990s, two new TMS vaccines, the HIB and Hepatitis B, were added to the recommended schedule (7).

I know I am spending a lot of time on this point, but it is important. The idea that there is a dose-response relationship between thimerosal and the presumed risk of autism is fundamental to the arguments made by groups like SafeMinds.

A sister organization to SafeMinds, Generation Rescue, says the same thing. In their take, “This is the schedule from 1983. If it worked for kids then, why doesn’t it work for kids now?”. Generation Rescue leader and spokesperson Jenny McCarthy wrote in her book, Healing and Preventing Autism: A Complete Guide, “In 1983, we had 10 shots on the vaccine schedule and autism was one in 10,000. Today there are 36 given and autism is nearing one in 100”. I.e. if we go back to the 1983 vaccine schedule, autism rates should drop to 1 in 10,000.

The 1983 schedule, as graphically presented in expensive full page newspaper ads by Generation Rescue, included 4 DPT shots (yes, the old whole cell pertussis vaccine). Each of those shots included 25 micrograms of mercury.

It strikes this reader that the thimerosal exposure from 4 DPT shots, the amount in the 1983 schedule that supposedly only resulted in 1 in 10,000 kids having autism, should be a “low” exposure amount. If groups are going to point to 1983 as a safer schedule and point to the increases in thimerosal exposure in the 1990’s as the major sign of the “epidemic”, we should be able to take their word that the levels in 1983 were somehow safer.

Let’s look at that figure from the Price study again, shall we? I will highlight how many kids have “low exposure” (i.e. comparable to the 1983 vaccine schedule) to thimerosal. Again, click to enlarge if you wish.

By my eye, something approaching 50% of the kids in the study received the thimerosal exposure of the 1983 schedule. Certainly more than 25%. Those highlighted in red have the same thimerosal exposure as kids did in 1983, so they should have the same autism prevalence that SafeMinds and Generation Rescue claim for that time period: 1 in 10,000.

If that group has a prevalence of 1 in 10,000–or even anything significantly lower than the prevalence of those with higher thimerosal exposure– this study would have found it.

In other words, a thimerosal-induced epidemic of autism didn’t happen. Even using the logic that SafeMinds used to hypothesize it in the first place:that, somehow, the thimerosal exposures in 1983 resulted in a low autism prevalence.

Yes, this is far from rigorous. But, so is the logic that claims that increased thimerosal exposure led to an autism epidemic.

If we read further into the SafeMinds response, we see some of the confusion:

The study sample did not allow an examination of an exposed versus an unexposed group, or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates. There were virtually no subjects who were unvaccinated and few who were truly less vaccinated; rather, the low exposed group was mostly just late relative to the higher exposed group, ie, those vaccinating on time.

SafeMinds seems to be assuming this is a study on the number of vaccines, not the amount of thimerosal. They also don’t appear to have read the study thoroughly enough to note that, yes, there is a large fraction who were “less vaccinated” and, more importantly to this study, a large fraction who had lower thimerosal exposures. As noted above, the low thimerosal exposures result from the fact that many of the children received thimerosal free vaccines.

It is unfortunate that SafeMinds (and other groups like them) can not adapt to science as it comes out. Science which clearly shows that many of their hypotheses were wrong.

The Respectful Insolence blog also discusses some of the failings of the SafeMinds response.

Age of Autism – the book – sales figures

20 Sep

Deep in the heart of the Big Pharma Wackosphere, shadowy figures, twisted into parodies of humanity by their greed, shuffled to and fro. They all carried the stain of Big Pharma – a tattoo of Darth Offit – on the back of their left hand so that they might know each other. The stink of corruption hung in the air like the stench of a festering wound. Not that the Wackosphere cared. Such was their corruption that they breathed deep of the foetid stench…and called it good.

Two figures, barely human broke off from the main rank and file and walked towards a small door. They glanced quickly at each other. Nobody entered this room lightly. Behind its plain brown door lay secrets the likes of which those – the sheeple – outside of the Big Pharma Wackosphere could not even imagine. Dark secrets of events that had the power to blast ones sight and scar one’s mind. Repeated visits rubbed away at a man’s conscience until all that was left was greed and the desire to do harm via blogging. This was…The Knowledge Room.

The two figures steeled themselves. Once they had been simple bloggers, sheeple themselves, but over the years they had first sipped at the Cup of Corruption and then swigged greedily from its poisoned chalice. Now all they wished for was to do as much harm as was possible, whilst getting paid for it in silky Big Pharma cheques.

The first figure, who called himself Kev but who’s real name has passed beyond knowledge, turned to the other who called himself Sullivan, a twisted joke on the name of a sheeple film where monsters are the good guys.

“Go on, then.”
“Its your turn”
“Are you sure?”
“I think so.”
Kev uttered an oath. “I still don’t like this,” he said gloomily.
“Think of the money.”
“True.”
Kev reached out a hand and pushed at the door. It was unlocked as always, inviting visitors into its cold heart.

The room was a small, plain, somewhat arid brown box with a chair in front of a TV. The TV, as always was on and showing the snow of an untuned station.

Kev went to sit in the chair, then stopped.

“Are you sure its my turn?”
“Pretty sure.”
“Damn.”

He sat down.

“Erm…hi…I was wondering if you could tell us how many copies of The Age of Autism had actually sold this week. Uh…Please.”

The room went dark. Sullivan stepped back from the chair. All he could see was the dull throbbing of the tattoo of Darth Offit on Kev’s left hand. He knew what Kev was going through now. Delivery of the answer was always a hideously painful process. The price one paid for having access to this room.

Slowly the room lightened, little by little Sullivan made out the figure of Kev. He had fallen to the floor and was panting like a boxer who was still floored after a big punch.

“Well? How many?” Much rested on the answer to this question. If the book was a success, Big Pharma would have to spend more of their resources refuting the book. That meant less money for Wackosphere bloggers.

Kev looked up from the floor. “Twenty-six.” he panted.

“Twenty six?” Sullivan laughed darkly…by the power of Wyeth! To the Blogging Chamber!!”

Hannah Poling and the Pediatrics thimerosal study: two “big” stories with little press response

18 Sep

Two stories which are “big” news in some segments of the online autism community are the settlement amount for Hannah Poling and the recent study showing no link between autism and thimerosal in vaccines. While these have caused a fair amount of discussion on blogs (like this one), they didn’t generate that much press coverage.

We broke the Hannah Poling award story here on LeftBrainRightBrain on September 3. The story was ignored, even by such pro autism-as-vaccine-injury blogs as the Age of Autism until September 9th, when Sharyl Attkisson (who has some connection to the people at the Age of Autism blog) wrote about it for CBS.

There are a couple of dozen entries in Google News on Hannah Poling. Few major outlets. One that did carry it is the Atlanta Journal Constitution, the home town newspaper for the Poling family. In Settlement reached in autism-vaccine case the AJC quoted Dr. John Shoffner:

Dr. John Shoffner, a neurologist and national expert who has conducted research on autism and its causes, said researchers have found no link between vaccines and autism. And he said he strongly favors vaccination.

“The preponderance of data shows that vaccines are important and safe for children to prevent preventable and sometimes life-threatening infectious diseases,” Shoffner said. “I certainly am in favor and support the CDC’s as well as the American Academy of Pediatrics’ recommendation of vaccination.”

Shoffner is a co-author of a journal article that describes Poling’s case without naming her.

Edited to add: I forgot to include this quote from the Atlanta Journal Constitution:

“It’s critical to remember that the government has never compensated, nor has it ever been ordered to compensate, any case based on a determination that autism was actually caused by vaccines,” said Martin Kramer, communications director for the Health Resources and Services Administration. The National Vaccine Injury Compensation Program is part of the administration. The U.S. Court of Federal Claims decides who will be paid damages for injuries that result from vaccines, under a 1988 law that created a program.

Another so-called “big” story from the last few weeks is the study on autism and thimerosal in Pediatrics, Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism. Sometimes when an important paper comes out (that I am aware of) I watch Google News as the embargo is lifted. I did so with this paper. Nothing happened. OK, I think Disability Scoop had a story out right at midnight (this one, if I recall correctly). Heck, it wasn’t until Friday that the CDC added the study to their website (it isn’t mentioned on the main cdc.gov webpage). Even SafeMinds (who are, in cases like this SafeBet–as in, it is a safe bet they will put out a critique of the paper) didn’t respond for days.

Sure, I was interested. And, yes, these stories sparked some of the most active conversations on this blog in a while. But I am still left with the basic conclusion: the general public has already absorbed these stories. The government conceded the Hannah Poling case 2 years ago. It isn’t new. The idea that mercury in vaccines cause autism–no longer part of the front line public discussion.

I’m not the only one to make this comment. The Washington Post had this to say four days after the paper was made public:

But when the journal Pediatrics published on Monday a study that found no increased risk of autism among more than 1,000 babies who’d been exposed prenatally or in the first 20 months of life to ethylmercury from vaccines, it was met with a general shrug. Neither The Washington Post nor The New York Times even reported on it, though the Los Angeles Times did, in its Booster Shots blog.

Sure, these stories will never completely go away. The vaccine/autism story will never go completely away. But the heyday is over.

Further results from the thimerosal-autism study

14 Sep

The recent study on thimerosal and autism was extensive. Much data and many results were included in two technical reports (nearly 400 pages total, volume 1 and volume 2). I haven’t had the time to read them thoroughly yet, but I did catch some interesting pieces of information.

The authors give the ASD prevalence (cases/1000) as a function of HMO and year of birth:

This is pretty flat. No huge increase seen over that 6 year time span. No evidence for an “epidemic”. The prevalence is about 1.1%. This is consistent with the current value quoted by the CDC.

There are remarkably a big variation by parents educational status (63% kids born to mothers who graduated from college). However, since the researchers are working with kids who are enrolled in an HMO, it seems likely this is due to some bias. I.e. the HMO participants could be better educated (and higher income) than the average.

There are indications that increasing parental age is related to increased autism risk. 36% of mothers were in the 30-34 age bracket, 35% were in the 35+ age bracket. So, about 70% of mothers were over 30 years of age. They list father’s age with different brackets, but 79% were 30 years old or older at the time of birth of their child. Again, could be some bias due to HMO membership, but a large fraction of the parents were older.

Some children (both ASD and controls) received no vaccines. Many received vaccines but no thimerosal–i.e. all their vaccines were thimerosal free.

The use of prenatal vitamins is given as having an increased risk of autism, but the odds ratio is not given.

Being a first-born or second-born child has a significant increased risk for autism (hazard ratios of about 1.6). They may discuss this, but I don’t know right now how much of this is due to parents of autistic kids deciding not to have larger families.

One of the stranger results–there is an increased risk of autism when mothers were using prenatal vitamins with folic acid. The hazard ratio was 2.3 with a p value of 0.0176

Pica and childhood lead exposures had very high hazard ratios: 3.7. This is a good case where it is worth asking if this is causal–does pica cause autism or, as is more likely, does autism cause pica and, with it, higher lead exposures.

Poverty was slightly protective for autism (hazard ratio of 0.92). Again, one has to question if this is real or whether poverty just results in a greater likelihood that a child’s autism will be misdiagnosed.

The authors list coexisting conditions for the autistic, ASD and control children:

Epilepsy is much higher at about 5%, compared to 1.6% for controls. Reports of the prevalence of epilepsy amongst autistics are often much higher, though.

Developmental delay (by parent report) is at about 18% for autistics, compared to about 0.66% in controls.

Gi disorder prevalence is about 2% amongst autistics. It is the same (or slightly higher) for controls. This is very interesting given the anecdotal reports of a high prevalence of GI disorders amongst autistics. I suspect this will form some of the complaints about this study–some will say they aren’t looking at the correct population and that a specific study on autism/regression/GI complaints needs to be done.

Cases (those with ASD) were more likely to get thimerosal free HepB and HIB vaccines.

Infants in this study do not get flu vaccines (near zero). Unless that habit has changed dramatically in the past few years–and that most doctors are giving infants flu vaccines with thimerosal–flu vaccines are not likely to be a reason for the continued climb in autism prevalence.

There is a lot more information there. If/when I get the chance to give the reports a more thorough read I’ll post what I find.

Thimerosal in vaccines did not cause an autism epidemic

13 Sep

There have been two main theories linking vaccines to an “epidemic” of autism. Both theories have been studied. Both have been heard in the courts. Neither theory had a sound scientific basis and epidemiological data has shown that neither theories explained the increase in autism prevalence in the last 20 years.

First it was proposed that the MMR vaccine resulted in persistent measles infections that lodged in the intestines of children leading to “leaky guts” and that harmful substances were leaked into the blood, traveled to the brain and resulted in autism symptoms. This was proposed by Dr. Andrew Wakefield and has since been shown in epidemiological and other studies to be unsound. (This theory morphed for the Omnibus Autism Proceeding, the vaccine court. The argument there was that the measles virus itself traveled to the brain. Again, it is not supported by epidemiological data and is not scientifically sound).

The second theory was that mercury in vaccines from a compound called thimerosal caused autism. In that theory, it was proposed that autism symptoms were similar to mercury poisoning (autism was a “novel” form of mercury poisoning). This theory was not scientifically sound as autism symptoms are not like mercury poisoning. Previous epidemiological studies have also shown thimerosal was not behind the rising numbers of people diagnosed with autism.

In 2007 there was a study which looked at 1,000 kids aged 7-10 to see if various neurological symptoms were more prevalent in those who received higher exposures to thimerosal. Orac at Respectful Insolence blogged it and Kev posted that piece here on LeftBrainRightBrain as well. That study showed indications that in some measures children may perform more poorly with thimerosal exposure. It also showed that in some measures children may perform better with thimerosal exposure. This mixed result is (a) not very strong in either direction and (b) not very surprising when you look at a lot of different measures at the same time. Chance will result in some measures positive, some negative.

The 2007 study was published in the New England Journal of Medicine as Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years, by Thompson, et al.. (Thompson (2007))

What was missing in that report was a direct study of autism. Given the numbers of children (1,047) selected, there would only be about 10 kids with ASD expected in the group. This is too few for a strong conclusion on autism. At the time of that study it was noted that another study would follow concentrating on autism alone.

That study has just been published in the journal Pediatrics as Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism. They studied “256 children with ASD and 752 controls matched by birth year, gender, and [managed care organizations]”. I will give some details here. I expect the treatment on the Science Based Medicine and Steven Novela’s Neurologica blogs to cover the science thoroughly should you wish more detail.

Short answer: thimerosal exposure doesn’t cause an increased risk of autism. Neither thimerosal from vaccines given to the children nor thimerosal from products like Rhogam are behind the increase in autism prevalence we have seen.

It is worth noting that the authors looked at autism with and without regression.

Here is the abstract:

OBJECTIVE: Exposure to thimerosal, a mercury-containing preservative that is used in vaccines and immunoglobulin preparations, has been hypothesized to be associated with increased risk of autism spectrum disorder (ASD). This study was designed to examine relationships between prenatal and infant ethylmercury exposure from thimerosal containing vaccines and/or immunoglobulin preparations and ASD and 2 ASD subcategories: autistic disorder (AD) and ASD with regression.

METHODS: A case-control study was conducted in 3 managed care organizations (MCOs) of 256 children with ASD and 752 controls matched by birth year, gender, and MCO. ASD diagnoses were validated through standardized in-person evaluations. Exposure to thimerosal in vaccines and immunoglobulin preparations was determined from electronic immunization registries, medical charts, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. We used conditional logistic regression to assess associations between ASD, AD, and ASD with regression and exposure to ethylmercury during prenatal, birth-to-1 month, birthto-7-month, and birth-to-20-month periods.

RESULTS: There were no findings of increased risk for any of the 3 ASD outcomes. The adjusted odds ratios (95% confidence intervals) for ASD associated with a 2-SD increase in ethylmercury exposure were 1.12 (0.83–1.51) for prenatal exposure, 0.88 (0.62–1.26) for exposure from birth to 1 month, 0.60 (0.36–0.99) for exposure from birth to 7 months, and 0.60 (0.32– 0.97) for exposure from birth to 20 months.

CONCLUSIONS: In our study of MCO members, prenatal and early-life exposure to ethylmercury from thimerosal-containing vaccines and immunoglobulin preparations was not related to increased risk ASDs. Pediatrics 2010;126:656–664

My guess is that there will be much discussion of the methods on many websites. For now, here are the data from Table 2 and Table 3.

Table 2 (click to enlarge)

Table 3 (click to enlarge)

As with Thompson (2007) the authors will make longer reports available on their website and will allow access to the data.

This study is not the first of its kind. Here are a few of the large studies which have shown a lack of association between thimerosal exposure and autism in the past.

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data

Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization Database

Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association

Autism and Thimerosal-Containing Vaccines Lack of Consistent Evidence for an Association

There are more.

One question is whether this will finally quiet those claiming an autism epidemic caused by mercury in vaccines. Unfortunately, I sincerely doubt it. This study included Sallie Bernard of SafeMinds in the acknowledgments. Ms. Bernard was also involved in the Thompson study of 2007. At that time she was listed as a “dissenting” member of the team. She submitted a letter to the NEJM discussing the reasons for her dissention, Perhaps the lack of the word “dissenting” this time is a good sign. I’ll wait and see.

The main question is how much impact this will have on the next generation of families with autistic children. I can’t but wonder that the age of the mercury hypothesis has seen its peak. Not only in research but in general acceptance.

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