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Advocacy Success: NIMH Use of Stimulus Money Includes Services-Research

5 Mar

If you’ve read what I’ve written on the IACC process, and been able to get past my annoyance with the political maneuverings, you know that I’ve had great hope for the research into areas involving services and adult issues.

Given that, you can imagine that I was quite pleased to get this email from Ari Ne’eman of ASAN (the Autistic Self-Advocacy Network), discussing recent RFA’s (Requests for Applications) for research topics in specifically these areas.

Hello,

Recently, the National Institute of Mental Health released several Request for Applications (RFAs) on services-research topics relevant to autistic people and our families as part of a broader effort to identify NIMH’s priority areas for use of stimulus funds. The RFAs utilize funds specifically allocated under the recently passed American Recovery and Reinvestment Act (aka: the Stimulus bill). As you may be aware, the Autistic Self Advocacy Network and the broader autistic and disability communities have been lobbying for increased representation of services-research and bioethics issues in the NIH research agenda for some time. We’re pleased to share with you these RFAs, which hopefully will yield research that will have a positive impact for our community.

04-MH-104 Access to services by individuals with autism and their families. Engage well-characterized subjects and families in existing autism research activities in preliminary studies exploring variations in access to and use of services, identification of targets for services interventions, and exploration of how variations in service use affect family functioning in diverse populations. Contact: Denise M. Juliano-Bult, M.S.W. 301-443-3364, djuliano@mail.nih.gov

02-OD(OSP)-104* Ethical Issues in the Translation of Genetic Knowledge to Clinical Practice. Genetics and genomics have great promise for the development of personalized medicine, yet the ethical, legal and social implications of both the research and application of genetic and genomic knowledge and technology are far reaching. Studies are needed to better understand the factors that influence the translation of genetic information to improved human health and the associated ethical issues. Examples of studies include those to address ethical issues related to broad sharing and use of new genetic information and technologies for research to improve human health, human subjects protection in genetic and genomic research, the identifiability of genetic/genomic information and how our understanding of identifiability is evolving, return of research results and incidental findings to subjects, alternative models of informed consent for broad data sharing for research, and the impact of intellectual property (IP) issues on development of new technologies. OD(OSP) Contact: Abigail Rives, 301-594-1976, rivesa@od.nih.gov; NIMH Contact: Jean Noronha, Ph.D., 301-443-3367, jnoronha@mail.nih.gov

05-MH-101* Leveraging Existing Healthcare Networks for Comparative Effectiveness Research on Mental Disorders and Autism. Existing large integrated healthcare networks are needed to more efficiently conduct large-scale effectiveness trials in “real-world” patient settings. The NIMH solicits individual or collaborative, linked grant applications from researchers with experience conducting studies within large integrated healthcare delivery systems to develop and test infrastructure to efficiently conduct trials on the effectiveness of treatment, preventive and services interventions to improve care for people with mental disorders and autism. Applicants can propose studies to 1) demonstrate the ability to identify, recruit and enroll large patient populations into clinical trials, 2) harmonize electronic medical record data across multiple integrated systems for research use, 3) pool data for common analyses, and 4) build capacity for the collection and storage of biologic material. Contact: David Chambers, D.Phil., 301-443-3747, dchamber@mail.nih.gov

05-MH-103* Collaboration with AHRQ Comparative Effectiveness Research Program
In FY09 and FY10 the Agency for Health Research and Quality (AHRQ) plans to support research grants (PA-09-070) on comparative effectiveness of clinical treatments and services as authorized in the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) Section 1013. MMA section 1013 mandates two mental health categories: Depression and other mental health disorders; and Developmental delays, attention deficit hyperactivity disorder and autism. NIMH is interested in funding ancillary studies including but not limited to: 1) studies on the comparative effectiveness of important new or existing technologies; and 2) assessment of the comparative effectiveness of treatments that are commonly administered to children but have been evaluated for safety and effectiveness in adult populations. Two year studies will contribute to successfully implement the mental disorders components of MMA Section 1013 by utilizing AHRQ networks ( e.g. EPCs, DEcIDE, CERTs, PBRN, ACTION, etc) to generate information for health care decision-making. Contact: Agnes Rupp, Ph.D., 301-443-3364, arupp@mail.nih.gov

04-MH-105 Developing interventions and service delivery models for the transition to adulthood. Conduct pilot studies to develop and test developmentally appropriate, evidence-based prevention interventions and service delivery models for youth with who are at high risk for, or experiencing severe mental illnesses who are transitioning to adulthood. Studies would propose strategies to address discontinuities in service systems and health care financing. Contact: Joel Sherrill, 301-443-2477, jsherril@mail.nih.gov

Furthermore, NIMH also released the funding of the Inter-Agency Autism Coordinating Committee (IACC) Strategic Plan as an RFA. ASAN has been active in lobbying for the inclusion of quality of life oriented research in the IACC’s priorities since this IACC’s inception in 2007. While having both positive and negative components, the IACC Strategic Plan includes services- and quality of life-research components, including research on meeting the needs of autistic adults. It can be found below.

04-MH-101* Autism: Addressing the challenge. Target research gap areas identified by the Inter-Agency Autism Coordinating Committee (IACC) Strategic Plan for Autism Spectrum Disorder Research, including biomarkers, novel interventions, and new tools for screening, among other topics. Contact: Ann E. Wagner, Ph.D., 301-443-5944, awagner@mail.nih.gov

We encourage you to transmit this information to your contacts in the research and scientific communities, encouraging them to apply for funding for projects that will positively impact the lives of autistic people while working with the self-advocate community to ensure inclusive and participatory models of research, as we practice through our partnership with the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE). Please feel free to e-mail us at info@autisticadvocacy.org with questions on ASAN’s research advocacy and how you can get involved. If you are a researcher, interested in interfacing with ASAN and our research partner AASPIRE on research priorities, design and implementation, we encourage you to contact ASAN Board Member and AASPIRE Project Co-Director Dora Raymaker at dora@aaspireproject.org.

Regards,
Ari Ne’eman
President
The Autistic Self Advocacy Network
1660 L Street, NW, Suite 700
Washington, DC 20036
http://www.autisticadvocacy.org
732.763.5530

Oops! The Kirby Autism-Speaks connection.

26 Feb

David Kirby just published a piece at the Huffington Post about an Autism Speaks interview that supports the idea that we need to do research on the proposed autism-vaccine connection.

No surprises there.

I was laughing at myself on the way home from work, thinking “Heck, if I were one of the Generation Rescue crowd, I’d be claiming a conspiracy. I’d be saying, ‘looks like Generation Rescue and Autism Speaks and the rest are on a concerted effort to ramp up hype on vaccines”.

But I’m not that paranoid.

Then David Kirby posted to the EOHarm yahoo group about his Huffington Post piece.

He included an email exchange between himself and Peter Bell of Autism Speaks. [edit: Note that Peter Bell is not just anybody at Autism Speaks. He’s Executive Vice President. See the first comment below]

Oops.

Here’s Peter Bell telling David Kirby about the interview

From: Peter Bell [mailto:pbell@…]
Sent: Wednesday, February 25, 2009 5:29 PM
To: David Kirby
Subject: NICHD Director Dr. Alexander Discusses the Need for More Research on Environmental Risk Factors for Autism Spectrum Disorders

I think you will find this of interest: http://www.autismspeaks.org/science/science_news/nichd_alexander_interview.php

We just posted this on our website.

And David Kirby’s response. He’s going to blog it!

From: David Kirby [mailto:dkirby@…]
Sent: Wednesday, February 25, 2009 6:32 PM
To: Peter Bell
Subject: RE: NICHD Director Dr. Alexander Discusses the Need for More Research on Environmental Risk Factors for Autism Spectrum Disorders

Wow!

Amazing

I will write about this – thanks

DK

For some reason, Mr. Bell doesn’t want people to know that he tipped David Kirby off:

—–Original Message—–
From: Peter Bell [mailto:pbell@…]
Sent: Wednesday, February 25, 2009 7:03 PM
To: David Kirby
Subject: RE: NICHD Director Dr. Alexander Discusses the Need for More Research on Environmental Risk Factors for Autism Spectrum Disorders

You just happened to find this on our website, right? J

And Mr. Kirby agrees to keep the story…only he didn’t. He forwarded the entire exchange to the EOHarm list.

—–Original Message—–
From: David Kirby [mailto:dkirby@…]
Sent: Wednesday, February 25, 2009 7:24 PM
To: ‘Peter Bell’
Subject: RE: NICHD Director Dr. Alexander Discusses the Need for More Research on Environmental Risk Factors for Autism Spectrum Disorders

I go there often, yes!

The piece will be up in minutes

NICE JOB!

dk

Oops. Again.

I don’t really know why Autism Speaks wants to keep their connection with David Kirby a secret. I mean, it’s pretty clear that AS has vaccines as their top priority (they didn’t mention anything else about the IACC’s strategic plan).

OK, I can see why Autism Speaks would want a bit of distance between themselves and David Kirby and Generation Rescue. It can’t help fundraising efforts, for one thing to be “just another anti-vaccine autism organization”.

But one more time: Oops!

Did you think that was it? More MMR bull arrives

25 Feb

The recent decision by the Special Masters in the Autism Omnibus case that MMR/thiomersal can’t cause autism according to evidence presented by HHS and lack of evidence presented by Master et al hit the mercury militia hard. They genuinely thought they were going to win.

But, of course, there was a ‘Plan B’ ready just in case. Today we see its co-ordinated unveiling. In part one, that scientific heavyweight Jenny McCarthy, together with her partner Jim Carrey released a press release:

Jenny McCarthy and Jim Carrey’s Los Angeles-based non-profit autism organization, today announced that the United States Government has once again conceded that vaccines cause autism…

Both the inference and the statement of fact are in error here. The United States Government has _never_ conceded that vaccines cause autism. I challenge McCarthy and Carrey to show the statement that contradicts me. Team McCarrey’s announcement today also fails to establish that the US government have conceded vaccines cause autism.

Of course, the historical reference is to Hannah Poling. As has been discussed numerous times, Hannah Poling’s autism has not been shown to have been caused by vaccines. I have asked various people, including David Kirby numerous times to provide back up to their belief the government have said vaccines caused ehr autism. They cannot. They have not. In point of fact, only three of Hannah Poling’s symptoms that were described by both HHS and a scientific case study co-authored by her father as those being caused by vaccines, tally with the DSM (IV) criteria for ASD.

The case of Hannah Poling is a red herring.

As we shall see, so is this ‘new’ case.

Team McCarrey go on:

The announcement comes on the heels of the *recently unsealed* court case of Bailey Banks vs. HHS

If by ‘recent’ one means July 2007 then they may have a point. But I don’t think ‘recent’ can really apply to a case which has had open access to it (Kathleen blogged about it in May 2008) for about a year and a half. So why lie? To add to the drama, whip up mystery and confusion of course.

But now we get to the meat of it – the actual ruling. In Part II of today’s coordinated attack, RFK Jr and David Kirby blogged about this case.

Kennedy jumps straight in:

…last week, the parents of yet another child with autism spectrum disorder (ASD) were awarded a lump sum of more than $810,000 (plus an estimated $30-40,000 per year for autism services and care) in compensation by the Court, which ruled that the measels-mumps-rubella (MMR) vaccine had caused acute brain damage that led to his autism spectrum disorder.

Whereas David is a tad more circumspect:

Is vaccine-induced ADEM (and similar disorders) a neurological gateway for a subset of children to go on and develop an ASD? That question will now become subject to debate…Special Master Abell had no trouble linking MMR to ADEM in Bailey Banks’ case. But linking his ADEM to PDD/ASD was more difficult.

So, lets rewind a little. Bailey was awarded a payment because he was found to have suffered vaccine induced damage. Cool. Thats the system working as it should – a child is damaged by a vaccine, they get compensated. What the MMR vaccine was established to have done in Bailey’s case was cause something called ADEM. What McCarthy, Carrey, Kennedy and David are now all claiming is that this ADEM resulted in an ASD diagnosis.

They rest their case on the conclusion of Special Master Abell:

The Court found that Bailey’s ADEM was both caused-in-fact and proximately caused by his vaccination. It is well-understood that the vaccination at issue can cause ADEM, and the Court found, based upon a full reading and hearing of the pertinent facts in this case, that it did actually cause the ADEM. Furthermore, Bailey’s ADEM was severe enough to cause lasting, residual damage, and retarded his developmental progress, which fits under the generalized heading of Pervasive Developmental Delay, or PDD. The Court found that Bailey would not have suffered this delay but for the administration of the MMR vaccine, and that this chain of causation was not too remote, but was rather a proximate sequence of cause and effect leading inexorably from vaccination to Pervasive Developmental Delay.

On the fact of it, it looks like they are right. But they aren’t.

Bailey has a diagnosis of PDD-NOS (Pervasive developmental disorder not otherwise specified) which is indeed a subtype of ASD.

However, whilst PDD-NOS is a subtype of ASD (alongside autism etc). ASD is in turn a subtype of PDD. As the National Dissemination Center for Children with Disabilities notes, the term PDD actually refers to a category of disorders and is not a diagnostic label. So when Abell refers to Bailey’s vaccine induced ADEM as leading to PDD he is not referring to ASD. He is referring to PDD. Not PDD-NOS, which _is_ a subtype of ASD but PDD, of which ASD itself is a subtype. Or, to quote Wikipedia:

PDD-NOS is often incorrectly referred to as simply “PDD.” The term PDD refers to the class of conditions to which autism belongs.

Abell made something of a worrying statement in his conclusion. I’ll quote from David Kirby:

Abell also chided MacDonald for his assertion that “all the medical literature is negative” in regards to an ADEM-PDD link. “However, soon thereafter, he corrected this statement by clarifying, ‘I can find no literature relating ADEM to autism or [PDD],'” Abell wrote. “It may be that Respondent’s research reveals a dearth of evidence linking ADEM to PDD, but that is not the same as positive proof that the two are unrelated, something Respondent was unable to produce. Therefore, the statement that ‘all the medical literature is negative’ is incorrect.”

Was any evidence that there _is_ a link between ADEM and PDD produced? I’ll have to read through more carefully. Its worrying that the SM is reduced to ‘chiding’ a witness for such a thing as a clarification of terms. Wasn’t he more worried that there was an extreme lack of evidence linking ADEM to PDD at all? Did Petitioners produce _any_ evidence that there was a link? A quick search of PubMed reveals nothing for ‘ADEM autism’ or ‘ADEM PDD’. I don’t want to second guess a Special Master but it does make me worried that maybe he simply didn’t get some of the science.

David also lists some of the symptoms of ADEM:

Symptoms usually appear within a few days to a couple of weeks. They include: headache, delirium, lethargy, seizures, stiff neck, fever, ataxia (incoordination), optic nerve damage, nausea, vomiting, weight loss, irritability and changes in mental status.

None of these say autism to me. I also did fine one ADEM paper in PubMed together with measles:

We report a seven year old male with measles associated acute disseminated encephalomyelitis (ADEM) despite having received measles vaccination in infancy. The diagnosis was based on serum antimeasles antibodies and MRI brain. The patient was managed with high dose corticosteroids along with supportive measures. There was a complete neurologically and physica recovery.

There was a complete mental and physical recovery. This doesn’t seem to indicate causation or autism.

In my opinion based on what I’ve read so far here we have a little boy who either already had or was on the cusp of PDD-NOS. He was also vaccine damaged resulting in ADEM….and thats where the link breaks down. It might be enough for 50% and a feather but the fact that PDD is not PDD-NOS, together with the total lack of any evidence I can see to link ADEM to PDD, let alone PDD-NOS speaks volumes.

One Click Hacks and Homophobes

22 Feb

As blogged by Anthony at Black Triangle the One Click Group – who say they are:

…a British-based international health advocacy pressure group and worldwide raw news hub…

described Brian Deer and his involvement with the MMR case thusly:

By all accounts a gay man and therefore unlikely ever to have to face the multiple vaccine risk agonised over by parents from around the world in relation to their children…

Nice. Sounds to me like they’re a bunch of homophobic stupidniks to me. As Anthony says:

Even if Deer is homosexual, it does not necessarily mean he has no stake in vaccine safety. Homosexuals are not some mysterious alien presence in our society, they have families which include small children. Homosexuals can even adopt children.

Unless you’re a Daily Mail reading OneClickTwit of course.

They are anti-vaxxers of course and really really don’t like Brain Deer much at all. This makes the JABS loonies recently in evidence in the monumental ‘Wakefield‘ post on this blog big, big fans of theirs naturally. Amusingly, these same JABS loonies have been complaining about the horror of Brian Deer _making_ the news and then _reporting_ on the news regarding Wakefield. Not that he has, but thats how they see it. The amusing thing is that one of the straplines of the OneClickGroup is:

We not only break the news, we also make it.

They also proudly boast of receiving ‘7,000 – 33,000 hits per day’…..woah…big time baby!

Just for fun, I ran LB/RB, JABS and OneClickGroup through the Compete analyser which analyses Unique Visitors (a much more reliable indicator of traffic than ‘hits’):

Sadly, you’ll notice only two lines there. OneClickGroup didn’t generate enough statistics to be measurable.

So, this member of the antivaxosphere, carried on from homophobic attacks on Brian to carrying an alleged ‘out of control’ attack from Brian on their owner/Director/whatever – one Jane Bryant. Here’s how its ‘reported’ on the OneClickGroup website:

Brian Deer Is Out Of Control

On Monday 7 April 2008, with the Defence presentation for Dr Andrew Wakefield at the General Medical Council MMR Vaccine Trial UK concluded, Brian Deer went berserk in the Press Room of the General Medical Council. This incredible aggressive behaviour is not that of a responsible and objective journalist with ethics covering a story in the public interest….I entered the GMC Press Room to discover Deer holding court over what he clearly perceived to be his case with the assembled media. Comfortably sprawled in lounging lizard position

Out of control…went berserk…incredible aggressive…holding court…lounging lizard…

and these descriptives are used before Bryant even _begins_ her description of Brian’s behaviour. Thank goodness for impartial media!

When she does get to that transcript (which has clearly been edited) it reveals _more_ editorialising and less fact.

When asked if Deer was the complainant and if this was his case with the GMC, Deer simply exploded. Springing to his feet, placing his body inches from mine and invading my space, Deer proceeded to threaten, to rant and to jab his fingers close to my face.

Brian Deer: “No! I’ve not complained! I’ve got letters from the GMC saying I’m not the complainant! Ask me the question again! Ask me and I’ll tell you!”

Deer continued ranting: “So, you’ve this, um, dribbling idiot here,” gesturing towards investigative writer Martin J Walker who has exposed Deer’s vaccine activities in the aforementioned Complainant, “pumping out this information and you believe it and this is what this whole MMR thing has been about! Andrew Wakefield enjoys giving evidence! You get these CLOWNS who just MAKE THNGS UP as they go along!”

I wondered if any other members of the press ( the ones Brian Deer was holding court over) had reported on this behaviour from Brian. That of threats, invasion of body space and jabbing his fingers close to Bryant’s face. Funnily enough, the answer is ‘no’ – nobody from the other members of the press Brian was apparently ‘holding court’ over when Bryant arrived noticed this. I can find no record of this behaviour in any mainstream media. And there were plenty there. How odd.

Its also worth noting that Brian was right. He is _not_ the complainant and he _does_ have letters from the GMC to establish that fact.

Next in Bryant’s highly selective account was the issue of who was paying Brian. At the end of which despite not mentioning any intimidation she reports:

At this point, people in the foyer piled in to the doorway of the Press Room to witness a fully grown male journalist attempting to intimidate a press colleague and deploying classic bully boy techniques against a very small woman on her own.

What bully boy techniques exactly? Answering her questions? Or is this more of the finger jabbing and space invasion that only Bryant witnessed and reported on? Lets not forget that Bryant also directly accused Brian of threats (‘Deer proceeded to threaten’) – no sign of a threat so far…lets continue.

Jane Bryant: “Why are you being so abusive?”

Brian Deer: “Of who?”

Jane Bryant: “Of the parents, of the children…”

Brian Deer: “What parents have I been abusive to?”

Jane Bryant: “You have just been abusive to me.”

Brian Deer: “Are you a parent?”

Jane Bryant: “Yes, I am a parent, I’m also press. Why are you being so abusive? Get away from me, Brian! Stay away from me.”

With Brian Deer out of control, Editor Polly Tommey of The Autism File showed support.

Polly Tommey: “Stay away from her Brian, keep away. Look, you’re a journalist, give her some space.”

Is Bryant parent to an autistic child? I can’t find anywhere that says she is.

Anyway, notice how Tommey of the antivax magazine ‘The Autism File’ also chimes in. These two poor cowering ladies who are in terror of a man answering their questions. I’ll say it again. I can find nowhere else that reports on the eminently newsworthy story of two women being threatened by an out of control Brian Deer – other than OneClickGroup itself. In a room full of the media no one takes notes, no one turns on their dictaphones and no one turns on their cameras. The _only people_ who capture this threatening, out of control Brian Deer are a couple of anti-vaxxers. What an amazing coincidence.

At this point in the proceeding, Brain Deer calls for security. He has to call them again later that day.

Later on in her piece, Bryant accuses Brain Deer of damaging the equipment of Polly Tommey.

Interestingly, the only person’s equipment that got damaged that day was that of Polly Tommey, Editor of The Autism File. Having left her belongings in the Press Room whilst she went to conduct an interview in the foyer, two of the recordings destined for Autism One Radio were purposefully deleted by someone. I will leave One Click readers to surmise just who the perpetrator might be, who had the access and the motive.

She also says:

The GMC has now categorically on the record refused to deny Brian Deer’s complainant status. They will simply not comment on Deer. So much for Deer’s GMC back up

Which, as we know is simply incorrect. I look forward to Bryant’s correction on her massively popular website.

If you want to see the depths and lengths that St Andy’s fan Club will stoop to, look no further than this. The word of a homophobic woman who seems to mislead people about her status as parent to an autistic person (assuming I’m right about that) and who wants to paint a man as an out of control tyrant when I suspect he was just a bit pissed off.

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Another misinterpreted study. This time they are misusing Israel data

22 Feb

Kent Heckenlively from the Age of Autism blog has recent post up on a study out of Israel on autism. In it, he notes that the “incidence” of autism in Israel actually dropped for a few years

What’s curious, though, is how this population of medical professionals who were supposedly good at identifying and diagnosing autism in 1999, then had a drop of more than 40% by 2002. Did they lose their newly-acquired skills in a sophomore slump? If I’m not mistaken, those were also the years of the vaccine-autism “panic” which began shortly after the publication of Dr. Andrew Wakefield’s article in the Lancet, linking the MMR shot and autism. Was there a drop in vaccination rates in Israel after the Wakefield publication? Did vaccination rates then subsequently go up in later years?

Here’s the figure.

Figure 1 from Israel Autism Paper

Figure 1 from Israel Autism Paper

Let’s do this quickly. The interpretation is nonsense. Start from the fact that Google Ph.D.’s seem to rarely check simple facts using google.

Enter “Israel Vaccine Schedule” into google. The top link is a WHO site.

Take a look at how the MCV (Measles Containing Vaccine) coverage has varied with time.

MCV uptake was increasing steadily up until 2003, when it dropped for two years.

Year MCV Uptake Measles cases
1998 97% 8 (Year of Wakefield paper)
1999 97% 14
2000 97% 36 (year “incidence” starts to drop in Israel
2001 96% 19
2002 98% 2
2003 95% 124
2004 84% 116 (year MCV uptake drops)
2005 96% 2
2006 96% 9
2007 96% 539 (measles spike)

Obviously the drop in autism “incidence” in Israel isn’t related to measles vaccines–the drop in uptake happened after the drop in autism “incidence”. Note that I put “incidence” in quotes. The paper isn’t measuring incidence. I’ll get to that later.

In 2007, something else happened. Measles cases spiked. Yep, 3 years after vaccination rates dropped, there’s a big spike in measles. Are they connected? Possibly. I would want to see information like how many of the 539 measles cases were children 4-5 years old, for example.

Other issues with the paper.

1) they don’t give “incidence” or “prevalence”, really. They are giving the number of people who are getting services for autism. Sorta like the California DDS data. Why is this important? We don’t know how easy it is to qualify for services. We also don’t know how hard they are looking for people with autism. It isn’t the same thing as a measure of all the people with autism.

2) Note that 97.5% of the people with autism are Jewish. About 25% of the population in Israel is non Jewish (if Wikipedia is accurate). So, is being Jewish a “risk factor”, or is there an issue with access to services.

3) According to Mr. Heckenlively, the prevalence of Autism in Israel is 1 in 2,400. I guess low prevalence numbers invalidate studies when they are in Denmark, but not when they are in Israel?

By the way, consider that low “incidence” value for Israel. Now look at their vaccine schedule (I am only listing those for very young children)

DTaPHibIPV: 2,4,6,12 months
HepA: 18, 24 months
HepB: Birth, 1, 6 months
MMR: 1 year, 6 years

Hmmm. Remember how Israel has a low autism “incidence”?

Look at that first big combo vaccine–5 vaccines at once. I guess combo vaccines don’t cause autism, eh?

HepB is given at birth. I guess that isn’t a risk factor either, eh?

Separating out the combo vaccines, I count 28 different vaccines given by 24 months in that vaccine schedule. So much for “too much, too soon”, eh?

Of course, this is stretching the Israel data waaaay too far. Of course we can’t say that the Israel data prove that HepB, combo vaccines and too-many-too-soon are not risk factors. Just like we can’t use these data to support Dr. Wakefield’s hypotheses.

I’m glad to see autism studies come out of new countries. Let’s not use data with big limitations to support our preconceived ideas, shall we?

(note, I made corrections shortly after publishing. These did not change the content substantially. I did change the title to clarify that it is not the Israeli researchers who are misinterpreting the data)

Who carries the authority?

19 Feb

The recent Omnibus decisions are hoped by some to stem the tide of rabid anti-vaccine beliefs espoused by people who shame the name of autism advocacy. On Salon, Rahul K. Parikh says:

In the case of autism, science and reason have too often failed to reach people. And consequently they have turned to the courts. For those of us who believe in the scientific method, the autism trials have not been necessary. But judges, unlike doctors in their cold white coats, still command a great deal of respect, and so perhaps the court’s recent ruling will sink in and finally persuade parents to regain their confidence in vaccines.

Never happen Rahul, never happen. These same anti-vaxxers have already began spin campaigns not only against the legality of the verdicts but against the three Special Masters themselves. To this group, the Special Masters command no respect whatsoever and neither do their verdicts. Take this piece of rampant stupidity from Barbara Loe Fisher:

The U.S. Court of Claims special masters are hampered from considering evidence which has not yet been published in the medical literature regarding potential associations between vaccines and the development of regressive autism

I don’t see how it is possible to make a dumber statement. What she’s saying is she wanted the Special Masters to look at unpublished science. As is well known, unpublished science is not like an unpublished novel. Unpublished science means its science that has not been put through the rigour of peer review, not had its methods examined to ensure they are transparent and reproducable, not had its conclusions reviewd to see iof they are accurate and not had its data examined to see if it is usable. This unreviewed, unpublished ‘science’ is what got us to this stage in the first place. A ten year multi-million pound, dollar and euro effort to close down bad science.

So how does she and people like her get away with saying such things? *Just because they can* . Because people believe extremes and people believe celebrities. People believe bloggers and people believe those who have shared (or think they have) experiences. I’m not saying its right but its true. If anyone genuinely believes this ruling will shut the door on these people they’re wrong. For confirmation of that you need look no further than Rolf Hazlehurt, father of one of the kids who made up the three test cases from the Autism Omnibus.

If we win, we keep going.
If we lose, we keep going.
If we win, the going will be easier.
If we lose, the going will be more difficult.
However, the Court rules, we will keep going.

You have to understand. This is not about scientific truth – or even truth at all – to these people. Its about winning and its about pushing their antivaccine beliefs as fast and far as they can. Even as they claim to not be anti-vaccine they write emails to others clearly showing they are. One of these emails will come to light very soon I believe. Expect to see very familiar names on it.

To these people science has no authority. Doctors have no authority. The Special Masters have no authority. The only people who have authority – real authority – can probably be counted on the fingers of one hand. David Kirby. Jenny McCarthy. Maybe Dan Olmsted. If one of these people were to bow to the obvious and say so publicly then we might have a very different scenario. But they won’t. They have too much invested in esposuing the anti-vaccine line.

Mainstream media have a lot to apologise for also. The red tops, the broadsheets and all those hundreds of little bitty TV channels all over the US that gave the anti-vaxxers airtime in the name of impartiality and allowed them to scare away facts and reason, they need to reverse that policy.

But more than that, scientists and doctors need to get online and blog, get on Twitter and use them. Talk to people in their own language. Screw decorum. Ask people who’ve been using their blogs to support vaccines for _years_ what to do and how to do it. People like Oracand Ben Goldacre are prime examples.

This needs to happen because we’ve already lost one generation of kids to their loony parents. The loony parents who only recognise the authority of celebs, authors and each other in nests of email lists and blogs. If we want to give up another generation to the reach of the internet then keep on keeping on and hope that Rahul K. Parikh is right. But he’s not.

Give your ego a rest

17 Feb

hu·bris (hy??’br?s)
n. Overbearing pride or presumption; arrogance.

Since the first set of Omnibus decisions have come in we’ve seen demonstration after demonstration of the personal hubris of one person after another from the antivaxosphere. This is not unusual from that camp of course. Who can forget Mark Blaxill’s self-aggrandising pontificationon AoA regarding blogs that don’t agree with him:

Let serious people do serious work.

The implication being of course that what AoA do is ‘serious work’ and the people it calls scientists are ‘serious scientists’.

Trouble is, as has recently been made absolutely crystal clear, the sort of person Mark Blaxill likes to refer to as serious of are _not_ serious scientists at all.

Sadly, the petitioners in this litigation have been the victims of bad science, conducted to support litigation rather than to advance medical and scientific understanding of ASD

…..

After careful consideration of all of the evidence, it was abundantly clear that petitioners’ theories of causation were speculative and unpersuasive

….

[they have]…been misled by physicians who are guilty, in my view, of gross medical misjudgment.

Just in case anyone is in any doubt, those judgements are referring to the people who formulated the ‘science’, practised ‘medicine’ on children and who stood as ‘experts’ in its defence during the Omnibus hearings.

On AoA since the decisions were made the spin has been so furious I’m surprised the planet has orbit has changed direction. Over there I’ve read:

1) ….They really believe that we are a bunch of anti-science, creationist, non-global-warming believing, tin foil hat wearers. Really. It’s just so surprising and disappointing to me that the same people who are so willing to “fight the power” on the political front have absolutely no concept of where the recent science is….

2) …this ruling couldnt be more transparent, its not about the topic or the science, but the word play….

3) ….I’m actually rather appalled at the Special Masters summation of the expert testimony, and the fact that they actually stated the respondents “were better and more qualified” (defamation?)….

4) …While large scale studies have not shown a link between vaccines and autism, there are lingering legitimate questions about the safety of vaccines that must be addressed… (Autism Speaks statement)

5)…I have to think that the reason it took nineteen months for a verdict is that the decision was difficult to conclude. The burden of scientific proof in vaccine court is “more likely than not” that the vaccine caused the child harm. These Special Masters must have wrestled with their verdicts….(TACA statement)

There are so many other examples that I would be here for a long time putting them all down. The JABS loonies attacks on Brian Deer whilst refusing to tackle the content of what he says, Kent Heckenlively’s petulant ranting about the decisions following his gloating predictions on AoA that victory was assured, Melanie Phillips statement that the Omnibus decisions looked ‘pretty thin’ to her – as if she had the intelligence or familiarity with the subject matter to offer a legitimate opinion – I could go on and on.

Here’s the bottom line. The people you rely on for science are not scientists. The people you rely on for medical treatment are cranks. The big organisations you think represent you are useless. A lot of you are individually egotistical fools so convinced you are right that you will twist and spin anything. I have read accusations of conspiracy, comparisons to Hitler and Nazi’s generally – all the usual crap that the antivaxosphere reel out when their bottom lip starts trembling after reality has just kicked their collective arse. I sincerely hope the Special Masters have taken steps to protect themselves and their families.

And heres another thing. All the antivax groups who released statements ‘acknowledged’ the three families. As well they should. These three families were their lab rats. But lets not beat around the bush. These families are going to be pretty much bankrupt as a result of being their labrats.

I’ve estimated that the collective spend of some antivax orgs, based on registered accounts for 2004/05/06 is over US$2M. I’m not sure what exactly thats gone on but I have a suggestion for where the next two mil could go – the Cedillo’s, Snyder’s and Hazlehursts who bankrupted themselves in the name of…well…nothing…

And here’s the last thing for now…I’m fucking furious. Really, really angry. £16M in the UK has been spent defending the MMR/autism shit. Christ knows how much the Omnibus proceedings are costing. For shit science, from shit scientists. For ‘results’ that people have been saying for _years_ are rubbish and mean nothing. You people are actively holding back autism science.

You’ve been proved wrong. Now shut up and get the fuck out the way.

What you talking about, Safe-Minds?

13 Feb

And the spin continues on the Omnibus decisions. Anyone surprised?

This time, Safe-Minds has chimed in on the Omnibus decisions with:

Federal Vaccine Court Rules Against Autism Families: Government’s Refusal to Fund Sound Science Stacks Deck Against Vaccine-Injured Children.
One more reason to distrust the government’s vaccine program, says SafeMinds

The main theme is a rather contradictory one:

The denial of reasonable compensation to families was based on inadequate vaccine safety science available to the court.

How many times have we all heard from groups like SafeMinds that the science is very conclusive?

If the science is inadequate, why are groups such as SafeMinds and Generation Rescue recommending chelation as a therapy for autism?

As a friend of mine used to say to other drivers while driving down the highway, “Pick a lane, buddy”. Either you got the science or you don’t. Seems like you don’t.

SafeMinds perseverates on the IACC. I do to, so I can’t blame them for that. I can blame them for misrepresenting what happens in IACC meetings:

Last month, the government-dominated Interagency Autism Coordinating Committee blocked critical vaccine-autism research studies from moving forward even though they had been requested by their own scientific advisors and autism advocates.

Uh, one of the BIG problems with the proposed vaccine research was precisely the fact that they were not recommended by the scientific advisory subcommittees. Nice spin, though.

and, again on the IACC, SafeMinds states:

The director of the NIH institute in charge of autism studies, Dr. Tom Insel, has admitted that HHS has a conflict of interest preventing NIH from allowing autism-vaccine science due to the court cases.

Uh, no. He raised the question of whether there is a conflict of interest. He didn’t “admit” to any conflict of interest.

I am actually getting very tired of this claim made about the vaccine court:

Many of these cases were quietly settled by the government so the public is not aware of them.

Sounds oh so conspiratorial.

Of course the government is quiet in the decisions. Quiet in they don’t advertise or call press conferences. What they do is put them on a public website. That is appropriate.

Is it the government’s fault that the vaccine-autism “advocates” never checked? Seriously, you are working on cases costing many millions of dollars and no no seems to have gone through the previous cases searching for the word “autism”?

Is it the government’s fault that the lawyers who worked on the previous cases involving autistics who were injured by vaccines weren’t savvy enough to think of communicating that fact to the Omnibus lawyers? C’mon, at least one of them is working on the Omnibus proceeding!

SafeMinds, you and your sister organizations found out about the other cases from Kathleen Seidel! That’s who is doing your homework.

Even leading vaccine proponents have accused the CDC of carrying out safety research “on the cheap,” and two major systematic reviews of vaccine research by the world renowned Cochrane Collaboration have found studies to be of “poor quality” and “inadequate.”

Who are these “leading vaccine proponents”? And, how many “leading vaccine proponents” think that a lot of time and money is spent on vaccine safety research?

That last sentence is why “..and the whole truth” is included in swearing in witnesses. How many studies did they find to be “poor quality”. The way it is phrased, SafeMinds is trying to make it seem like all the research is substandard. Ironic given that SafeMinds still has the Hornig mouse study on its website with no mention of the MIND study that refuted it.

That said, the Special Masters who wrote the decisions for the Omnibus hearings made it very clear that they had good evidence, good studies to work from.

Here’s a comment that goes to the heart of the future problems:

“The government must fund an extensive vaccine safety program, including studies of the health outcomes of vaccinated and unvaccinated groups,” stated Sallie Bernard, executive director of SafeMinds. “Trust in immunization will continue to deteriorate without the perception of a fair hearing. It is time for a neutral agency to oversee vaccine safety.”

Ms. Bernard: this was a fair hearing. The petitioners were given many years of extra time to get the research that they needed. Much research was done on vaccine safety in regards to autism in that time, and it only helped the defendents.

Also, trust in vaccinations may continue to deteriorate because of the publicity campaigns you and your sister organizations are putting on. Own the responsibility for your own actions.

What you talking about, TACA?

13 Feb

TACA have issued a statement on the Omnibus decisions. We’ve already discussed some of this, but there is something in the TACA statment that is sooo bad that it needs to be pointed out.

TACA states

The VICP was set up for individuals that suffered an “on the table” vaccine injury. That is, an injury that happened within minutes or hours after receiving a vaccine.

What?

But, more importantly…What?

An injury has to be suffered “on the table”? That’s what they think a “table injury” is?

Once again….What?!?

You’d expect TACA to understand that better than I, since I am not involved in the litigation. Sadly, this is not true.

A “Table Injury” is described thus:

The Vaccine Injury Table (Table) makes it easier for some people to get compensation. The Table lists and explains injuries/conditions that are presumed to be caused by vaccines. It also lists time periods in which the first symptom of these injuries/conditions must occur after receiving the vaccine. If the first symptom of these injuries/conditions occurs within the listed time periods, it is presumed that the vaccine was the cause of the injury or condition unless another cause is found. For example, if you received the tetanus vaccines and had a severe allergic reaction (anaphylaxis) within 4 hours after receiving the vaccine, then it is presumed that the tetanus vaccine caused the injury if no other cause is found.

Granted, the definition of “table” in this case is not the most common. It is, in fact, #8 or #9 on the list:

an arrangement of words, numbers, or signs, or combinations of them, as in parallel columns, to exhibit a set of facts or relations in a definite, compact, and comprehensive form; a synopsis or scheme.

So, that was a bit of an “oops” from our good friends at TACA.

Just to be more precise, the VICP was not built just around “table” injuries. Instead, anyone who has read the decisions will be able to tell you that much time is spent deciding cases of possible non-table injuries.

There are more errors in the TACA statement. But, the main one we have already discussed–the fact that the court was very decisive in what they wrote.

Omnibus: the decisions are decisive

13 Feb

The first autism omnibus proceeding decisions are in: MMR does not cause autism, either alone or in conjunction with thimerosal.

Having said that, I can imagine that some of my readers are already accusing me of spinning the conclusions. That’s because the spin has already been put forth that the decisions are weak on the idea of general causation. Another theme is that the decisions only pertain to the test case families. But, as we will see, those ideas are the spin.

Here is a section from the From Autism Speaks statement on the Omnibus:

Today the National Vaccine Injury Compensation Program ruled that the combination MMR vaccine — with and without the preservative thimerosal — did not contribute to three particular children’s autism.

Why did they chose to say “…three particular children’s autism” when they know full well that the point of using “test cases” is to discuss general causation?

TACA is less subtle:

The fact that it took this long for these three decisions has to mean that the vaccine injury evidence had some merit. Poor evidence would have produced a negative decision very quickly.

The fact that they took a long time to decide indicates a tough decision? Either they didn’t read the actual decisions or they are deliberately trying to muddy the waters. Seriously. The comments in the decisions are so clear, so decisive, that one just can not make the TACA statement in good conscious.

Take a look at what the special masters actually said. Granted, there are hundreds of pages of decisions and I am picking a few paragraphs out, but I think you will agree–the statements are very (very!) clear. The decisions were not close. It was not a struggle for the special masters to come to these conclusions.

From the conclusion of the Cedillo case by Special Master Hastings:

This case, however, is not a close case. The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories. The result of this case would be the same even if I totally ignored the epidemiologic evidence, declined to consider the video evidence, and/or excluded the testimony of Dr. Bustin. The result would be the same if I restricted my consideration to the evidence originally filed into the record of this Cedillo case, disregarding the general causation evidence from the Hazlehurst and Snyder cases. The petitioners’ evidence has been unpersuasive on many different points, concerning virtually all aspects of their causation theories, each such deficiency having been discussed in detail above. The petitioners have failed to persuade me that there is validity to any of their general causation arguments, and have also failed to persuade me that there is any substantial likelihood that Michelle’s MMR vaccination contributed in any way to the causation of any of Michelle’s own disorders.

emphasis in the original.

Take a couple of lines out, shall we? Starting with, “…not a close case”. He even emphasized it with italics.

“The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories. ”

and

” The petitioners’ evidence has been unpersuasive on many different points, concerning virtually all aspects of their causation theories, each such deficiency having been discussed in detail above. ”

This is a clear and decisive decision, not doubts about it.

From another section of the decision, this one entitled Summary concerning general causation issue

For all the reasons stated above, I conclude that the petitioners have failed completely to demonstrate that it is “more probable than not” that the MMR vaccination can be a substantial factor in contributing to the causation of autism, in individuals suffering from regressive autism or any other type of autism. To the contrary, the evidence that I have reviewed makes it appear extremely unlikely that the MMR vaccine can contribute to the causation of autism. It is clear that the causation theories themselves are weak, not just the case in specific for Miss Cedillo.

I expect fragments like “extremely unlikely” to be taken out of context.

An entire section of the decision (page 34) is titled, “I have found above that petitioners general causation theory concerning immune damage is without merit.”

As to part (1) of petitioners’ three-step theory (see previous paragraph), I have already explained in detail, at pp. 22-34 of this Decision, why I have found no merit in the petitioners’ theory that thimerosal-containing vaccines in general can damage infant immune systems.

Doesn’t bode well for the next three Omnibus test cases, does it? The second three focus on thimerosal alone.

Back to MMR, there are two more decisions. From the concluding paragraph to the Hazlehurst decision, by SM Campbell-Smith,

Having carefully and fully considered the evidence, the undersigned concludes that the combination of the thimerosal-containing vaccines and the MMR vaccine are not causal factors in the development of autism and therefore, could not have contributed to the development of Yates’ autism.

Again, for emphasis, let’s pull a phrase out: “the undersigned concludes that the combination of the thimerosal-containing vaccines and the MMR vaccine are not causal factors in the development of autism”

From the Snyder case,

To conclude that Colten’s condition was the result of his MMR vaccine, an objective observer would have to emulate Lewis Carroll’s White Queen and be able to believe six impossible (or, at least, highly improbable) things before breakfast. The families of children with ASD and the court have waited in vain for adequate evidence to support the autism-MMR hypothesis.

Pretty strong words, but I can see some people saying that there is the indication that it is just “highly improbably” raised to the sixth power. “Highly improbably^6 is not zero!” we will hear.

From another section, specifically addressing the general causation question:

However, the problems with the case presented by petitioners for general causation are overwhelming. The quality of the petitioners’ experts paled in comparison to the world-class experts proffered by respondent. The theories petitioners’ experts advanced lacked support in both logic and research. As Dr. Ward testified, an hypothesis has a life span. An hypothesis may be biologically plausible at the time it is first advanced. As evidence accumulates, the hypothesis may be strengthened or weakened. The MMR hypothesis may have appeared biologically plausible at its inception, but the accumulating body of scientific evidence has tipped the scales decisively against it. Snyder Tr. at 975. The weight of the scientific evidence is that the measles vaccine virus plays no role in the pathogenesis or triggering of autism. I thus conclude that petitioners have failed to demonstrate that the MMR vaccine can cause autism, even in the highly circumscribed subset of children with regressive ASD and gastrointestinal symptoms.

Again, for emphasis, here is a line pulled from the above “The weight of the scientific evidence is that the measles vaccine virus plays no role in the pathogenesis or triggering of autism”

It will be frustrating to watch the spin continue. I expect to hear “The decisions weren’t really that decisive” for some time to come.

But, the fact of the matter is that these decisions are clear and, well, decisive.

This is not just a statement about the spin-factor, by the way. The vaccine lawyers have just done millions of dollars worth of groundwork for their appeal and later civil cases on the taxpayer’s dollar. The fact that the Court of Federal Claims has issued such incredibly strong decisions makes it much more difficult for those cases, especially the civil cases, to actually go to trial.

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