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Immunization uptake in younger siblings of children with autism spectrum disorder

12 Oct

If one child has autism, the chance that a younger sibling will have autism is about 18.7%. (see the study Recurrence Risk for Autism Spectrum Disorders: A Baby Siblings Research Consortium Study and discussions here and elsewhere). Anecdotally, we hear a lot about families deciding to forgo or delay vaccines after having an autistic child. This raises a question and an opportunity for research: does delaying or stopping vaccines result in a lower risk of autism? Looking at younger siblings, one would have a population that both has a higher autism risk and a possibly higher percentage of use of alternate (including no) vaccine schedule.

A study has been published this week on this very topic: Immunization uptake in younger siblings of children with autism spectrum disorder. The answer? Immunization does not increase the risk of autism. But I get ahead of myself.

The authors divided the children into three groups

Immunization status was divided into three predefined categories: (a) Fully immunized: Children with four doses of DPTP (2, 4, 6, and 18 months) and the initial MMR dose at 12 months, (b) Partial/delayed immunizations: Children with any missing dose of DPTP or MMR at any age or a delay of 3 months or more for at least one of the doses of DPTP or MMR, and (c) Not immunized/declined: Children for whom all immunizations had been withheld as of 3 years of age.

In case you are wondering, yes, comparing groups (a) and (c) is a vaccinated/unvaccinated study design. [edit to add–see note below] (b) just gives more dimension to the study.

Yes, siblings of autistic children are vaccinated differently (on average) than younger siblings of non-autistic children:

MMR immunization uptake. The analysis revealed a significant group difference in MMR immunization status (Fisher’s exact test = 80.82, p < .001). Bearing in mind that the Public Health Agency of Canada recommends that children receive their initial MMR vaccine at 12 months (in contrast to the United States, where it is recommended at 12–15 months; Public Health Agency of Canada, 2006a; CDC, 2011), only 42 of the 98 (43%) younger sibs received the 12-month MMR vaccine ontime (i.e. by at least 15 months of age; see Figure 2); an additional 38 (39%) received the vaccine after 15 months of age, and 18 (18%) had not been immunized against MMR by the age of 3 years. In contrast, 88 of 98 (90%) probands received the MMR by 15 months, 9 (9.2%) were delayed, and only 1 had not been immunized by the age of 3 years. Similarly, 63 of 65 (97%) controls had completed their MMR immunization on time (i.e. only two were delayed, and none had parents who had fully declined).

Only 42% of younger siblings of autistics received the MMR ontime. 18% were not given the vaccine by age 3. Compare this to the control group, where 90% received the MMR by 15 months and 98% by age 3.

Differences were seen with the DPTP vaccine as well:

DPTP immunization uptake. A significant group difference was also found for DPTP immunization status (Fisher’s exact test = 38.95, p < .001), with just over half (55.1%) of the younger sibs having been immunized on time (31.6% were delayed, and 13.3% were not immunized by the age of 3 years; see Figure 3). The rates of DPTP uptake were higher for probands (86.7% immunized on time, 12.2% delayed, and 1% not immunized) and controls (90.8% immunized on time, 9.2% delayed, and none declined).

What did this do to autism risk for these un- and under-vaccinated younger siblings? Statistically nothing:

Of the 39 younger sibs who had completed their immunizations on time, 6 (15.7%) were diagnosed with ASD and 2 with speech-language delay (SLD). Of the 47 younger sibs for whom immunization as delayed, 15 (31.2%) received an ASD diagnosis and 2 had SLD. Of the 12 younger sibs who had not received any immunizations, 4 (33.3%) were diagnosed with ASD and 1 with SLD. Note that of those children who did not receive a diagnosis, 43.8% were fully immunized. The Fisher’s exact tests revealed no significant difference in the rates of diagnoses between immunized and nonimmunized groups for MMR (Fisher’s exact test = 5.46, p = .22), DPTP (Fisher’s exact test = 3.65, p = .44), or both (Fisher’s exact test = 4.13, p = .37), although small sample size renders these comparisons exploratory only.

And, by “statistically nothing”, I am not saying, “the calculated risk for vaccinated siblings are higher, but we can’t claim they are because the p values aren’t statistically significant”. No, I’m saying, “the calculated values are lower for vaccinated siblings.”

The authors found about 15.7% autism risk for baby siblings. Very close to the Baby Siblings study mentioned above which found 18.7% risk. The risk found for siblings with delayed vaccination was 31.2% and for unvaccinated was 33.3%. Again, these values are not statistically significant from the 15.7%.

So, when one does a vaccinated/unvaccinated study, one finds that autism risk (for familial autism) is not increased.

Since people will undoubtedly be looking for the conflicts of interests for the study authors, the COI statement is “The authors declare that there is no conflict of interest.” and their funding is “This research was funded by the Canadian Institutes of Health Research and Autism Speaks.”

Limitations include sample size and the fact that the authors relied upon parent recall for much of the data:

Parents of 22.2% (58/261) of the children provided a copy of their child’s immunization record or had it sent by their doctor; for the remaining 77.8%, status report was based on parent recall (note that this information was typically gathered at each visit, at 3- to 6-month intervals, to avoid recall bias). Due to the potential for recall bias (e.g. see Dorell et al., 2011, for bias in recall for the older children), we examined the influence of information source (card copy vs parent recall) on immunization status. No significant relationship was found for MMR (Fisher’s exact test = .38, p = .84), DPTP (Fisher’s exact test =1.71, p = .44), or “both” (Fisher’s exact test = 1.58, p = .48).

Here is the abstract:

Background: Parental concerns persist that immunization increases the risk of autism spectrum disorder, resulting in the potential for reduced uptake by parents of younger siblings of children with autism spectrum disorder (“younger sibs”).

Objective: To compare immunization uptake by parents for their younger child relative to their
older child with autism spectrum disorder (“proband”) and controls.

Design: Immunization status was obtained for 98 “younger sibs,” 98 “probands,” and 65 controls.

Results: A significant group difference emerged for overall immunization status (Fisher’s exact test = 62.70, p < .001). One or more immunizations in 59/98 younger sibs were delayed (47/98; 48%) or declined (12/98; 12.2%); immunizations were delayed in 16/98 probands (16.3%) and declined in only one. All controls were fully immunized, with only 6 (9.2%) delayed. Within the “younger sibs” group, 25/98 received an autism spectrum disorder diagnosis; 7 of whom (28%) were fully immunized. The rates of autism spectrum disorder diagnosis did not differ between immunized and nonimmunized younger sib groups, although small sample size limits interpretability of this result.

Conclusion: Parents who already have one child with autism spectrum disorder may delay or
decline immunization for their younger children, potentially placing them at increased risk of
preventable infectious diseases.

Edit to add: The authors have clarified that unvaccinated means not vaccinated with MMR or DPTP, not necessarily completely unvaccinated.

A breach of privacy

10 Oct

Privacy is an important point for all of us. I blogged for a long time under a pseudonym in order to protect my child’s privacy. The subject is important enough to me that when I noticed what I considered to be a breach of privacy by Andrew Wakefield and his “Dr Wakefield Justice Fund”, I wrote to them with the information in order to give them the chance to correct this. To explain: the “Dr. Wakefield Justice Fund” posted documents from Mr. Wakefield’s defamation suit filed against Brian Deer and Fiona Godlee. One of those documents includes the full names and birthdates of seven of the patients seen at the Royal Free Hospital in the 1990’s.

I sent the following email to one of the contact email addresses for the “Dr Wakefield Justice Fund” (info@drwakefieldjusticefund.org).

Hello,

if you aren’t already aware of this, you may want to know that in this document:

[link redacted by me for this article]

You have made public the full names and birth dates of seven patients seen at the Royal Free. Given the complaints levied against Mr. Deer for, as I recall, publishing the first names of the Lancet 12, I thought you might want to take the effort to redact that document.

Matt Carey

I sent this Friday of last week and so far have received no response and no correction has been made. I have not made an effort to find and remember the names of the “Lancet 12” so these names are unfamiliar to me (with the exception of two last names). I did a quick internet search on some of the names and did not find them linked to Mr. Wakefield or MMR in a relatively brief search, so this seems like a true breach of privacy. I’ll note that in the GMC hearings names were occasionally spoken but the court kept to a standard of anonymizing child and parent names in the transcript.

I would encourage the “Dr. Wakefield Justice Fund” to redact that and any other documents which contain such information.

—
By Matt Carey

Andrew Wakefield tops the “Retraction Epidemic”

5 Oct

We recently discussed a paper in the Proceedings of the National Academy of Sciences: Misconduct accounts for the majority of retracted scientific publications. A reader sent a copy to me and there are a couple of interesting points (OK, there are a number of interesting points, but a couple specific to the autism communities).

First, consider the abstract:

A detailed review of all 2,047 biomedical and life-science research articles indexed by PubMed as retracted on May 3, 2012 revealed that only 21.3%of retractionswere attributable to error. In contrast, 67.4% of retractions were attributable to misconduct, including fraud or suspected fraud (43.4%), duplicate publication (14.2%), and plagiarism (9.8%). Incomplete, uninformative or misleading retraction announcements have led to a previous underestimation of the role of fraud in the ongoing retraction epidemic. The percentage of scientific articles retracted because of fraud has increased ∼10-fold since 1975. Retractions exhibit distinctive temporal and geographic patterns that may reveal underlying causes

Yes, the “retraction epidemic”. My guess is the use of “epidemic” here will rankle one or more of Mr. Wakefield’s supporters.

One point that I discussed previously was that Mr. Wakefield’s 1998 Lancet paper tops the list as the most cited retracted paper. The list of top cited retracted papers is shown in this figure (Click to enlarge):

The figure lists the reasons for retraction. The reason for Mr. Wakefield’s paper? Fraud.

As many readers will recall, Mr. Wakefield sued the BMJ and Brian Deer and editor Fiona Godlee for defamation for calling Mr. Wakefield’s paper fraudulent. Which begs the question: how can one call something defamatory when it is a generally accepted fact within the research community?

At present Mr. Wakefield is appealing the decision that stated he doesn’t have the standing to sue in Texas. As always in this case, it isn’t enough to show that his reputation is poor. He has to show that someone other than himself is at fault for his poor reputation. And that is a tough hurdle to cross.

—
By Matt Carey

Mark and David Geier, holed up in Missouri?

5 Oct

There is really no fun in writing about people whose lack of ethical standards harm disabled children. Seriously, it is painful. I know at least one autism blogger who quit in no small part because it was just too hard to keep writing about these topics.

And here in one week, both Andrew Wakefield and the Geiers (Mark and David) come back up in the news. A recent story in the St. Louis Post Dispatch discusses the Geiers: Controversial autism doctor loses license elsewhere, but can still practice in Missouri, Illinois

Mark Geier is an M.D. and was licensed in multiple states (I’ve lost count of how many and which ones). His home base is Maryland. His license was suspended there and many other states have followed suit. David Geier holds no medical credentials and is charged with practicing medicine without a license in Maryland.

As noted above, most, but not all, states have followed suit with suspending Mark Geier’s license.

The St. Louis Post Dispatch writes (reminding me of which states Mr. Geier has been licensed):

Dr. Mark Geier has opened eight autism treatment clinics called ASD Centers across the country but is only allowed to practice at two of them — in St. Peters and Springfield, Ill.

Missouri and Illinois are among the last states to seek discipline against Geier, whose hormone therapy for children with autism has been called dangerous, abusive and exploitive by various medical boards.

In the last two years, his medical license has been revoked or suspended in California, Florida, Indiana, Kentucky, Maryland, New Jersey, Texas, Virginia and Washington.

Missouri, Illinois and Hawaii have filed complaints against Geier based on other states’ actions, but his license remains active in all three states. A disciplinary hearing in Geier’s case is set for Oct. 19 before the Missouri Board of Registration for the Healing Arts in Jefferson City

The Geier hypothesis is that mercury binds with testosterone in the brain, making it difficult to chelate. They prescribe Lupron to reduce testosterone. The idea would be laughable if it weren’t being used on humans (or any animal for that matter).

Briefly–the Geier’s cited a paper showing that in hot benzene,
(more details in Miscellaneous Mercury Nonsense), mercuric chloride and testosterone can be induced to form chemical complexes.

I had hopes that the Geiers had moved away from this idea, but they stand by it:

David Geier said Wednesday that “many peer-reviewed scientific studies” have been published that support the theory. All of the research articles cited on the ASD Centers’ website are co-authored by Mark or David Geier.

The fact that the Geiers were able to get papers published in third rate journals doesn’t make their ideas true. Or even feasible.

Mr. David Geier did not attend medical school. Neither did I but I will offer him this small bit of medical advice: Among other logical problems with your idea, the human brain is not the same thing as a beaker of hot benzene.

Point two: even if your idea held any merit, Lupron lowers the level of testosterone in the blood, it doesn’t break up these mythical mercury-testosterone complexes.

The Geiers are demonstrating a major problem with the medical license system in the U.S.. It took years to bring the Geiers to hearing. Now that Mark Geier has lost his license in his home state, he has moved to other “safe havens” to continue business? How is this right.

I recall a number of med students and premeds I knew while in college and grad school. The hoops they had to jump through to get their degrees and get licensed and start working seemed enormous. Now we see why: it’s so hard to stop someone from practicing.

Christian Science Monitor: Fraud in scientific research: It happens, and cases are on the rise

4 Oct

The Christian Science Monitor has an article out today: Fraud in scientific research: It happens, and cases are on the rise

Of 2,000 retractions of published scientific papers since 1977, 866 were because of fraud, a new study finds. Another 201 were plagiarized. But it’s hard to know if more scientists are cheating, or if detection is simply better.

Is it a real increase, or just better awareness…

Who is their prime example of science fraud? I’m sure you’ve guessed it: Andrew Wakefield. Ironically, on the day when Mr. Wakefield is giving a faux press conference in a public park, the Monitor uses a photo from Mr. Wakefield’s public park appearance during a past AutismOne convention:

Why use Mr. Wakefield as the example? Many reasons come to mind, but the fact that he is probably the most publicly recognizable that the Monitor could have chosen. Also, the Monitor states:

One of the most high-profile examples involved the issue of childhood immunizations.

That paper, which the PNAS [Proceedings of the National Academy of Sciences] study identifies as the most widely cited retracted work, cited research purported to uncover a link between autism and vaccines given to children. The work was published in 1998 in the British medical journal Lancet. Subsequent studies reportedly indicated that the data were fraudulent. Meanwhile, Britain’s General Medical Council stripped the study’s author, Andrew Wakefield, of his status as a “registered medical practitioner” for misconduct after investigating his research effort.

So Mr. Wakefield has the dubious distinction of having written the most cited retracted work. He’s the best at something.

—
By Matt Carey

Andrew Wakefield tries to make himself relevant again

2 Oct

Andrew Wakefield is the former research surgeon who championed the idea that the MMR vaccine causes autism. Multiple researchers have told me that even at the time of Mr. Wakefield’s first research announcements, Mr. Wakefield’s idea was a stretch in terms of biological feasibility. For a few years at least, Andrew Wakefield was relevant in the autism research community. People worked to replicate his findings and otherwise answer the questions he posed. That was years ago. The result is we now know his ideas of persistent measles infection and a leaky gut causing autism were not valid and that, at best, Mr. Wakefield was a mediocre scientist who took this poorly conceived hypothesis and ran with it. Running as in a “running with scissors”, ignoring safety. As has been demonstrated since, he was also ignoring ethical concerns as well. But this is all old news.

In 2004, yes 8 years ago, Brian Deer exposed many of the ethical lapses in Mr. Wakefield’s autism career. Since then we’ve heard a lot of words from Mr. Wakefield about how it is all about the children, but seen a lot of his actions more akin to it being all about himself. He sued Mr. Deer over those 2004 reports (how is that helping autistics?). Mr. Wakefield abandoned his suit (how is that helping autistics?). Mr. Wakefield asked that the GMC look into the possible charges stemming from the reported actions (OK, that helps autistics a little by exposing Mr. Wakefield’s ethical and scientific deficiencies better, but that wasn’t exactly his intention). Mr. Wakefield attended the GMC hearings even though he sayed he didn’t need his medical license (registration) any more. This provided a great deal of drama (again, how does this help anyone but Mr. Wakefield?) but not much advancement. Mr. Wakefield was struck off the register (which could be argued helps autistics in a small way). Mr. Wakefield appealed and then dropped his appeal of the GMC decision. When Mr. Deer wrote more articles, this time for the BMJ, Mr Wakefield filed a complaint with the PCC (press complaints commission) in the UK, but he appears to be not pursuing that. Just letting it exist as a complaint (again, benefit?). Then, this year, he chose to sue Brian Deer, the editor of the BMJ and the BMJ itself this year for defamation over another set of articles and public statements (again, to what benefit to autistics?).

Mr. Wakefield’s latest day in court was short, but likely expensive. A judge in Texas ruled that Mr. Wakefield doesn’t have the standing to bring that case to trial.

Recently Mr. Wakefield appealed. Which, frankly, was enough of a non event in my view that with Respectful Insolence covering the discussion I felt no need to.

In the past eight years we can point to no advances in autism research championed by Mr. Wakefield, but we can (and just have) point to numerous occasions of Mr. Wakefield use procedural methods to keep himself in the news.

Mr. Wakefield claims essentially that calling him a fraud is defamatory. Which brings up the part of recent events that I did find interesting. Again at Respectful Insolence, in Time to rally the troops against the antivaccine movement, Orac calls on people to, well, rally. I’ll stand apart from Orac on this one. Frankly, making this appear to be a controversy, adding drama, is not helping matters.

One might rightly ask, why write about this at all? Why spend time on a topic which has obviously become irrelevant? In setting up his press conference Mr. Wakefield (through his team) made a bit of a poor move.

Mr. Wakefield’s approach to the discovery of his ethical and scientific failings has been to deny even the most clear facts. For example, when presented with direct evidence that he had major financial interests in creating a viable court case out of the MMR/autism hypothesis (being a paid expert witness, creating test kits with the idea that litigation-driven profits will be millions per year, etc.), Mr. Wakefield tells us it is all about the children, and he made all his financial ties public in advance (which he didn’t). When it was discussed on TV that he had a patent application in place covering an alternative measles patent–one whose commercial viability hinged directly on the confidence level of the current vaccine–he told us that it was all misdirection on the part of Mr. Deer. Later it became public that Mr. Wakefield had business plans in place to develop the invention as a potential vaccine.

Essentially, after being caught with his hand in the cookie jar, Mr. Wakefield tells us he was never in the kitchen and, besides, he was only getting the cookie for the children.

From a public relations standpoint (and let’s not forget that Mr. Wakefield had a PR representative since before Brian Deer entered the scene) Mr. Wakefield has played his hand somewhat well. He plays the role of a man who remains polite even in the face of this alleged adversity we are to believe has been put upon him. Mr. Deer, on the other hand, is (I believe in his own words), mercurial and has made statements which are easy to use against him.

Mr. Wakefield is portrayed as the guy you’d love to sit down to a glass of beer (or more likely wine) with while Mr. Deer is someone you’d best not provoke (I believe the term “reptilian” has recently been used by his detractors). I’m not so motivated by the opportunity to sit down to a glass of wine with unethical people, but let’s move on.

In an article on the Age of Autism blog, Ed Arranga writes about Mr. Deer being brought out to the U.S. to give talks to some academics and how Mr. Wakefield will hold a press conference. As one would expect from the Age of Autism, the approach is strongly negative. Here’s how it starts out:

Brian Deer – a liar, fraud, and former reporter for The Sunday Times of London – is coming to the University of Wisconsin-La Crosse October 4 and 5 to lecture you about Dr. Andrew…

Mr. Arranga is doing the attack here, allowing Mr. Wakefield to retain his polite persona. But with a multi-million dollar lawsuit ongoing, is this really enough distance for Mr. Wakefield? How will the above statements play out should Mr. Wakefield win the chance to sue?

Mr. Arranga runs AutismOne, whose convention presents Mr. Wakefield as a prime draw. In other words, Mr. Arranga has a financial interest in Mr. Wakefield’s reputation. A small conflict of interest which, while obvious to most of his readers, should have been made clear in Mr. Arranga’s article. Mr. Arranga also serves on the “Strategic Autism Initiative”, a charity formed after Mr. Wakefield’s ouster from Thoughtful House. [Correction: Mrs. Arranga serves on the SAI board, but Mr. Arranga is not listed in the available tax document]. Most importantly to this discussion, Mr. Arranga is also on the “executive staff” of the “Dr. Wakefield Justice Fund“.

So someone intimately involved with Mr. Wakefield’s career and defense is calling Mr. Deer a “fraud” and a “liar” and, in general, attacking Mr. Deer. Consider that Mr. Wakefield’s case is based at least in part on the idea that using terms such as “fraud” is defamatory. Mr. Wakefield’s original court filing states that defamation occurred: “Based on Defendants’ purported “reanalysis,” Defendants made and continue to make assertions that Plaintiff Dr. Wakefield committed fraud and is “a fraudster.”” Again, one should ask, did Mr. Wakefield blunder in allowing this personal attack on Mr. Deer? How will a judge or jury view a man who sets his team to attack others while claiming that the very same terms are defamatory? It’s not enough to cost him the case, but it was not a wise move.

The sad thing is that this is as close to relevance and Mr. Wakefield can currently attain in the autism communities. Holding a press conference in response to lectures by Brian Deer, who is discussing events that happened 15 years ago. Attacking Mr. Deer through surrogates. Putting time, money and effort into the latest in a string of procedural maneuvers which, even if he were right, hold no benefit for the communities.

As far as cost/benefit calculations go, Mr. Wakefield is a simple case. Costs to the autism communities in time and resources wasted chasing the ideas he championed. Costs to the public at large in terms of health scares and increased infectious disease. All this weighed against a complete lack of benefit brought to the communities by Mr. Wakefield. I guess we should put this in terms of a benefit/cost ratio to avoid dividing by zero.

—
By Matt Carey

Children with neurologic disorders at high risk of death from flu

29 Aug

Sometimes I get taken to task for spending too much time discussing vaccines. The thimersal and MMR hypotheses failed. Why keep discussing vaccines on what is primarily an autism focus site?

Well, for one thing, public health does involve us all. Just in general.
But there really is another level. Many autistics are more medically fragile than the average.

People die from influenza. Even in the relatively clean United States with its modern health care. People die. Amongst those are a disproportionate number of children with neurological disorders.

Below is a CDC press release on deaths from flu. Here for emphasis:

Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions. One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.

People and groups that spread misinformation about vaccines put everyone at risk and people with neurological conditions even more so.

They put my kid at risk. As is often discussed, some people don’t get immunity from vaccines. The only way I’ll know if my kid isn’t protected will be when an outbreak occurs.

I love the nurses in our local pediatric ward. But they dont want to see us again and I don’t want to see them again unless it is at a local Starbucks (in which case I pick up their tab. )

Children with neurologic disorders at high risk of death from flu
Health care and advocacy groups join to protect children most vulnerable to influenza

A disproportionately high number of children with neurologic disorders died from influenza-related complications during the 2009 H1N1 pandemic, according to a study by scientists with the Centers for Disease Control and Prevention. The report in the journal Pediatrics underscores the importance of influenza vaccination to protect children with neurologic disorders. CDC is joining with the American Academy of Pediatrics, Families Fighting Flu and Family Voices to spread the message about the importance of influenza vaccination and treatment in these children.

The Pediatrics study looked at influenza-related deaths in children during the 2009 H1N1 pandemic based on data submitted to CDC from state and local health departments. The number of pediatric deaths associated with 2009 H1N1 virus infection reported to CDC during the pandemic was more than five times the median number of pediatric deaths that were reported in the five flu seasons prior to the pandemic. Sixty-eight percent of those deaths occurred in children with underlying medical conditions that increase the risk of serious flu complications.

Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions. One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.

“We’ve known for some time that certain neurologic conditions can put children at high risk for serious complications from influenza,” said Dr. Lyn Finelli, chief of the surveillance and outbreak response team in CDC’s Influenza Division. “However, the high percentage of pediatric deaths associated with neurologic disorders that occurred during the 2009 H1N1 pandemic was a somber reminder of the harm that flu can cause to children with neurologic and neurodevelopmental disorders.”

“Flu is particularly dangerous for people who may have trouble with muscle function, lung function or difficulty coughing, swallowing or clearing fluids from their airways,” said study coauthor and pediatrician Dr. Georgina Peacock. “These problems are sometimes experienced by children with neurologic disorders,” said Peacock, of CDC’s National Center on Birth Defects and Developmental Disabilities.

The most commonly reported complications for children with neurologic disorders in this study were influenza-associated pneumonia and acute respiratory distress syndrome (ARDS). Seventy-five percent of children with a neurologic condition who died from 2009 H1N1 influenza-related infection also had an additional high risk condition that increased their risk for influenza complications, such as a pulmonary disorder, metabolic disorder, heart disease or a chromosomal abnormality.

CDC is partnering with the American Academy of Pediatrics and influenza advocacy groups to help promote awareness about the importance of influenza prevention and treatment in these high risk children. Since the H1N1 pandemic, children with neurologic conditions continue to represent a disproportionate number of influenza-associated pediatric deaths. CDC, the American Academy of Pediatrics (AAP), Family Voices, and Families Fighting Flu recognize the need to communicate with care takers about the potential for severe outcomes in these children if they are infected with flu.

“Partnering with the American Academy of Pediatrics, influenza advocacy groups and family led-organizations CAN help prevent influenza in children at highest risk,” said CDC Director Dr. Thomas R. Frieden.

The partnering organizations are working to coordinate communication activities with their constituents, which include parents and caregivers, primary care clinicians, developmental pediatricians and neurologists in hopes to increase awareness about flu prevention and treatment in children with neurologic disorders.

“The American Academy of Pediatrics, Families Fighting Flu and Family Voices were all natural partners when we thought about how to reach as many key people as possible with this message,” Dr. Peacock adds. “The collaboration and energy around this effort has been fabulous.”

“Our network of physicians is committed to influenza prevention in all children, and especially in reducing complications in those children at higher risk for experiencing severe outcomes as a result of influenza-like illness,” says Robert W. Block, M.D., president of the AAP. “This coalition can more broadly engage the entire community of child caregivers to express how serious flu can be for these children. These efforts emphasize why the medical home is so important for children and youth with special health care needs.”

Family Voices is a national family-led organization supporting families and their children with special health care needs. Ruth Walden, a parent of a child with special needs and president of the Family Voices Board of Directors, says, “It’s frightening to think that flu can potentially lead to so many complications or even death. We’re pleased to see organizations working together to educate families and providers about the importance of prevention.”

Families Fighting Flu, an advocacy group dedicated to preventing influenza, has a long history of reaching out to families who’ve lost loved ones to flu. “Throughout the years we’ve seen firsthand how flu can affect these kids and their families’ lives. We understand that prevention is absolutely critical,” explains Laura Scott, executive director of Families Fighting Flu. “Working with other groups only expands our mission of keeping kids safe throughout the flu season.”

CDC recommends that everyone aged 6 months and older get an annual influenza vaccination, including people who are at high risk of developing serious complications. Flu vaccine is the best prevention method available. Antiviral drugs, which can treat flu illness, are a second line of defense against flu.

To learn more about influenza, visit http://www.cdc.gov/flu.

—
By Matt Carey

Mark Geier’s license suspended in Florida, revoked in Indiana

22 Aug

Dr. Mark Geier is well known within the alternative-medicine and vaccine-causation segments of the autism communities. As a practitioner, Dr. Geier is probably best known for therapies purporting to treat autism through approaches claiming to work on removing mercury. The idea that mercury is involved in autism etiology is a failed hypothesis on it’s own. But Dr. Geier’s treatment ideas included a frankly incredible notion that mercury is bound in the body by testosterone, so, he hypothesized, by reducing the body’s production of this hormone, one could better remove the mercury. To reduce testosterone, Dr. Geier proposed (and prescribed) drugs such as Lupron. It is not a bad idea–it is a series of bad idea. Very bad ideas.

These ideas are so poor in concept that it is difficult to get insurance companies to pay for Lupron for reducing mercury in the body. In an apparent move to avoid this difficulty, Dr. Geier diagnosed autistic children with precocious puberty. Dr. Geier’s methods were lacking and due to this and other factors, Dr. Geier’s license came under suspension in his home state of Maryland.

Dr. Geier was licensed in many states. When a doctor faces disciplinary action in his home state, he is supposed to report those actions to other states where he holds a license. As Catherina reports in Bad month for the Geiers: Mark R. Geier’s medical license suspended in Florida, Dr. Geier appears to have failed to inform Florida in a timely manner. The full decision is linked on the Just the Vax site, and also can be found here.

Todd W. of Harpocrates Speaks further notes that Dr. Geier’s license had been revoked–not suspended, revoked–in Indiana. In Mark “Castrate ‘Em” Geier’s License Suspended – Part 7 Todd W. notes:

Indiana also made a further step, going beyond mere suspension to actually revoking his license in that state. The revocation comes because he failed to appear before the board regarding his suspension, thereby defaulting on any appeal to their decision. The final order, dated July 5, 2012 further imposed a $5 fee and a fine of $3,000.

Further reading about the “Lupron Protocol” can be found at Neurodiversity.com, where Kathleen Seidel’s thorough reporting was the first to expose many of the questionable practices.

If I understand correctly, Dr. Geier remains licensed in both Illinois, Missouri and Hawai’i. However, he faces more charges in his home state of Maryland.

Missouri notes the fact that Dr. Geier has faced license suspension in other states. His license is up for renewal there Jan 31, 2013. In Illinois, his license is active, with a notation that he has not been “ever disciplined”. His license comes up for renewal there July 30, 2014. His Hawai’i license is “current, valid and in good standing” and valid through 01/31/2014.

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by Matt Carey

(note, the last paragraph was added shortly after this article was published)

From Bill Gates, A Toilet Challenge Spills Forth

16 Aug

Warning: this article isn’t about autism. It isn’t about that all too common side topic of vaccines either. Not directly, at least. This article is about Bill Gates. And toilets.

Bill Gates is attacked regularly online by a small but vocal segment of the autism parent community. Why? Because he has put a large part of his fortune towards vaccines. Vaccine research and bringing vaccines to the developing world.

One common complaint is that he is misspending his money. That the developing world needs clean water, better hygene, and good food. It’s a false dichotomy; an either/or argument that makes a division where none exists. Why not both clean water and vaccines, for instance.

Well, Mr. Gates is putting another chunk of his money where his mouth is. What’s a major source of water contamination? Human feces. Why? No good toilets.

From NPR’s From Bill Gates, A Toilet Challenge Spills Forth:

NPR.org, August 15, 2012 · SEATTLE (AP) — These aren’t your typical loos. One uses microwave energy to transform human waste into electricity. Another captures urine and uses it for flushing. And still another turns excrement into charcoal.

They are part of a Bill & Melinda Gates Foundation competition to reinvent the toilet for the 2.5 billion people around the world who don’t have access to modern sanitation.

This is what divides the Gates Foundation from false "vaccine safety" advocates. Well, this and billions of dollars. I haver never read someone write, "instead of vaccines we should focus on clean water that’s why I donate money to organization X which is bringing clean water to the developing world“. I’ve emphasized the part that is missing. Perhaps someone will be kind enough to point me to the “vaccine safety org” that is putting a major effort into an alternative preservative to thimerosal or improving cold chain access so that clinics in the third world don’t need preserved vaccines. I’ve seen some passing reference to an existing alternative preservative, but rarely and without real support for the idea.

I’ll be watching to see how this is twisted into an attack on Mr. Gates. His vaccine work has been twisted into a claim that he’s attempting genocide.

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By Matt Carey

David Geier ordered to pay $10,000 for practicing medicine without a license

13 Aug

David Geier is the son in a father-son team which ran a clinic purporting to treat autism through such unproven and biologically implausible methods as chelation and lupron.  In addition, the team produced questionable quality research promoting the link between autism and vaccines.  While Mark Geier holds an M.D., David Geier holds no degree nor other qualifications in medicine.

The Maryland State Board of Physicians charged Mr. Geier with practicing medicine without a license and, recently, the board found him guilty and fined him $10,000. Mr. Geier has the right to appleal. More details can be found in the Board’s order.

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by Matt Carey

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