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Autism vs features of autism

14 Mar

In sum, DVIC has concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder.

– HHS

If one has the right set of “features” of autism, one has autism……Hannah Poling has autism — as defined in every book, in every library, in every university in the world. Dr. Parikh’s insistence otherwise is perplexing.

– David Kirby, to EoH group in response to Dr. Parikh’s article in Salon.

Its a massively ambiguous point. Do ‘features of autism’ equate to a _diagnosis_ of autism? David Kirby and some commenter’s to this site say ‘yes’. I personally think ‘no’.

But I think we need to be clear here. In this particular case, Hannah Poling can still be autistic but the HHS are arguing (in my opinion) that the features listed as those being aggravated/caused by vaccines do not add up to enough by themselves to give a diagnosis of autism.

To illustrate this idea, I went through the symptoms given by Dr Zimmerman that he put forward as being vaccine aggravated in a previous post (green = hit with DSM (IV), red = miss):

1) Loss of previously acquired language
2) Eye Contact
3) Relatedness
4) disruption in CHILD’s sleep patterns,
5) Persistent screaming
6) Arching
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination

So, three of the symptoms given by Dr Zimmerman as being vaccine aggravated can be matched with the DSM (IV). This is way below what is needed for a diagnosis of autism.

But, we cannot discount the idea that she _could be_ autistic. To me, it seems likely that here is an autistic child who has her vaccines and who presents with nine symptoms following those vaccines, three of which tally with DSM (IV) criteria.

This presents two questions. First, is there a difference made by autism diagnosticians about autistic features vs a diagnosis of autism?

The best way to answer this is to ask autism diagnosticians. I wrote to some autism diagnosticians. They asked to remain anonymous, which I have to respect. The email I sent in essence asked them if they thought that:

a) ‘with features of autism spectrum disorder’ is directly equivalent to a diagnosis of autism?
b) ‘with features of autism spectrum disorder’ means that some elements of the DSM (IV) are present but not enough to diagnose autism?
c) ‘with features of autism spectrum disorder’ means that some elements of the DSM (IV) are present but not enough to diagnose ASD?
d) ‘with features of autism spectrum disorder’ means something else entirely?

The responses I got back stated that b) was most likely, maybe c) .

So according to these autism diagnosticians, some elements of the DSM (IV) are present but not enough to diagnose autism, or possibly ASD. This tallies with my own personal opinion.

The second question is; did Hannah Poling present with any diagnosable symptoms of autism _before_ her vaccines? Sadly, it seems we will never accurately know the answer to this question. The Poling’s will say no of course. David Kirby et al will say no of course.

I will remember the Cedillo’s however, who testified that their daughter (who they claimed was made autistic by vaccines) showed no symptoms of autism before her vaccines were administered. However, when home movies of their daughter taken before her vaccines were shown to several diagnosticians, they testified that she was indeed exhibiting symptoms of autism prior to vaccine administration. The Cedillo’s didn’t lie. Its simply not possible to remain clinically objective about one’s own child. Even for an employee of Johns Hopkins, it is not possible to remain objective about one’s own child.

That doesn’t mean Hannah Poling _did_ exhibit symptoms of autism prior to vaccines of course. It simply means that we need to be skeptical of the claim that she didn’t.

Is Hannah Poling autistic? Could be. Seems likely.

Did the vaccines cause the nine symptoms Dr Zimmerman found? HHS ‘concede’ they did.

Do the fact that three of those nine symptoms tally with the DSM (IV) mean that the vaccines are the cause of her autism? No, thats not logical.

Vaccines, Autism and the Concession

1 Mar

1) Concession Report (This document has been removed due to the possibility of it being illegally obtained). If people really wish to read the document for themselves it can be founf here, at the Huffington post
2) Zimmerman Case Study

When David Kirby wrote his piece in the Huffington Post, I’ll admit I read it with my jaw on my chest. Here was evidence I was wrong. I emailed David Kirby to get the whole report from him and he was kind enough to provide not only a PDF version but a plain text version as well.

This enabled me to contact a few people that I know are medical people and/or scientists and/or closely connected to this case. For example I contacted Dr Zimmerman and learned that it was not possible for him to offer any sort of opinion on this case due to the fact that his patients parents had not allowed him to discuss his thoughts and opinions with anyone except the court. I was told however that ‘the comments on your site with questions raised and loopholes pointed out about the way others are interpreting the facts of the situation, are right on track.’

It is clear to me then that there is some wordsmithing going on – either deliberately or unintentionally. What we need to do is look closely at the wording of two documents. The concession report and the case study performed by Dr Zimmerman.

The claim by David Kirby et al is, in essence, that the US Government have conceded that vaccines cause autism in this one case. Lets look at the so-called concession report in relation to what it says about autism.

Dr. Andrew Zimmerman, a pediatric neurologist, evaluated CHILD……on February 8, 2001. Dr. Zimmerman reported that after CHILD’s immunizations of July 19, 2000, an “encephalopathy progressed to persistent loss of previously acquired language, eye contact, and relatedness.” He noted a disruption in CHILD’s sleep patterns, persistent screaming and arching, the development of pica to foreign objects, and loose stools. Id. Dr. Zimmerman observed that CHILD watched the fluorescent lights repeatedly during the examination and would not make eye contact. He diagnosed CHILD with “regressive encephalopathy with features consistent with an autistic spectrum disorder, following normal development.”

Features consistent with. He did not diagnose her with autism. What were these features?

1) encephalopathy progressed to persistent loss of previously acquired language,
2) eye contact,
3) relatedness
4) disruption in CHILD’s sleep patterns,
5) persistent screaming
6) arching,
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination
10) would not make eye contact

Of these ten, one is repeated (eye contact issues) so I make nine clear separate symptoms there. Which of these appear in the DSM (IV)? Green equal matches, red equal misses.

1) Loss of previously acquired language
2) Eye Contact
3) Relatedness
4) disruption in CHILD’s sleep patterns,
5) Persistent screaming
6) Arching
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination

To meet the DSM(IV) criteria a person must meet no less than 6 of the criteria. So, as described perfectly exactly by the Dr Zimmerman in the concession report, this child has features consistent with an ASD. But its clear she does not meet the criteria for autism.

Later on,

CHILD was evaluated by Alice Kau and Kelley Duff, on May 16, 2001, at CARDS. The clinicians concluded that CHILD was developmentally delayed and demonstrated features of autistic disorder.

Almost the exact same phrasing. Consistent with. But no one has said thus far that the child has been diagnosed with an ASD.

The concession report concludes with:

the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder….

This is the phrasing that caused the uproar. But when looked at in light of the previous, it is clear that far from suggesting that vaccines cause autism via a mitochondrial disorder, the vaccines worsened an occluded or underlying mitochondrial disorder which took on a few of the symptoms of autism _but was never actually diagnosed as autism at all_ . Because it wasn’t autism.

Before we switch to Dr Zimmerman’s Case Study, lets clear up a few things.

No one, I repeat, no one is saying this child wasn’t autistic. She may well have been. What we are doing is looking at the science reported in the concession report and Zimmerman’s paper and seeing if what the _science_ says in these two papers means that it was the vaccines that caused any autism. The concession report clearly says that no it wasn’t. Thats why this case was uncontested. She was affected by her vaccines but autism was not the result.

Zimmerman’s case study is entitled ‘Developmental Regression and Mitochondrial Dysfunction in a Child With Autism’ – this is further evidence against the case presented that it was the vaccines that caused the autism. This child is reported as being one with autism. Not one who develops autism as a result of vaccines.

However, it is clear that this child _does_ develop autism:

We describe a female patient in whom developmental regression and autism followed normal development…..Evaluation at 23 months showed …..[t]he Childhood Autism Rating Scale (CARS) score was 33 (mild autism range), and she also met Diagnostic and Statistical Manual for
Mental Disorders-IV criteria for autism

and yet this autism was so mild that at that exact same period (23 months):

the patient began speaking again at 23 months old

which means that expressive language was lost for a sum total of one month (it is reported being lost at 22 months). It should also be noted that CARS is _not_ designed for diagnosis but is an indicator only. Overall, we get a picture of a child who had an underlying mitochondrial dysfunction exposed by the illnesses following her vaccinations which caused developmental regression. This developmental regression presented with some features of autism.

Did the vaccinations cause her developmental regression? Seems likely. It is an undisputed fact that vaccines do cause injury, that is why after all there is a compensation program to claim from in the US and the UK.

Was her developmental regression autism? No. At no point in either the concession report is it claimed that the developmental regression the child went through _was_ autism. However, in the same way that Leukemia (weakness, paleness; fever and flu-like symptoms) can have the same symptoms as flu (weakness, paleness; fever and flu-like symptoms) but be totally different, this child’s developmental regression shared certain features of autism.

So was this child autistic. She might well have been. However, her autism was not caused by a vaccine.

Update

This column was forwarded to me by a friend. Thanks to him.

The practice of calling certain things near-autism, or even autism itself is not new. Here’s a quote from a Science article regarding HIV in 1989:

The signs of AIDS dementia in children are clear and, Pizzo says, “very painful to watch. Very young children lose words.” Words like “mommy” and “daddy” and “bear” are too hard to remember as the AIDS virus multiplies in the young child’s body and penetrates the central nervous
system.

An 8-year-old boy, once normal, was rendered practically autistic by HIV, Pizzo said. He stopped speaking. Asked to trace a simple
outline of an elephant, the boy could not. Painfully, he knew what a simple task it was, and he knew he was failing it. But he could not cry even though his doctors could see tears welling up in his eyes.

Pizzo has seen children lose IQ points one boy lost as many as 28-as AIDS ravages their brains. “Kids who used to do well in school really deteriorate,” says Pizzo who has “before and after” IQ data from school-age children.

But in a series of remarkable studies, Pizzo has seen AZT (azidothymidine) reverse these symptoms. The child who lost words like “mommy” and “daddy” “got them back,” Pizzo says. The boy who lost IQ points is restored to his former capacity.

The 8 year old cries. After just a couple of weeks of continuous AZT therapy, the boy who could not trace an elephant is successful at tracing a horse.

Now, we all know that ‘tracing an elephant’ and losing IQ points are not symptoms of autism but it is intriguing to see a doctor describe a regression as ‘practically autistic’. Note also, just like in this case, in Zimmermans case study, the child quickly loses, then very quickly regains aspects of their former regression. But HIV didn’t cause autism any more than vaccines did.

US government concededs vaccine/autism case

26 Feb

As per this story from David Kirby in the HuffPo.

I have some doubts about it but lets see. I’ve emailed David Kirby to ask him to provide me with a full copy of the concession. His willingness to provide this information as well as the information itself should tell us more about what this concession report contains.

Ya ken that hidden horde, aye?

24 Feb

So – the ‘Hidden Horde’ – the term that anti-vaccinationists like to smirk about as evidence of an autism epidemic. The logic goes like this: if there’s no autism epidemic then where are all the [insert age here] year old autistic adults? I’ve heard people asking for evidence of 75 year old autistics (conveniently forgetting that the average mortality age in the US and UK is around 70), 50 year olds – even 30 year olds.

Never mind that there’s been plenty of evidence for adult autistics. Thats not convenient for the anti-vaccinationist agenda so it gets ignored.

Anyway, todays Sunday Herald carries another story about adult autistics in Scotland called ‘Revealed: ‘invisible’ adults living with autism’.

According to the National Autistic Society (NAS) Scotland report, due to be launched this week, 52% of adults have not had an assessment of their needs since the age of 18…..It is estimated that more than 35,000 adults in Scotland have the condition, but campaigners said they were “invisible” to local authorities, who are failing to record the number of people with autism in their area.

The population of Scotland is 5,062,011. The latest prevalence estimates for the UK are 1 in 100. This means that 50,620 people are autistic. If 35,000 adults in Scotland are autistic then 69% of autistic people in Scotland are adults.

Hidden horde aye?

New mercury/autism paper to misrepresent

22 Feb

A new study on autism and mercury has been published:

Autism is a highly heritable disorder, however, there is mounting evidence to suggest that toxicant-induced oxidative stress may play a role. The focus of this article will be to review our animal model of autism and discuss our evidence that oxidative stress may be a common underlying mechanism of neurodevelopmental damage. We have shown that mice exposed to either methylmercury (MeHg) or valproic acid (VPA) in early postnatal life display aberrant social, cognitive and motor behavior.

Some people have reported on this study thusly:

New Study Implicates Mercury In The Development Of Autism

Um, right.

These same people, well known for their anti-vaccine beliefs, fail to note anywhere that this study says:

…., it is important to note that autism was not found to be associated with either pre- or neonatal exposure to organic mercury.

One form of organic mercury being, of course, thiomersal.

Might it be very uncharitable of me to suggest that this was a deliberate obfuscation? I guess it might but I still think it was. Especially when this same person says:

….will they all continue to proffer the lie that there is no convincing evidence linking vaccines to autism, while ignoring all the studies that are piling up on the hard drives of parents across the country?

Hmmm, so this study quite categorically states there is no link between organic mercury and autism and yet this person calls others liars? Projection is a terrible thing.

There will be more to say on the quality of this study – especially its references – but I wanted to get this clear as soon as possible.

Brad Handley Offers Us A Chance To Evaluate

6 Feb

A couple of days ago, Brad Handley wrote a blog entry on Age of Autism called ‘DR. NANCY MINSHEW & ME: WHO’S CRAZY?’.

Let us instead examine Brad’s criteria for deciding on who is crazy and who is not between Dr Minshew and he.

I disagree with almost every single thing you have written or said about autism. Since we both can’t possibly be right, one of us has to be crazy. I’m scared to death it might be me. As a psychiatrist, I thought you could help.

Says Brad to Dr Minshew in an email. He then continues with:

It is maddening for parents like me that our “experts” can’t agree on the most fundamentally important and critical data point in the entire field of autism: is prevalence truly rising or not? This very binary notion impacts everything else. If it’s growing, it’s the environment. If it’s not, it’s genetics. From you perspective, “The increase in number of cases reflects the increase in recognition of verbal children.” I was confounded by this point, because I can’t find a single sentence in the scientific literature to support this. What I do look to is the following:

OK, lets pause. Brad says there’s no scientific literature to support the idea that there isn’t an epidemic. We’ll come back to that. Firstly, however, he cites a few bits and bobs to support his hypothesis that there is.

First off he cites:

[1]Report to the Legislature on the Principle Findings from The Epidemiology of Autism in California: A Comprehensive Pilot Study MIND Institute, UC Davis, Oct 2002.

This is not in the scientific literature. It is not peer reviewed. According to Brad’s own specified criteria of utilising the scientific literature, he cannot cite this document.

The second (and last) paper he cites is:

[2]National Autism Prevalence Trends From United States Special Education Data. Pediatrics, March 2005. Craig J. Newschaffer, PhD..

Using Special Education data has been debunked in a paper published four months after that Newschaffer paper. The author (James Laidler) says:

Many autism advocacy groups use the data collected by the US Department of Education (USDE) to show a rapidly increasing prevalence of autism. Closer examination of these data to follow each birth-year cohort reveals anomalies within the USDE data on autism……These anomalies point to internal problems in the USDE data that make them unsuitable for tracking autism prevalence.

and Shattuck says:

The mean administrative prevalence of autism in US special education among children ages 6 to 11 in 1994 was only 0.6 per 1000, less than one-fifth of the lowest CDC estimate from Atlanta (based on surveillance data from 1996). Therefore, special education counts of children with autism in the early 1990s were dramatic underestimates of population prevalence and really had nowhere to go but up. This finding highlights the inappropriateness of using special education trends to make declarations about an epidemic of autism, as has been common in recent media and advocacy reports.

So thats the sum total of Brad’s ‘science’ regarding the autism epidemic. A non-science report and a twice debunked study.

Is there actually anything in the scientific literature that suggests the ‘epidemic’ is not anything of the sort?

Variation in the administrative prevalence of ASD is associated with education-related spending, which may be associated with better-trained educational staff who can recognize the problem, and more and better trained in-school specialists who can provide screening. It is also associated with the availability of health care resources. Increased access to pediatricians and school-based health centers may lead to improved recognition of ASD. Interstate variability in the identification of ASD should be taken into account when interpreting the results of prevalence studies based on administrative data and the associated system characteristics taken into account by policy makers working to improve the recognition of ASD.

David S. Mandell, ScD; Raymond Palmer, PhD

The incidence of research-identified autism increased in Olmsted County from 1976 to 1997, with the increase occurring among young children after the introduction of broader, more precise diagnostic criteria, increased availability of services, and increased awareness of autism. Although it is possible that unidentified environmental factors have contributed to an increase in autism, the timing of the increase suggests that it may be due to improved awareness, changes in diagnostic criteria, and availability of services, leading to identification of previously unrecognized young children with autism.

William J. Barbaresi, MD; Slavica K. Katusic, MD; Robert C. Colligan, PhD; Amy L. Weaver, MS; Steven J. Jacobsen, MD, PhD

We observed dramatic increases in the prevalence of autism spectrum disorder as a primary special educational disability starting in the 1991-1992 school year, and the trends show no sign of abatement. We found no corresponding decrease in any special educational disability category to suggest diagnostic substitution as an explanation for the autism trends in Minnesota. We could not assess changes in actual disease incidence with these data, but federal and state administrative changes in policy and law favoring better identification and reporting of autism are likely contributing factors to the prevalence increases and may imply that autism spectrum disorder has been underdiagnosed in the past.

James G. Gurney, PhD; Melissa S. Fritz, MPH; Kirsten K. Ness, MPH; Phillip Sievers, MA;Craig J. Newschaffer, PhD; Elsa G. Shapiro, PhD

Brad continues:

You say vaccines are proven to not cause autism and that parents should vaccinate their children.

Dr. Minshew, you are either being intellectually dishonest on this point or it is outside of your expertise as a psychiatrist to understand the vaccine-autism issue, Let me explain:

Brad _seems_ to be basing this belief on the news article he quotes:

Dr. Nancy Minshew, Director of the University of Pittsburgh’s Center for Excellence in Autism Research, says it’s time to end the debate [about vaccines and autism] because research overwhelmingly proves there’s no connection and parents don’t need to worry about that anymore. Minshew says it’s time real experts dispel the rumors for concerned parents. “They deserve to hear the evidence, the real evidence. So I thought, ‘Enough is enough,'” she said. Minshew says people’s lives are at stake because some kids aren’t getting vaccinated for life-threatening diseases due to incorrect information. Since Thimerosal, an ethyl mercury preservative, was banned from most childhood vaccines in the U.S. seven years ago, autism rates have continued to increase – disproving the link. Minshew says it’s only a coincidence that toddlers are vaccinated around the same time autism is usually diagnosed.

Minshew did _not_ say ‘vaccines are proven to not cause autism’, that is what the article she was quoted in says. You can tell the bits she actually said as they will be surrounded with quote marks.

– Thimerosal was not banned from vaccines as you are quoted as saying, so this is a falsehood.

Minshew was not quoted as saying this. This is a falsehood.

– Thimerosal did not come out of vaccines seven years ago as you are quoted as saying, so this is a falsehood. In fact, it’s still in the overwhelming majority of the flu shot supply at full dose- the flu shot was recently added (2004) to the CDC’s recommended schedule.

Once more, Minshew was _not_ quoted as saying thiomersal came out of vaccines seven year ago. This is a falsehood. Your statement that it is still in the overwhelming majority of the flu shot is speculative and without foundation – unless you have something to back that up….?

And in *fact* – although Minshew never claims it, a CDC meeting reported on a study that said:

N.I.P. estimated the amount of thimerosal in provider vaccine inventories in a survey conducted September 20, 2001 to February 20, 2002. The targets were a convenience sample of providers getting site visits from public health officials across the country. Inventory counts were done of all refrigerators for D.T.a.P., Hib, and hep B pediatric vaccines. The thimerosal classification was based on the lot number information, which was verified by the manufacturers. In September 2001, 225 sites were canvassed, and 447 by February 2002…..During the visits, the providers were surveyed about thimerosal-containing vaccines in their inventories. Of the 447 interviews, 83.5 percent reported no thimerosal-containing vaccines in stock at any time since October 2001.

and

in September 2001, only 5.6%1 of all vaccines contained thiomersal. By Feb 2002, only 1.9% of all vaccines contained thiomersal.

(NB: The 5.6% figure seems to be a typo in the report. It should be 56%. From 33,500 doses out of 63,600; to 2,796 doses out of 149,147)

– If you believe that focusing on a single ingredient in vaccines (mercury) exonerates vaccines in totality, that’s an impossibility. We have grown our vaccine schedule from 10 vaccines in the early 1980s to 36 today. Yet, we never test the “combination risk” of so many vaccines. No one, except Generation Rescue, has ever studied unvaccinated children and looked at their autism rates. We never look at the aluminum that replaced thimerosal, the live viruses, or the many other toxic ingredients in vaccines at all.

So, Brad says that its not just mercury. Which is weird because in Feb 2005 (click the first video) he was saying:

What we immediately realised – and I think this is something that is a surprise to lots of people – um that autism is a misdiagnosis for mercury poisoning. If you line up 100 symptoms of mercury poisoning and 100 symptoms of autism they are exactly the same

So, to borrow a phrase, both can’t be true….is it a misdiagnosis for mercury poisoning or is it the combination of vaccines?

– The parent reports of children going upside-down and developing autism right after vaccination continues unabated. Will you ever listen to them?

People such as Minshew have done nothing _but_ listen. Generation Rescue keep promising something for them to listen to but keep failing to provide it.

Brad continues:

It strikes me, and perhaps I’m crazy for saying this, that now that you have publicly reassured parents that vaccines are safe, that you may well be the last person on earth, even in the face of overwhelming evidence, to concede that vaccines are in fact playing a role in autism.

That, my friend, is called ‘projection’. Now you have publicly hemmed and hawed about what vaccines role is in autism and now all your projections and predictions have singularly failed to materialise (read the rest of that blog entry with the video for details), even with an overwhelming lack of any evidence whatsoever you will be the last person to ever admit you were plain old wrong time and time again.

And yet there’s more.

You never mention recovered children.

In all the writings and quotes of yours, Doctor, I didn’t read one thing about children who have recovered from autism. Have you ever met a recovered child? Would you like to? Would you care to scan their brains and see how they look? I heard a noted neurologist mention an idea that we should scan the brains of children newly diagnosed with autism, let their parents who want to treat the children biomedically, and then re-scan the brains of any children who have recovered. Does that strike you as an interesting idea?

Ah, the famous recovered children. I wrote about this awhile ago. The upshot of it is that when actually looks in detail at the kids Generation Rescue claims as recovered, kids who no longer have a diagnosis account for about 5-7% of the total he presents as recovered. Its a con trick. I even managed to get my own daughter listed as a recovery story on his website.

Brad continues:

As a courtesy, I forwarded the above piece to Dr. Minshew one day in advance of posting it on Age of Autism. What follows is a short email exchange between us:

———————

Dr. Minshew:

What’s written below, by me, will be posted at The Age of Autism blog tomorrow. As a courtesy, I’m sending it to you first.

I have no issues with you personally. In fact, reading that you lost a child makes me very, very empathetic.

That said, it is my heartfelt belief that you are actually part of the problem with autism, rather than part of the solution. I’m sure that’s a comment you disagree with profoundly, but I really believe history will be a harsh judge of scientists like you who continue to deny the existence of a rising prevalence of autism and mistakenly reassure parents that vaccines are safe – a topic you can’t possibly be an expert on, by the way.

I also thought your email to Mr. —- reeked of intellectual arrogance in a very close-minded sort of a way. There are many well-credentialed scientists who would take exception to almost everything you believe about autism, but you speak with sweeping generalizations like you are in the only camp that actually knows where truth lies. I also found your continual reference to a court case in Maryland, while 2 tests cases before the Vaccine Court remain WIDE OPEN, to demonstrate either ignorance on your part or a case of selective fact gathering. What if the test cases in D.C. rule in favor of the plaintiffs?

So, I don’t expect us to be pen pals anytime soon, but I’m including the open letter to you below.

Sincerely,

JB Handley

——————–

From: Nancy Minshew
To: J.B. Handley
Sent: Mon Feb 04 11:50:31 2008
Subject: RE: Nancy & Me: Who’s crazy

Mr. Handley none of you have permission to share emails that i have sent to you as individuals with anyone besides the intended receiver nor do you have permission to quote me publicly. Unlike the newspaper which was public, private emails to individuals sent confidentially are not for public quotation.

——————–

From: J.B. Handley
Sent: Monday, February 04, 2008 11:54 AM
To: Nancy Minshew
Subject: Re: Nancy & Me: Who’s crazy

Says who?

And, tough shit.

J.B. Handley

——————–

Nice guy huh?

And also further example of Brad’s hypocrisy. Our very first online set-to Brad commented (in the comment section) about me publishing part of an email he sent me:

Mr. Leitch sent me an email on my private email account, I responded, and he put my comments on his blog without asking me.

Which wasn’t strictly true but anyway – if I’d known how Brad would chop and change his mind I would’ve just said ‘tough shit’.

Anyway, Brad concludes:

This is my world, Dr. Minshew, it seems clear as day. It’s so different from yours, I really, really need to know: which one of us is crazy?

Lets recap. In Brad’s world science isn’t science unless he says it is. He can chop and change his mind without it invalidating his earlier, contradictory beliefs and its OK to be a massive hypocrite. Are these the actions of a crazy man?

Mark Blaxill Thinks Bloggers Are Mean

4 Feb

Mark Blaxill, the token man of the mercury moms at SafeMinds, has written a lip-trembling post over on Age of Autism about how mean bloggers can be. Lets have a bit of fun with it shall we?

The rapid evolution of the Internet has created a host of fascinating, exhilarating and occasionally despicable new things. The Age of Autism is a blog and we’re proud to be a part of a new phenomenon called the blogosphere……But as one might expect with any new form of cultural expression, there’s a bizarre variant of the blogosphere out there. It’s a strange hybrid: it looks like a regular low end blog, based almost entirely on opinion, a dressed up version of the typical online discussion groups and chat rooms….In a disturbing way, this new hybrid has found its way into the debates and controversies around autism science…..Often connected with the so-called “neurodiversity” movement, many of these game players seem to define themselves by their own “autism”

So if I’m understanding Marky Mark, the blogosphere is a ‘new phenomenon’ upon which the light of the countenance of the Age of Autism has charitably fallen.

This ‘new phenomenon’ actually was first realised nine years ago Marky Mark. I await with bated breath Marky’s breathless announcement come 2017 that Age of Autism has discovered a ‘new phenomenon’ called Facebook. Truly the interweb is a wondrous thing. A piece of advice though Mark – never, ever type ‘Google’ into Google.

And these ‘low ends blogs’….my, my whomever could he be referring to? Surely not Autism Diva’s blog with a Google PR of 5 on the home page and over 1,150 Google backlinks to it? Or maybe Orac’s with a PR of 7 for the home page and which has over 6,100 Google backlinks to it? or maybe my own which has a PR 6 on the home page of the blog and over 2,700 Google backlinks to it.

Or maybe ‘low end’ might refer to a blog which has a PR of 3 on its home page and Google link operator can find no back link data for. I wonder, can anyone suggest a blog with user stats that low end?

Anyway, Marky Mark has a point to make and by god he’s eventually going to get around to making it dammit! Even if he has to rhetoricise our asses into verbal comas!!

But unlike people that engage in the blogosphere using their real names and identities, these avatars all have one thing in common.

They’re cowards.

Hmmmm, really? Is that why some people choose to blog anonymously?

I really hate to break this piece of news to Marky Mark but passing opinions online predates the web. Why go back to the old BBS’s and you’d find a whole bunch of people chatting away with (gasp!) fake names. In fact, I hear tell that some CB radio enthusiasts use fake names too!! The dirty cowards!

There’s a damn good reason why some people blog anonymously Marky Mark as I have good reason to know about – people who espouse similar views to you Marky Mark, target their children. People like John Best for example are very good reasons for preserving anonymity. Here’s what happens when one of his friends annoys him. What do you suppose he has in store for my child?

But who Marky Mark is really pouting about is Do’C and Interverbal, two bloggers who took the time out to look at a recent paper that Marky Mark was counting on to support his kook hypotheses. So annoyed by these two ‘low end’ bloggers (PR 5 on each of their blogs) that he elected to censor out the name of the blog they wrote at!

“Unfortunately, the main bloggers of [censored wackosphere site name] have taken the time to respond to almost all of the other blogs about this article

‘wackosphere’ (tee-hee!!) is the name Marky Mark has bestowed upon autism related blogs more popular than his it seems. That’s a lot of blogs.

So shocked was I at this blatant censorship that I nearly contacted the Ever So Important Editor on Age of Autism to ask if they would write a piece about this – after all they penned 10 blog entries last week decrying censorship – they must really hate it!

In fact so grasping does Marky Mark become that he actually says:

In fact, at a deeper level, there’s a widespread pattern of scientific intimidation and censorship underway in autism science that relies on a wide range of attack dogs…

Hey yeah – I know what you mean Marky Mark like what happened to Dr Paul Offit at the hands of the mercury militia:

….as Paul Offit, a vaccine expert who served on the committee, tried to make his way through the crowd, one of the protestors screamed at him through a megaphone: “The devil—it’s the devil!” One protester held a sign that read “TERRORIST” with a photo of Offit’s face. Just before Offit reached the door, a man dressed in a prison uniform grabbed Offit’s jacket. “It was harrowing,” Offit recalls.

….
He has since received hundreds of malicious and threatening emails, letters and phone calls accusing him of poisoning children and “selling out” to pharmaceutical companies. One phone caller listed the names of Offit’s two young children and the name of their school. One email contained a death threat—”I will hang you by your neck until you’re dead”—that Offit reported to federal investigators.

Or Paul Shattuck, also from the mercury militia:

One person said, “Don’t be surprised if you get a knock on your door in the middle of the night and I’ll be there.” Another message said it was easy in the age of the Internet to find out where people live.

Shattuck also had various utterly untrue allegations made about him by the NAA.

Or how about Arthur Allen and Professor Roy Grinker who have also been on the receiving end of threats of violence:

these people need to be horse whipped…

Or how about Ray Gallup, Director and co-founder of the Vaccine Autoimmune Project? here’s what he had to say recently:

Dear ****:

Since you seem to follow what is going on with the Leitch list let me know if Leitch, Deer and the others get hit with a fast moving truck or bus that leaves their carcasses mangled and bloodly on the street.

I will be devotely praying night and day that something like this happens to them and their followers. Especially since these creeps say such hurtful things to parents. They deserve all the best in something terrible happening to every last one of them and I will pray daily.

I usually pray for good things for families that suffer but in their case I will make a big exception.

Ray Gallup

Or what about this Marky Mark?

A-YEAR-and-a-half ago, a vaccines expert in the eastern US received a phone call at home. The man on the line did not identify himself; he simply stated the names and ages of the researcher’s two children and the schools they attended, then hung up. The threat was shocking, but not a surprise. “I get hate mail every day,” says the researcher, who asked not to be named.

Many vaccine scientists in the US have received similar threats in recent years. They are thought to come from a hard core of parents who, in the face of overwhelming evidence to the contrary, are convinced that small amounts of mercury in vaccines have made their children autistic. What’s more, they believe that researchers are complicit in the scandal.

How about what EoH member and mercury militia jackass Brian Hooker did to Dr Sarah Parker? He harasses her to the point her campus security services had to get involved and she sent this email to Hooker – which he proudly displayed online:

Date: Tue, 19 Apr 2005 14:03:17 -0600
From: Sarah Parker
Subject: Re: Sarah Parker on the show “To The Point”
To:
Cc:

I have received your phone messages (yesterday evening and today) and emails. I would like to inform you that due to your previous threat to me in November and the tone and content of these current calls and emails I consider these as threats/harassment as well and am documenting them with the campus police department. I respect your right to disagree and wish you would respect that same right with me. Please do not contact me again in the future.

Sarah Parker

How about Brad Handley of Generation rescue saying to me:

If we were on a rugby pitch, Kev, I’d put my boot in your eye and twist…

Marky Mark is quite right that there are wacko’s in the online autism community. All he has to do to find them is look to his left and right. He closes his diatribe with:

We need to defend some minimum standards for how people are permitted to participate in a public debate. At the top of the list of these standards should be this: if anyone wants to participate in a debate about autism, put your real self on the line: your real name, your actual body of work (if you have any) and your professional accomplishments and reputation. Put the things that really matter — your family’s future and your personal career prospects — out in public for everyone to see if you want to exercise the privilege of participation in civil society. If you’re willing to do that, then you have a right to be heard. If you’re not, then you should go back to your game and keep playing with yourself. Let serious people do serious work.

And he’s serious. He means it. How he:

a) Expects to set himself up as the arbiter of whats acceptable online and;
b) Expects people to be comfortable using their real names when he stands alongside the people listed above

I really can’t imagine. Believe me, if I’d known that pond scum like John Best shared a planet with me I would never have used my real identity. Its also quote clear that Mark Blaxills friends and colleagues hold no compunctions about besmirching reputations with groundless attacks and or threats of violence upon them or their children.

Look around you Marky Mark. That rarefied air you’re sucking down? Its the polluted air of the real wackosphere. A land where threats against children is fair game and where killers and paedophiles are welcomed in with no checks and open arms and the leaders of the many antivaccine kook organisations encourage and salivate after violence against anyone who disagrees with them.

Autisms Poor Excretors

31 Jan

Pediatrics released a study refuting the autism/thiomersal hypothesis early yesterday. They said that they did it to counter the upcoming Eli Stone pilot (of which there will be more to speak of soon). If that’s true then we need to thank the creators of Eli Stone for prompting the early release of more science debunking the anti-vaccine stance.

I don’t have this new study yet so I want you to bear in mind that I can only go on what’s in the news reports. This isn’t ideal but there are numerous quotes from the study authors over the news.

Basically, this study refutes the idea that autistic kids are poor excretors of mercury. Obviously, a lot of Hub bloggers have already taken this silliness apart but this is (IIRC) the first science paper to do so.

A proviso of this study would seem to be that it was done on NT kids rather than ASD kids but there’s no real scientifically valid reason to use ASD kids particularly anyway.

“….Now it’s obvious that ethyl mercury’s short half-life prevents toxic build-up from occurring. It’s just gone too fast,” Pichichero said.

To illustrate, researchers cite that infants in the 6-month-old group — who, in their lifetimes, had encountered more total ethyl mercury that any other group studied — still had the same pre-vaccination blood-mercury levels before their checkups as most 2-month-olds had before theirs. This suggests that, before each round of shots, the mercury has plenty of time to be cleared.

Source

Now, a group of people we all know are going to claim that the Burbacher et al showed that this was becuase the ethyl-mercury was going into the brain. This isn’t strictly accurate. Though total levels in the brain were lower for the thimerosal group, a higher ratio of inorganic mercury was noted. The anti-vaxxers tried to link this to Vargas because inorganic mercury is alleged to cause microglial activation.

But Burbacher detected no neuroinflammation. He should now know if there is neuroglial activation in his primates however. This paper was due some time ago but seems to be having trouble finding a publisher. Its pure speculation on my part that this would either be because his sponsors (SafeMinds) didn’t like the results and pulled the plug, or the science is bad and can’t find a journal to be published in.

Anyway, here’s this new paper that demonstrates that thiomersal is very quickly eliminated from the body. What is the typical mercury militia response to this?

And if it’s not thimerosal, then it must be some other vaccine-related interaction, said Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center.

……

“Mercury doesn’t belong in any product,” Fisher added. “Mercury doesn’t belong in vaccines whether it’s proven or not proven that mercury is a problem in vaccines.”

You see? Its not even really about mercury to these geniuses. Its about vaccines. Always. Even when it isn’t. And when it is mercury it doesn’t matter if its actually dangerous or not. What a shame there’s no vaccine for stupidity.

Note: Bart Cubbins has done an excellent video on some of the shortcomings of the Burbacher study.

A bad day for antivaccinationists: Yet another study fails to support an association between vaccines and neurodevelopmental disorders

30 Sep

This blog entry first appeared at Respectful Insolence. It is reproduced here with permission.

A bad day for antivaccinationists: Yet another study fails to support an association between vaccines and neurodevelopmental disorders
By Orac.

I’m almost beginning to feel sorry for the mercury militia.

Think about it. They’ve been claiming for the past several years that the mercury in the thimerosal used as a preservative in childhood vaccines is a cause of autism. If you believe Generation Rescue, A-CHAMP, SAFEMINDS, and various other activist groups, vaccines are the root of all neurodevelopmental evil, culminating in what to them seems to be the most evil of evil condition, autism. Yet, in study after study in the new millennium, no correlation has been found to implicated their favorite bte noire thimerosal, which serves as a surrogate for their general dislike of vaccines in general.

It comes as no surprise, then, that A-CHAMP would want to launch a pre-emptive strike against a large study of thimerosal-containing vaccines that was published in the New England Journal of Medicine today. Blazing out of their website is the headline New CDC Study Falsely Claims Thimerosal is Safe

On September 27, 2007 the New England Journal of Medicine will publish a study entitled, “Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years.” For more than two years we at A-CHAMP have been hearing rumors of a new study that “exonerates” thimerosal, despite the fact that the study results were supposed to be kept strictly confidential.

Now the rumors have been turned into hype – another government funded study that tries to spin data and clear thimerosal of any suspicion of causing neurodevelopmental disorders. The study authors claim in their “Conclusions” that “[o]ur study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and neuropsychological functioning at the age of 7 to 10 years.”

The statement is plainly false. The study’s conclusions do not reflect the study’s data or the limitations of the study,

You’d think that at least A-CHAMP would correct that hanging comma at the end of the sentence there.

Sarcasm aside, the study’s conclusions do reflect the study’s data, quite well, as we will see, and A=CHAMP’s complaints boil down to the usual crank technique of cherry picking the evidence, combined perhaps with sour grapes. Let’s lay the abstract out for all to see before we look at A-CHAMP’s individual points:

Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years
William W. Thompson, Ph.D., Cristofer Price, Sc.M., Barbara Goodson, Ph.D., David K. Shay, M.D., M.P.H., Patti Benson, M.P.H., Virginia L. Hinrichsen, M.S., M.P.H., Edwin Lewis, M.P.H., Eileen Eriksen, M.P.H., Paula Ray, M.P.H., S. Michael Marcy, M.D., John Dunn, M.D., M.P.H., Lisa A. Jackson, M.D., M.P.H., Tracy A. Lieu, M.D., M.P.H., Steve Black, M.D., Gerrie Stewart, M.A., Eric S. Weintraub, M.P.H., Robert L. Davis, M.D., M.P.H., Frank DeStefano, M.D., M.P.H., for the Vaccine Safety Datalink Team

Background It has been hypothesized that early exposure to thimerosal, a mercury-containing preservative used in vaccines and immune globulin preparations, is associated with neuropsychological deficits in children.

Methods We enrolled 1047 children between the ages of 7 and 10 years and administered standardized tests assessing 42 neuropsychological outcomes. (We did not assess autism-spectrum disorders.) Exposure to mercury from thimerosal was determined from computerized immunization records, medical records, personal immunization records, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. We assessed the association between current neuropsychological performance and exposure to mercury during the prenatal period, the neonatal period (birth to 28 days), and the first 7 months of life.

Results Among the 42 neuropsychological outcomes, we detected only a few significant associations with exposure to mercury from thimerosal. The detected associations were small and almost equally divided between positive and negative effects. Higher prenatal mercury exposure was associated with better performance on one measure of language and poorer performance on one measure of attention and executive functioning. Increasing levels of mercury exposure from birth to 7 months were associated with better performance on one measure of fine motor coordination and on one measure of attention and executive functioning. Increasing mercury exposure from birth to 28 days was associated with poorer performance on one measure of speech articulation and better performance on one measure of fine motor coordination.

Conclusions Our study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.

It’s noted that a similar study looking at autism will be published next year. Of course, the fact that this study didn’t look at autism leaves the antivaxers a huge opening to say, “Well, yes, but you didn’t look at autism.” Never mind that there are now several studies that did look at autism and found no association between thimerosal-containing vaccines and autism. So what are the main complaints that A-CHAMP has about this study? Let’s take a look, starting with the first one:

The Study’s Claim of No Causality is Contrary to the Study’s Data. The study authors claim that the data disproves causality when in fact, several findings show a negative effect on neuropsychological functioning warranting more study. At least one such adverse association was also found to be associated with low dose thimerosal exposure in other studies. As with earlier studies hyped by vaccine promoters, the study is unable to prove or disprove causality. The blanket dismissal of the troubling neuropsychological outcomes in this study is disingenuous and misleading.

First off, the study didn’t claim that there was “no causality.” What it stated is exactly what you see in the Conclusions section: That the study does not support a causal relationship. There’s a difference there too subtle for the ideologues who wrote this press release to understand. It’s impossible ever to prove “no causality.” It is, however, possible to conclude from the data that the data does not support a causal relationship. Second, A-CHAMP is cherry picking associations here. It is true that there were some negative correlations found that achieved statistical significance. When running 42 tests, it would be shocking if there were not a few anomalous findings. What makes the study authors fairly confident that the findings are anomalous is that they were divided roughly equally in both directions, good and bad. Consequently, if A-CHAMP is going to insist that the correlation, for example, with increasing mercury exposure and poorer performance on the GFTA-2 measure of speech articulation test, then it must also accept the findings of a beneficial association between mercury and identification of letters and numbers on the WJ-III test, as there is no reason to reject it. Naturally, the mercury militia picks on the associations as being true that they want to be true and ignore the other associations, which, if true, would be arguments for including thimerosal in vaccines. It’s far more likely that all of them are just noise. Again, the reason that investigators can reasonably conclude that the associations found are most likely due to random chance is because of their random distribution between positive and negative.

Another complaint:

Children with autism were excluded from this study. The early media contacts we have received suggest that this study shows no association between thimerosal and autism. In fact, the study specifically did not look at children with autism as the sample size was too small and the testing is impossible to complete for the typical child with autism. The exclusion of children with autism from the study may have undermined the power of the study to draw any conclusions about thimerosal.

This is a really, really dumb statement. I’m sorry, but there’s no other way to put it. It just is. It’s like criticizing an apple for not being an orange. The explanation for this is right in the paper, “Since the CDC is conducting a separate case-control study of autism in relation to mercury exposure, a measure of autism was not included in the test battery.” Get it, idiots? A separate study is being done and the results will be reported in a separate paper! That renders this complaint utterly irrelevant. It’s nothing more than a red herring designed to fire up the faithful.

This complaint is not really stupid, but definitely overblown:

The Study’s Methodology has Serious Limitations Negating Any Conclusions Drawn. Major flaws that that causes a large underestimation of neurological adverse effects burden the study: 70% of the families recruited for the study failed to participate. This kind of bias in epidemiological studies is well known to distort even large studies of health effects…It is well established that people who choose to participate in this kind of study are probably very different than those who refuse to participate (the “healthy person” or “complier” effect); especially when the ones who refused to participate said they were too busy.

Simply put: if you have a kid with ADHD or mild ASD or other neurodevelopmental disorders, you are likely to be busier, more stressed, and less available than the mother of a healthy normal child. This phenomenon serves to amplify the effect of the “complier”, the ;healthy families,” – those who do cooperate with the study – confounding or confusing the study’s results. The cooperative parents included in the study were more likely to be those with relatively trouble-free kids

There’s no evidence that this sort of bias existed, and A-CHAMP conveniently omits other biases that might be result from such a selection bias. For example, it is also quite possible to argue that parents who think vaccines may have caused their child’s condition would be even more likely to want to participate in the study (self-selection bias), than parents whose children are normal or who don’t believe vaccines had anything to do with their child’s problems; they might have thought that it wasn’t worth their bother. It’s good of the antivaxers who have been championing the execrable telephone survey done by Generation Rescue to recognize that this sort of bias exists; too bad they only mention it when it suits their purposes (i.e., to trash a study whose results they don’t like) and ignore it when it doesn’t, for example when it calls into doubt the results of the Generation Rescue telephone poll.

In reality, the fact that only 30% of the families who were approached for the study agreed to participate is probably the most significant weakness of the study. The authors don’t try to hide it. Rather, they are right up front with it in the Discussion section, while at the same time pointing out that this is this possible bias was ameliorated by enrolling children on the basis of having received vaccinations without regard to the seeking of health care or having been given a neurodevelopmental diagnosis, as well as noting that many children weren’t enrolled because they couldn’t be located. Moreover, exposure information was obtained from many different sources. It also looked at prenatal exposure to thimerosal-containing vaccinations from vaccines that the mother might have had while pregnant.

Next complaint:

Vulnerable Children Were Excluded from the Study; Early Intervention Was Ignored. Children with a birth weight under 5 lbs. 8 oz. were excluded from the study further skewing the results, as these children are likely more vulnerable to thimerosal than larger babies. In addition, the fact that early intervention may have reduced deficits such as speech delay detected by neuropsychological testing of children aged 7-10 was not accounted for in the study results. There also was no analysis of combined prenatal and postnatal mercury exposures. Only 103 mothers who were exposed to mercury from prenatal immune globulins participated in the study, far too small a group for researchers to draw conclusions regarding the safety of thimerosal in these products.

This is a grab-bag of the specious and semireasonable. The reason for excluding low birthweight children was obvious: Such children are more likely to have neurodevelopmental problems completely independent from any external cause, such as thimerosal. Including preemies and lower birth weight children would only contribute to the background noise and make finding true associations more difficult. A-CHAMP should be glad that the investigators did that, given that it was almost certainly done to make the study more likely to find an association between vaccines and neurodevelopmental disorders. In addition, there is no evidence that low birth weight children are “more vulnerable to thimerosal.” Of course, once again, A-CHAMP fails to point out that the authors themselves pointed out the shortcoming in regard to not being able to account for interventions such as speech therapy. As for the whining about not analyzing combined prenatal and postnatal mercury exposures, that’s just a red herring; the study did test an a priori assumption of interaction between pre- and postnatal mercury exposure.

The rest of the complaints are the standard ones: Conflict of interest, for example, because several of the study’s authors had received funding from pharmaceutical companies. These potential conflicts of interest are clearly stated in the study. A-CHAMP also brings up a totally specious complaint of the study supposedly not accounting for “efflux” disorder (i.e., children who are allegedly “poor excretors” of mercury). Fortunately, Prometheus has provided a good explanation of what a crock that whole myth is, so that I don’t have to.

Of course, there is another reason, besides this study failing to show what the mercury militia wants it to, that there is such hostility here:

The politicization of the thimerosal issue has led researchers to take unprecedented measures. Unlike previous studies, the current study included more than a dozen outside consultants, including at least one advocate for families of children with autism. “We have really tried to make the entire process–from experiment design to manuscript review–as transparent as possible,” says Thompson. But that effort may not have made a difference in the long run. Sallie Bernard, executive director of Safe Minds, a nonprofit parents’ organization that focuses on the role of mercury in neurodevelopment disorders, consulted on the study but still takes issue with its findings. “All the studies, including this one have certain limitations in their design and their methodology,” she says.

Sour grapes, anyone? Ms. Bernard was a consultant on this study and helped contribute to its design! She apparently didn’t like the results that it was producing and decided to drop out and start criticizing it–even jumping the gun on the 5 PM embargo yesterday to do so! Indeed, she is listed on the study in a way that I’ve never seen before: as a “dissenting member.”

How many studies by mercury militia enablers Mark and David Geier include even a note of dissent?

Although this study is not without flaws, it nonetheless does not support a correlation between thimerosal-containing vaccines and the neurodevelopmental problems studied. Even better, the New England Journal of Medicine included two editorials along with the story. One editorial discussed the explosion of vaccine litigation that the now discredited thimerosal “hypothesis” has unleashed, immune to the findings of science. The second editorial is by Paul Offit (the Antichrist to antivaxers) and makes an excellent point about the unintended consequences of taking precautionary measures on the basis of little or no evidence:

On July 9, 1999, after much wrangling, the CDC and AAP decided to exercise the precautionary principle. They asked pharmaceutical companies to remove thimerosal from vaccines as quickly as possible; in the interim, they asked doctors to delay the birth dose of hepatitis B vaccine in children who weren’t at risk for hepatitis. A press release issued by the AAP revealed the ambivalence among its members: “Parents should not worry about the safety of vaccines,” it read. “The current levels of thimerosal will not hurt children, but reducing those levels will make safe vaccines even safer. While our current immunization strategies are safe, we have an opportunity to increase the margin of safety.” Critics wondered how removing something that hadn’t been found to be unsafe could make vaccines safer. But many parents, frightened by a sudden change in policy, reasoned that thimerosal was targeted because it was harmful — and their faith in the vaccine infrastructure was shaken. Doctors were also confused by the recommendation.

I could see how that would confuse parents and doctors. Offit concludes:

Despite several years of reassuring studies, the thimerosal controversy continues to be emotionally charged. Physicians, scientists, government policy advisors, and child advocates who have publicly stated that vaccines don’t cause neurologic problems or autism have been harassed, threatened, and vilified, receiving hate mail and occasionally death threats. The CDC, in response to planned protests at its gates, recently beefed up security and instructed personnel about how to respond if physically attacked.

During the next few years, thimerosal will probably be removed from influenza vaccines, and the court cases will probably settle down. But the thimerosal controversy should stand as a cautionary tale of how not to communicate theoretical risks to the public; otherwise, the lesson inherent in the collateral damage caused by its precipitous removal will remain unlearned.

Exactly. With the best of intentions, trying to be as “safe” as possible, the AAP and CDC unleashed a tsunami of fear of vaccines and laid the groundwork for pseudoscientists like Mark and David Geier to stoke the fears of mercury further with badly designed studies. This was an example of framing science at its worst.

In the end, it is always frustrating to watch how such studies are spun by antivaccinationists. Epidemiology is like that, though. It’s virtually impossible to conduct a cohort study like this without permitting significant shortcomings in it. The reason is that, unlike a bench experiment, the investigators can never control all the variables. Trade-offs are inevitably made, and rarely are there adequate resources to assure sample sizes large enough to be bullet-proof or to be able to account for all potentially confounding variables. No one study is ever sufficient to rule out correlations between undesirable outcomes and various compounds. However, as the weight of several studies starts to bear down on the problem, the preponderance of evidence must at some point be accepted, because we do not have unlimited resources to keep doing studies to answer the same question over and over and over again and every repeated study uses resources that could be used to study other potential causes and treatments for autism. This study happens to be one large and convincing chunk of that evidence, but it is not the only one. Coming next year, when the CDC releases a similar trial about autism, will be another. As Dr. Offit said:

In a new study, Thompson and his colleagues are taking another look at thimerosal exposure and autism. But for many, the question has been resolved. “This study is the third one of its kind. When the autism one comes out, it will be the sixth of its kind. They’ve all shown the same thing–that there is no significant correlation,” says Offit. “Meanwhile, the thimerosal question has diverted attention and resources away from the search for more promising leads on what causes autism. How many more studies will it take?”

That’s the difference between science and crankery. If this study had shown a clear and convincing correlation between thimerosal in vaccines and neurdevelopmental disorders, I would have accepted the results and perhaps started to change my mind. On the other hand, for cranks, no number of studies is ever enough to dissuade them from their beliefs. If God Himself were to come down from on high and design the absolutely perfect study, which when carried out showed no correlation between thimerosal in vaccines and neurodevelopmental disorders, the antivaccinationists would insist that it was flawed, that the investigators had conflicts of interest, and that it needs to be repeated until (although they would never admit this) it shows the results they want it to show.

In fact, expect just that. The CDC has pledged to make the raw data available to other researchers. I predict that, within a few months, a study by Mark and David Geier will use their trademark bad statistics and bad math to cook the numbers to make it look as though there are associations between thimerosal in vaccines and neurodevelopmental disorders that the CDC “covered up.”

Just wait.

ADDENDUM: Some more commentary on this study:

From Left Brain/Right Brain:

No, everything was fine and dandy as long as she [Bernard] was enjoying being fawned over as a “representative of the autism community” and a fellow-scientist instead of the commercial marketer she actually is. Here’s a clue, Sallie: If you’re going to play scientist, you have to follow the rules of science, and that means you stand by your results. You don’t get to say “heads I win, tails you lose” by waiting to see the outcome before deciding whether the study was any good.

And you really don’t get to have CDC at your beck and call, spend hundreds of thousands of taxpayer dollars to do a study to your specifications, then turn around and call them liars when you don’t like how it comes out.

And you, CDC? You’re not just a victim here. Every time you say “let’s do more research” or “we are examining this issue” in order to appease the mercury moms, you increase the chances that kids will go unvaccinated because you failed to give their parents confidence in the safety of vaccines. When you say a study is reassuring and then highlight what is virtually certain to have been a chance finding (a statistical association between higher thimerosal exposure and transient tics in boys) without making it abundantly clear that some false associations were inevitable given the study design, you defeat the purpose of doing the study.

From AutismVox:

Safe Minds, whose Executive Director, Sallie Bernard, was an external consultant and dissenting member of the study, put out a press release stating that the new study’s “draws a misleading conclusion.” But this statement is as “misleading” as the headlines cited above are about the study’s actual contents This only furthers the belief that–no matter how clearly it is stated and shown that there is no causal association between early exposure to thimerasol and later neuropsychological outcomes—a link between these has been firmly established in the public mind. And disputing that link will take more studies, more evidence, more efforts, and more self-scrutiny of why we believe what we believe.

From Autism Natural Variation:

The CDC study looked at 42 different outcomes, and determined multiple confidence intervals in each case, since different levels of exposure were tested. In total, I understand there were over 300 confidence intervals. Consequently, assuming the null hypothesis is correct, you should expect that an RR of 1.0 will be outside the 95% confidence interval in over 15 measures. What the study found was that in 12 measures there was an apparent protective factor, and in 8 measures there was an apparent risk factor. This is completely consistent with the null hypothesis. Therefore, the conclusion of the study, namely that the results of the same do not support a causal association between thimerosal-containing vaccines and neurological outcomes, is absolutely the correct conclusion.

From Arthur Allen on The Huffington Post:

Despite the wealth of data showing that vaccines do not cause autism, many parents continue to believe the theory. Jenny McCarthy, an ex-Playboy Bunny and TV personage, has been making the rounds of the media this week (Oprah, ABC, People magazine) to promote her book, in which she claims that her child was made autistic by vaccines but was “recovered” through alternative therapies.

A large CDC study comparing thimerosal exposure rates in autistic and non-autistic kids is due out around this time next year, as is an Italian study of the question. The data will probably duplicate the many previous studies that have shown no effect. The dogs may bark but the caravan moves on. Or is it the other way around

(The comments from die-hard antivaxers after Allen’s post are scary indeed.)

From Derek Lowe at In the Pipeline:

The director of SafeMinds, a group of true thimerosal believers if ever there was, actually was on the consulting board of this latest study. But she withdrew her name from the final document. The CDC is conducting a large thimerosal-and-autism study whose results should come out next year. Here’s a prediction for you: if that one fails to show a connection, and I have every expectation that it’ll fail to show one, SafeMinds will not accept the results. Anyone care to bet against that?

As a scientist, I’ve had to take a lot of good, compelling ideas of mine and toss them into the trash when the data failed to support them. Not everything works, and not everything that looks as if it makes sense really does. It’s getting to the point with the autism/thimerosal hypothesis- has, in fact, gotten to the point quite some time ago – that the data have failed to support it. If you disagree, and I know from my e-mail that some readers will, then ask yourself what data would suffice to make you abandon your belief? If you can’t think of any, you have moved beyond medicine and beyond science, and I’ll not follow you.

Commenting on David Kirby’s truly idiotic take on this study in The Huffington Post, Steve Novella at Neurologica:

What Kirby does is not just really dumb, it’s despicable. He cherry picks all the negative (meaning bad) neurological outcomes and pretends that the study shows a correlation (it doesn’t, when you look at ALL the data). He then tries to dismiss the positive (good) outcomes as absurd. He mockingly writes:

If they (the CDC) really mean that thimerosal increases IQ levels in males, then sign me up for a double-dose flu shot this year.

No, David, they don’t mean that. Not by any stretch of the imagination. It takes incompetent statistical analysis or the blindness of ideology to write something so ridiculous. What the CDC means is that the study does NOT show that thimerosal increases IQ, nor that it causes motor tics, or improve motor skills, or decrease language skills, or anything else. The study showed no correlations because it all averaged out as noise.

Steve, normally polite to a fault even with cranks, seems to be laying down a bit of the old Respectful Insolence(tm). I like it.

CDC: “Thank you, Sallie, May We Have Another?”

27 Sep

A CDC study released yesterday found no evidence to support “a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.” In other words, vaccines don’t scramble your brain.

The study didn’t examine autism as an outcome, although that is almost certainly what it was intended to get at. Instead, it looked for whether children’s exposure to thimerosal before birth or in infancy had any relationship to their later performance on 42 standardized tests which one would expect to be affected by autism. For each of the 1,047 children in the study, the researchers assessed speech and language; verbal memory; achievement (letter and word identification); fine motor coordination; visuospatial ability; attention and executive function; behavior regulation; tics; and general intellectual functioning.

CDC tried so hard. They invited one of the queen mercury moms, Sallie Bernard of “SAFEMINDs,” to participate in the planning of the study. They brought on a panel of outside advisors. The team spent at least two years administering forty-seven separate tests to each of the children and analyzing and writing up the results. They printed every piece of data generated in a companion volume to the published study.

They got kicked in the teeth, but don’t feel bad for them. They should have known better.

The autism-vaccine contingent has responded by spluttering about the study not having been large or random enough, and by accusing the researchers of being biased and of ignoring important associations in the data. It’s no news that these people don’t believe anything that comes from CDC – they’ve said as much, very clearly. But one would think that if you let the antivaxers in on the process from day one, if you were totally transparent, they couldn’t object, could they? They’d have to see the light when the results came back and say, “Well! I guess it’s not the vaccines after all!”

CDC, if you really thought that would happen, you were so, so wrong.

The appearance is that Sallie Bernard was going along with all this up until the day the results came in and – shockingly! – showed thimerosal didn’t do one bit of harm. If she’d thought from the outset, as a SAFEMINDs press release now claims, that there weren’t enough kids in the study or the sampling were biased, does anybody think this gadfly would have nodded and smiled and gone right along with it?

No, everything was fine and dandy as long as she was enjoying being fawned over as a “representative of the autism community” and a fellow-scientist instead of the commercial marketer she actually is. Here’s a clue, Sallie: If you’re going to play scientist, you have to follow the rules of science, and that means you stand by your results. You don’t get to say “heads I win, tails you lose” by waiting to see the outcome before deciding whether the study was any good.

And you really don’t get to have CDC at your beck and call, spend hundreds of thousands of taxpayer dollars to do a study to your specifications, then turn around and call them liars when you don’t like how it comes out.

And you, CDC? You’re not just a victim here. Every time you say “let’s do more research” or “we are examining this issue” in order to appease the mercury moms, you increase the chances that kids will go unvaccinated because you failed to give their parents confidence in the safety of vaccines. When you say a study is reassuring and then highlight what is virtually certain to have been a chance finding (a statistical association between higher thimerosal exposure and transient tics in boys) without making it abundantly clear that some false associations were inevitable given the study design, you defeat the purpose of doing the study. People who understand statistics weren’t the ones who needed to be convinced thimerosal is safe; the antivax crowd will never be convinced no matter what. You needed to speak to the well-meaning parents who worry about the rumors they hear at playgroup, and not only did you give them something new to worry about and whiff the opportunity to show them that the likes of Sallie Bernard are all about the rhetoric – you managed to tee up for yet another round of Righteous Long-Suffering Parents vs. Heartless Government Scientists.

Haven’t you learned yet who wins that one? Or are you going to invite Sallie back for another round of research?

Postscript: More commentary on this study by Arthur Allen, Orac, Joseph, Interverbal, and Kristina Chew.

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