Archive | Vaccines RSS feed for this section

Mark Geier: vaccine lover

7 Sep

Sometimes reality is just stranger than fiction. Consider Mark Geier. He’s the doctor whose license has been suspended in Maryland for his treatment of autistic children with Lupron. He’s been a regular expert witness in the vaccine court for something like 20 years. He’s got multiple papers out on the dangers of mercury in vaccines.

Think that’s enough to please the vaccines-cause-autism crowd? Think again.

Stroll over to Facebook where a heated discussion is ongoing.

…you’re wrong on that one…. from personal experience having dinner with Dr. Geier….he has no problem with the vaccines other than mercury. He told me to my face at dinner that he gave his patients the H1N1 vaccine last year (Hg free of course). Sorry, but that is from personal experience….he’s a hack in my book.

Yep. Giving vaccines makes one a hack. Treating faux precocious puberty, not so much.

the response?

…thanks for saying that…I detected he was a vaccine lover.

Yep, he’s a “vaccine lover”. Mark Geier. That’s his failing.

… I know I’ll probably make some enemies over this but I call em’ as I see em’ and this was NOT hearsay. He told me that to my face at dinner…I got up, called him a moron and didn’t come back to finish my dinner. I fumed all night!

Well, there you have it. Tell the wrong people you gave vaccinations and you are a hack, a “moron” and you make people lose their appetite.

The world never ceases to amaze.

MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science

6 Sep

In a commentary for the Mayo Clinic Proceedings, Gregory A. Poland, MD writes about MMR and autism. In case you don’t get the idea of his stance from the title of the article, MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science, it starts out with a quote:

Nothing is more terrible than to see ignorance in action.

Johann Wolfgang von Goethe

I’m sure people will counter that they are very “smart” and “well educated” and, therefore, not ignorant when they promote the MMR/autism notion. Is it ignorance, willful ignorance, bias, dishonesty, some mix or something else entirely that is behind the perpetuation of the idea? I don’t know. On a very real level, it doesn’t matter. What matters is the fact that the MMR hypothesis was wrong and that those who continue to promote it are causing a very real danger to society.

That said, here are Dr. Poland’s views in the introduction to his paper:

It is a truism that acting in one’s perceived self-interest is not always in one’s self-interest. Perhaps nowhere is this truer in contemporary public health than for the issue of the measles-mumps-rubella (MMR) immunization and persistent fears about a possible connection with autism. Although each of these 3 diseases had been controlled in the United States with the widespread use of the MMR vaccine, in the past decade those gains have been slipping. Even though the United States has had fewer than 50 measles cases per year during the past decade (mostly imported from other countries), 156 cases have already been identified in the first 6 months of 2011. 1 European countries such as England, Wales, Italy, France, Spain, and Germany are also experiencing substantial increases in measles outbreaks.

Why should we be concerned? Measles is the most transmissible human disease known. Even with modern medical care, approximately 1 of every 3000 infected persons die, and many more are hospitalized or otherwise harmed as a result. Population coverage (herd immunity) needs to be in excess of 96% to prevent outbreaks. In addition, measles is a disease for which eradication is both possible and planned, a goal that obviously cannot be met given current vaccine coverage levels.

This predictable sequence of falling coverage levels, followed by outbreaks of disease, has occurred because of decreased public confidence in the safety of the MMR vaccine. In large part, this has resulted from incorrect assertions that the vaccine plays a role in the development of autism, an idea promoted by Andrew Wakefield. No credible scientific evidence, however, supports the claim that the MMR vaccine causes autism, and indeed, national medical authorities and scientific professional societies have unanimously …

This article is commentary (i.e. not a research article), but there are some good points and questions made:

Why in the face of nearly 2 dozen studies and every scientific committee rejecting such an MMR-autism connection does this myth persist?

As expected, he notes the celebrity aspect of the vaccine-causation notion. He also discusses the recent paper in the PACE Law Review.

Under “Moving Forward”, Dr. Poland writes:

At some point, a point I believe we have well passed, the small group of people who claim such connections, who have no new or credible data, and for which their assumptions and hypotheses have been discredited must simply be ignored by scientists and the public and, most importantly, by the media, no matter how passionate their beliefs to the contrary. Such individuals are denialists at best, and dangerous at worst. Unfortunately, the media has given celebrities who comment on an autism-MMR link far more attention than they deserve, and the public, unfamiliar with the background science, has confused celebrity status with authority. Such a phenomenon has not been lost on those wishing to continue the discussion. As an example, J. Hanlon, cofounder of Generation Rescue (an organization that advocates for an autism-MMR vaccine link) commented, in regard to the finding that both Andrew Wakefield and his assertion of a connection between autism and MMR vaccine had been discredited, that to those who believe vaccines cause autism “Andrew Wakefield was Nelson Mandela and Jesus Christ all wrapped in one.”

Prediction: we will hear all about how this commentary is obviously worthless because the author didn’t correctly cite J.B. Handley. If you are wondering what I mean, read again, Mr. Handley is referred to as J. Hanlon. I wish the author hadn’t made that mistake as such small errors are exploited in exactly this way. But, at the same time, this puts some perspective on the situation regarding Mr. Handley. He is a well known name in a very small community. He has become one of the go-to people for comments critical of vaccination (as in the Jesus Christ/Nelson Mandella article).

Prediction 2: Dr. Poland’s article will be called an attempt at censorship (see the conclusion below). Probably with no sense of irony by the same people who recently stated that Autism Speaks should “Shut up, shut down and go away.”

Prediction 3: People will still refuse to see how strange the “Nelson Mandela and Jesus Christ” comment read to the majority of readers. OK, I am predicting the past here, but I expect this to go forward too. Dr. Poland didn’t pick this quote to place Andrew Wakefield in good light.

That all said, I agree with Dr. Poland. It is well past time for the MMR story to be set aside. Just because there are adherents to the idea doesn’t mean that news organizations need to give it false balance.

Dr. Poland concludes his article with a simple summary: the MMR/autism question has been investigated closely and no link is found. The decision to forgo immunization based on this fear is not without danger. Those who promote the MMR/autism link in the face of all the evidence are not working for the public good:

For anyone adhering to the scientific model of discovery, experimentation, and evidence, the trial is over and the jury back—there is no known scientific association between receipt of MMR vaccine and the subsequent development of autism. Making the decision to not immunize children with the MMR vaccine because of fear of such an association —rather than credible scientific evidence—places children and others at great risk as current measles outbreaks in the United States and Europe illustrate. Vaccine nihilists who continue to claim such associations are simply wrong, and they pedal an agenda other than for the public good. At this point, the antivaccine groups and conspiracy proponents promoting such an association should be ignored, much as thinking people simply ignore those who continue to insist that the earth is flat or that the US moon landing in 1969 did not really occur

He concludes simply but strongly:

There is no law against being foolish, nor any vaccine against ignorance; however, in the meantime the health of millions of children in the United States and worldwide is being placed at unnecessary and real risk through continued deliberate misinformation and discredited unscientific beliefs, and that should be a crime.

Lessons from the MMR scare by Fiona Godlee

2 Sep

Fiona Godlee, editor of the British Medical Journal, will address the National Institutes of Health (NIH) on Tuesday, Sept. 6th. Her talk, Lessons from the MMR scare, will take place at 11am eastern time, and is scheduled for 90 minutes.

It will also be videocast.

Please join BMJ Editor Fiona Godlee for a discussion of the stunning investigation she published earlier this year that revealed the MMR scare was based not on bad science but on deliberate fraud. The three-part series was produced by journalist Brian Deer, who spent seven years investigating Andrew Wakefield’s infamous study linking the MMR vaccine with autism, discovering Wakefield had been paid by a lawyer to influence his results and had blatantly manipulated the study data.

In an editorial accompanying Deer’s report, Godlee and colleagues noted, “Science is based on trust. Without trust, research cannot function and evidence based medicine becomes a folly. Journal editors, peer reviewers, readers, and critics have all based their responses to Wakefield’s small case series on the assumption that the facts had at least been honestly documented. Such a breach of trust is deeply shocking. And even though almost certainly rare on this scale, it raises important questions about how this could happen, what could have been done to uncover it earlier, what further inquiry is now needed, and what can be done to prevent something like this happening again.”

For more information, read the BMJ articles:

The fraud behind the MMR scare, Fiona Godlee, et al
Wakefield’s article linking MMR vaccine and autism was fraudulent
Institutional and editorial misconduct in the MMR scare

Secrets of the MMR scare: Brian Deer

Part 1: How the case against the MMR vaccine was fixed
Part 2: How the vaccine crisis was meant to make money
Part 3: The Lancet’s two days to bury bad news

The NIH website gives a brief biographical blurb on Ms. Godlee:

About Fiona Godlee

Fiona Godlee has been Editor in Chief of the BMJ since 2005. She qualified as a doctor in 1985, trained as a general physician in Cambridge and London, and is a Fellow of the Royal College of Physicians. Since joining the BMJ in 1990 she has written on a broad range of issues, including the impact of environmental degradation on health, the future of the World Health Organisation, the ethics of academic publication, and the problems of editorial peer review. In 1994 she spent a year at Harvard University as a Harkness Fellow evaluating efforts to bridge the gap between medical research and practice. On returning to the UK, she led the development of BMJ Clinical Evidence, which evaluates the best available evidence on the benefits and harms of treatments and is now provided worldwide to over a million clinicians in 9 languages. In 2000 she moved to Current Science Group to establish the open access online publisher BioMed Central as Editorial Director for Medicine. In 2003 she returned to the BMJ Group to head up its new Knowledge division. She has served as President of the World Association of Medical Editors (WAME) and Chair of the Committee on Publication Ethics (COPE) and is co-editor of Peer Review in Health Sciences. She lives in Cambridge with her husband and two children.

hat tip to a commenter at Respectful Insolence for this information.

Internet survey shows high autism rate in unvaccinated children

31 Aug

Informal surveys are fraught with problems. There can be all sorts of biases. Many ways for the data to be skewed one way or another. A great example of this was the Generation Rescue phone survey. The results were all over the map, and clearly flawed. Many of the results pointed to higher autism rates in partially vaccinated over fully vaccinated children.

That was four years ago. Recently an internet survey was undertaken to explore vaccine questions. The survey results can be found on the site vaccineinjury.info. People with agendas certainly can do surveys, but they shouldn’t be surprised when their agendas are pointed out. I won’t go into the survey or results in detail. I have a suspicion the results will be analyzed elsewhere. Rather, let’s just look at the autism results.

Here is the age distribution of the (mostly) children reported on in the study. Very skewed towards the very young.

Here is the distribution of an age distribution of the fraction of kids in each group reported to be autistic (click to make bigger)

If you are wondering, “did they just publish a graph showing high autism ‘prevalences’ in unvaccinated kids?”, you are correct. They are showing that in some age groups the fraction of unvaccinated autistic kids is about 2%. The current prevalence estimate for the U.S. and the U.K. is about 1%.

Do we really want to put any weight on this result? No, not really. It is a nicely packaged internet survey, but it is an internet survey after all. Can we speculate a little as to what this means? Sure. It could mean that the groups that were recruited for this survey included more families with autistic children. Given the high recurrence risk of autism (i.e. the high chances that a younger sibling of an autistic kid would be autistic) it is not only reasonable, but predicted, that such a survey might show a high fraction of autistic kids.

Keep something in mind–the number of autistic kids is small. If I did the math correctly, there are only 37 autistic kids total. [edit to add–this is incorrect. There are 44. I left out two age groups in my total] That means big uncertainties (error bars) in the “results”. Results which, as we’ve already discussed, are pretty skewed just by the design and limitations of the survey.

Must be unexpected for the people doing the survey. Rather than show a low autism prevalence, they show a high one. For those who claim (sometimes over and over) that there are no unvaccinated autistic kids, here is another piece of evidence that they are wrong.

It’s clear enough that even commenters at the Age of Autism blog have noticed it. From “Sarah”:

Help! What am I doing wrong trying to read these graphs? The one titled autism in UNVACCINATED children shows autism percentages above the commonly accepted level in vaccinated children, but in the full study, which also shows a similar graphic, they say only 4 children in the study had severe autism. Are the graphs supposed to be the levels in vaccinated children? What am I missing here? Does this study show higher rates of autism among the unvaccinated?

Yes, Sarah, you are seeing correctly. The study shows higher rates of autism amongst the unvaccinated. That’s what the >1% values for ages 3-12 means when compared to the 1% value currently reported for the United States.

And, you can see people trying to “interpret” these results in interesting ways:

Sarah, I see 0.57% for autism roughly half of the rate seen in vaccinated children.
Note also that many who are not vaccinating are doing it because they have a child with autism already and these families have an increased likelihood of another child having autism as well. These numbers could be much lower in a larger survey and the cases are less severe as noted already. I hope this helps.

Yes, if you want to water down the results by averaging, including infants too young to be reliably diagnosed, you can get a lower prevalence. Of course, to do that one has to ask: what is the prevalence of diagnosed autism amongst infants? We don’t know.

The website notes:

Due to the fact that the majority of children in the survey are between 0 and 2 years of age and some diseases generally do not appear in this age group, the results are subdivided into different age groups (click on the graphic). Information about country, gender, age, age distribution, breastfeeding, preferred tretment[sic] can be found here.

And they are correct. There are no autistic kids in the age 0-2 group reported. Looking at just the ages 3-18 kids, there are 4326 kids, making a “prevalence” of 0.85, if you want to average. That would be within the error bars of the current autism prevalence estimate in the U.S..

As I’ve noted, the Age of Autism blog has already discussed this (thanks to those who sent me the link). I doubt this will get much play from these groups as the results are really not good from their point of view.

The Autism Speaks Book List

29 Aug

I want to like Autism Speaks. I really do. I know some very good people working with Autism Speaks. From a very practical standpoint, they are one of the biggest autism organizations and I need them to be doing good.

Unfortunately, sometimes Autism Speaks does things which I really find difficult to support. Recently, I pointed out that Autism Speaks is sponsoring a conference by the National Autism Association. This conference will be hosting Andrew Wakefield to speak. In my view, Mr. Wakefield is a person whose damage to the autism communities can not (and should not) be minimized. Even though Autism Speaks isn’t directly hosting Mr. Wakefield, I feel that it would be good and appropriate to withhold sponsorship of such an event.

During the discussion of that article I decided to search for how Autism Speaks discusses Mr. Wakefield on their website. The Autism Speaks website is a resource for many families looking for information. I found that Autism Speaks has a book list in their Resource Library (Family Services » Resource Library » Books) and this list includes “Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy”, Mr. Wakefield’s account of the events surrounding the loss of his medical license.

Frankly, I find this a poor resource for autistics, families, well anyone looking for accurate and useful information. Shannon Rosa did what I should have done and contacted Autism Speaks for comment and reported the response the comments here.

Kim, you are awesome. And I agree, working towards real change is hard; it requires a lot of processing power, a lot of reflection, a lot of synthesis, a lot of perseverance—and an eye on long-term as well as short-term goals.

Re: listing Callous Disregard, Autism Speaks pointed me to their resources section’s legal disclaimer:

“Autism Speaks maintains the Family Services Resource Guide as a service to families as a reference tool. Every effort is made to ensure listings are up-to-date. Autism Speaks does not endorse or claim to have personal knowledge of the abilities of those listed. The resources listed on this page are not intended as a recommendation, referral, or endorsement of any resource or as a tool for verifying the credentials, qualifications, or abilities of any organization, product or professional. Users are urged to use independent judgment and request references when considering any resource associated with diagnosis or treatment of autism, or the provision of services related to autism.”

But I still think including Callous Disregard reflects badly upon them, and have said so. The conversation continues.

Since that time two small changes have occurred to that page. First, a disclaimer was added (it wasn’t there before, as the Google cache version confirms). The disclaimer:

Autism Speaks does not provide medical or legal advice or services. Rather, Autism Speaks provides general information about autism as a service to the community. The information provided on this website is not a recommendation, referral, or endorsement of any resource, therapeutic method, or service provider and does not replace the advice of medical, legal, or educational professionals. Autism Speaks has not validated and is not responsible for any information or services provided by third parties. You are urged to use independent judgment and request references when considering any resource associated with the provision of services related to autism.

I agree…to a point. Autism Speaks can’t be responsible for everything said in every resource. However, Mr. Wakefield was found guilty of dishonesty and unethical behavior in his research activities involving autistics. Even if one believes Mr. Wakefield’s account (which is clearly contradicted by the facts), it doesn’t give any real information of value to, say, a family with a new diagnosis. Autism Speaks can and does make a distinction of what books to host. You won’t find “The Empty Fortress” by Bruno Bettleheim on the list (surprisingly enough, it is still in print).

The second change to the Autism Speaks books resource page? The link has been removed to “Callous Disregard”. The book is still listed, but there is no link to the publisher’s site any longer.

The vaccine-autism notion has caused a great deal of harm to the autism communities. So much time and money has been thrown at researching the supposed epidemic of vaccine-induced autism. Much more to the point for an organization like Autism Speaks: this idea has caused a great deal of harm to families, a great deal of pain and, most importantly, a great deal of unwarranted and sometimes dangerous medicine to be practiced on autistics. This is why I would go further than to question why Autism Speaks lists a book by someone proven dishonest and unethical. I would ask why continue to give support to ideas whose time has clearly passed.

For example:

Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy
by David Kirby

David Kirby’s book was speculative at best when written. It is now very clearly false. Thimerosal did not cause an autism epidemic. And why list this under the subheading “Medical, Biomedical, Diet Interventions”? Mr. Kirby isn’t anything close to a medical professional and the book is more of a speculative thiller involving conspiracies which didn’t occur to cover up a mercury-induced epidemic that didn’t happen. Here’s the blurb for Evidence of harm:

Evidence of Harm explores the heated controversy over what many parents, physicians, public officials, and educators have called an “epidemic” of afflicted children. Following several families, David Kirby traces their struggle to understand how and why their once-healthy kids rapidly descended into silence or disturbed behavior, often accompanied by severe physical illness. Alarmed by the levels of mercury in the vaccine schedule, these families sought answers from their doctors, from science, from pharmaceutical companies that manufacture vaccines, and finally from the Center for Disease Control and the Food and Drug Administration-to no avail. But as they dug deeper, the families also found powerful allies in Congress and in the small community of physicians and researchers who believe that the rise of autism and other disorders is linked to toxic levels of mercury that accumulate in the systems of some children.

An important and troubling book, Evidence of Harm reveals both the public and unsung obstacles faced by desperate families who have been opposed by the combined power of the federal government, health agencies, and pharmaceutical giants. From closed meetings of the FDA, CDC, and drug companies, to the mysterious rider inserted into the 2002 Homeland Security Bill that would bar thimerosal litigation, to open hearings held by Congress, this book shows a medical establishment determined to deny “evidence of harm” that might be connected with thimerosal and mercury in vaccines. In the end, as research is beginning to demonstrate, the questions raised by these families have significant implications for all children, and for those entrusted to oversee our national health.

Other books of a questionable nature:

What Your Doctor May Not Tell You About(TM) Children’s Vaccinations
by Stephanie Cave

This is a book which links vaccines to autism using, for example, the incorrect comparison of mercury poisoning symptoms to autism, and gives the Wakefield (called “One of the most prominent researchers in MMR vaccine research) hypothesis for MMR causing autism.

Another example from the Autism Speaks book list:

The Age of Autism: Mercury, Medicine, and a Man-Made Epidemic
by Dan Olmsted, Mark Blaxill

This is another in the series of books making the link between autism and mercury. On the one hand, it is nice for Autism Speaks to host a link to a book by people who are such harsh critics of Autism Speaks. But, why be polite when the book is a failed hypothesis wrapped in a bad understanding of science?

Another book:

Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children
edited by Louise Kuo Habakus, MA, and Mary Holland, JD

Amongst other topics discussed, this book includes a chapter which is basically a summary of “Callous Disregard”. I know this is getting repetitive, but Autism Speaks could do families a service by steering them away from this.

The book list is long. No one will agree with all the books listed as being accurate and valuable. I have no problem with that. I do feel that some level of screening is being done and more should be done. A new family deserves better than to waste their time, money and emotions on the failed ideologies of the past decade. They are, after all, trying to perform a service with this book list. I am only asking that they follow through on the spirit of this. Perform a service. Pointing them at sources of misinformation is no service. Disclaimers don’t change that.

Adverse Effects of Vaccines: Evidence and Causality

26 Aug

The United States Institute of Medicine (IOM) has just published a lengthy report, Adverse Effects of Vaccines: Evidence and Causality.

The short summary, via Reuters, is: “the big take-home message is that we found only a few cases in which vaccines can cause adverse side effects, and the vast majority of those are short-term and self-limiting.”

As to autism? There are two main theories of autism and vaccines: MMR and Thimerosal. The autism and MMR theory is one of the most studied and most clear. The committee found that the research “Favors Rejection”. As in,

The committee concluded the evidence favors rejection of five vaccine-adverse event relationships. These include MMR vaccine and type 1 diabetes, DTaP vaccine and type 1 diabetes, MMR vaccine and autism, inactivated influenza vaccine and asthma exacerbation or reactive airway disease episodes, and inactivated influenza vaccine and Bell’s palsy. The evidence base for these conclusions consisted of epidemiologic studies reporting no increased risk; this evidence was not countered by mechanistic evidence

The epidemiological evidence says there is no increased risk. There is no good mechanism known or postulated whereby MMR could cause autism.

Thimerosal is barely mentioned in the report, with only 7 mentions. As far as autism+thimerosal is concerned, the IOM reviewed the literature years back and found no evidence of a link. Since that time, the evidence has grown greater against a link and thimerosal has been removed from the routine pediatric vaccine schedule (e.g. Price et al. Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism
and, while not specific to autism, Thomson et al. Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years)

Previous IOM reports on Thimerosal: Immunization safety review: Thimerosal -containing vaccines and neurodevelopmental disorders.

Previous IOM report on vaccines and autism (especially MMR and thimerosal): Immunization safety review: Vaccines and autism.

I expect much criticism to be focused on the IOM from some circles. The arguments will likely focus on “look at all the vaccines which have not been specifically studied in relation to autism”. It is a semi valid point. The problems with the argument are many, but include: what mechanism is there for these vaccines to cause autism? (Too many too soon is a slogan, not a scientific argument). Without a mechanism, and without some sort of data showing a possible link, there is such a low possibility of finding anything that resources are best spent elsewhere. In addition, the studies to date give a reasonable proxy for vaccine exposure: the more thimerosal an infant was exposed to, the more vaccines. Thimerosal exposure becomes a proxy for the number of vaccines. It has been shown (multiple times) that there isn’t an increased risk for autism with thimerosal.

Lastly, if you read the criticisms claiming “but they’ve only studied one vaccine and one ingredient”, watch for the intellectual honesty. That’s the part where the critic admits that “they’ve only studied one vaccine and one ingredient, and they found that those don’t increase the risk of autism“. Most critics in this field are cake-eaters. They want their cake (the argument that the studies have only looked in depth at MMR and thimerosal) and they want to eat it too (by denying the results of those studies). It’s predictable.

ACHAMP resorts to calling health legislation the “California Pedophile Protection Act of 2011”

25 Aug

ACHAMP, now the “Autism Action Network”, wants Californians to lobby against Assembly Bill 499. Why? Because it would allow minors access to the vaccine against HPV (human papillomavirus) without parental consent.

I have yet to hear a good explanation why supposedly autism organizations have such a fixation on the HPV vaccine. Seriously, has anyone made the claim that vaccines given to 12 year olds cause autism?

Here’s what ACHAMP has to say about this law:

If a twelve-year old child requests a vaccines for a sexually transmitted disease, what conclusion could a rational person come to other than a sexual crime has either occurred or will occur in the near future, which is exactly the standard required by California law for mandated reporters. How can a physician or nurse give a vaccine for a sexually transmitted disease, or other professionals counsel a child on getting such a vaccine, without the child’s parents’ involvement, and obey the mandated reporter laws? We don’t know either, which is why we consider this bill to the California Pedophile Protection Act of 2011.

The “California Pedophile Protection Act of 2011”?!? Wow, ACHAMP. Besides the fact that the logic is completely off, what’s the need for this language?

Here is the text of AB 499

FEBRUARY 15, 2011

An act to amend Section 6926 of the Family Code, relating to minors.

LEGISLATIVE COUNSEL’S DIGEST

AB 499, as introduced, Atkins. Minors: medical care: consent.

Existing law allows minors to consent to specified forms of medical or dental treatment.

This bill would, in addition, allow a minor who is 12 years of age or older to consent to medical care related to the prevention of a sexually transmitted disease.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

SECTION 1. Section 6926 of the Family Code is amended to read:
6926. (a) A minor who is 12 years of age or older and who may have come into contact with an infectious, contagious, or communicable disease may consent to medical care related to the diagnosis or treatment of the disease, if the disease or condition is one that is required by law or regulation adopted pursuant to law to be reported to the local health officer, or is a related sexually transmitted disease, as may be determined by the State Director of Health Services Public Health Officer
.
(b) A minor who is 12 years of age or older may consent to medical care related to the prevention of a sexually transmitted disease.

(b)
(c) The minor’s parents or guardian are not liable for payment for medical care provided pursuant to this section.

As stated, this modifies California Family Code Section 6926

(a) A minor who is 12 years of age or older and who may have come into contact with an infectious, contagious, or communicable disease may consent to medical care related to the diagnosis or treatment of the disease, if the disease or condition is one that is required by law or regulation adopted pursuant to law to be reported to the local health officer, or is a related sexually transmitted disease, as may be determined by the State Director of Health Services.
(b) The minor’s parents or guardian are not liable for payment for medical care provided pursuant to this section.

Aside from the blatant fear mongering and inflammatory language, ACHAMP is wrong on many counts. California already allows for minors to be treated without parent consent for sexually transmitted diseases, pregnancy, abortion, HIV testing and birth control.

Yes, California minors can seek treatment for STD’s, but if we try to amend the law to allow for prevention, it is a “pedophile protection act”.

I wonder how many members of ACHAMP waited until age 18 before participating in sexual activity with their peers? Or, do they allow former pedophiles (by their own definition) into their ranks? (see how your twisted logic works, ACHAMP?)

I’d like to say I’m surprised by ACHAMP. Unfortunately, I’m not. I do have hopes that someday these groups will abandon the cheap shots, inflammatory language and fear mongering. Heck, I have hope that they might focus the majority of their attention on making a better life for autistics.

Alleged Cases of Vaccine Encephalopathy Rediagnosed Years Later as Dravet Syndrome

19 Aug

A case study released this week looks at 5 children who were considered to have vaccine encephalopathy caused by pertussis vaccinations. In this case study, all five children were found to have Dravet Syndrome, a genetic condition involving how the brain uses sodium.

The phrasing of “alleged cases” will likely draw some critique. Parents are very sensitive to the accusation that they didn’t see what happened, in this case seizures and regression following vaccination. Alleged in this case doesn’t challenge what the parents saw, but what it means. It appears that individuals with Dravert syndrome don’t get through childhood without regression (there don’t appear to be cases with the mutation and no syndrome in adults). In the words of the vaccine court, these individuals would have Dravert’s syndrome in any event, making it impossible to show that vaccines are the causation in fact.

Dr. Vincent Ianelli reports over at pediatrics.about.com that the cases include:

14-year-old mentally retarded boy with autistic features, who was a healthy infant until he got his vaccines when he was 7 months old
20-year-old with delayed development and autistic-like features who began having seizures right after getting vaccines at 2 months
2-year-old with a mild expressive speech delay who developed seizures after getting vaccines at age 4 months
4-year-old with “slowing development” who began having seizures after the six month vaccines
3-year-old regressed development and autistic-like features who began having seizures after getting vaccines at age 4 months

In these five case, genetic testing resulted in a diagnosis of Dravet Syndrome.

From Dr. Ianelli:

Dravet syndrome is a rare, genetic cause of encephalopathy that causes seizures that are hard to control and developmental delays.

Since fever is the usual trigger of the first seizure and subsequent seizures, it is important that children with Dravet syndrome get all of their vaccines, since natural infections will cause more fever and put them at risk for more seizures. In another study, “A retrospective study of the relation between vaccination and occurrence of seizures in Dravet syndrome,” only 16% of patients with Dravet syndrome had a vaccine related seizure as their first manifestation.

The researchers also state “that although vaccination might trigger an earlier onset of the presenting symptoms of Dravet syndrome, there is no evidence that the outcomes, in terms of subsequent seizure types or intellect, are any different between those patients with Dravet syndrome whose symptoms started within 2 days of vaccination and those whose symptom onset was not related temporally to vaccination.”

Here is the abstract:

Dravet syndrome is a rare epileptic encephalopathy linked to mutations in SCN1A (neuronal sodium channel ?1 subunit) and characterized by an onset in infancy with polymorphous seizure types and developmental decline. It was reported recently that a proportion of patients previously diagnosed with alleged vaccine encephalopathy might possess SCN1A mutations and clinical histories that enabled a diagnosis of Dravet syndrome, but these results have not been replicated. We present here the cases of 5 children who presented for epilepsy care with presumed parental diagnoses of alleged vaccine encephalopathy caused by pertussis vaccinations in infancy. Their conditions were all rediagnosed years later, with the support of genetic testing, as Dravet syndrome. We hope that these cases will raise awareness of Dravet syndrome among health care providers who care for children and adolescents and aid in earlier recognition and diagnosis.

This isn’t the first work linking alleged vaccine encephalopathy with Dravet syndrome in some cases. Last year a study in The Lancet, Effects of vaccination on onset and outcome of Dravet syndrome: a retrospective study (also summarized in Pertussis Vaccination Triggers Dravet Syndrome in Predisposed Children) came to the conclusion:

Vaccination might trigger earlier onset of Dravet syndrome in children who, because of an SCN1A mutation, are destined to develop the disease. However, vaccination should not be withheld from children with SCN1A mutations because we found no evidence that vaccinations before or after disease onset affect outcome.

The anchor author on that study has a previous study, De-novo mutations of the sodium channel gene SCN1A in alleged vaccine encephalopathy: a retrospective study. They found 11 of 14 patients with alleged vaccine encephalopathy had Dravet syndrome (SMEI). Here is the abstract:

BACKGROUND:
Vaccination, particularly for pertussis, has been implicated as a direct cause of an encephalopathy with refractory seizures and intellectual impairment. We postulated that cases of so-called vaccine encephalopathy could have mutations in the neuronal sodium channel alpha1 subunit gene (SCN1A) because of a clinical resemblance to severe myoclonic epilepsy of infancy (SMEI) for which such mutations have been identified.

METHODS:
We retrospectively studied 14 patients with alleged vaccine encephalopathy in whom the first seizure occurred within 72 h of vaccination. We reviewed the relation to vaccination from source records and assessed the specific epilepsy phenotype. Mutations in SCN1A were identified by PCR amplification and denaturing high performance liquid chromatography analysis, with subsequent sequencing. Parental DNA was examined to ascertain the origin of the mutation.

FINDINGS:
SCN1A mutations were identified in 11 of 14 patients with alleged vaccine encephalopathy; a diagnosis of a specific epilepsy syndrome was made in all 14 cases. Five mutations predicted truncation of the protein and six were missense in conserved regions of the molecule. In all nine cases where parental DNA was available the mutations arose de novo. Clinical-molecular correlation showed mutations in eight of eight cases with phenotypes of SMEI, in three of four cases with borderline SMEI, but not in two cases with Lennox-Gastaut syndrome.

INTERPRETATION:
Cases of alleged vaccine encephalopathy could in fact be a genetically determined epileptic encephalopathy that arose de novo. These findings have important clinical implications for diagnosis and management of encephalopathy and, if confirmed in other cohorts, major societal implications for the general acceptance of vaccination.

A recent study out of Germany took a bit more cautious interpretation: A retrospective study of the relation between vaccination and occurrence of seizures in Dravet syndrome. But the abstract does not address the question of whether outcome depends upon whether the first seizure is possibly vaccine related or not.

At least two cases of have been heard in the vaccine court claiming vaccine injury in children with Dravet syndrome. Both cases (here and here) were denied compensation.

More information about Dravet syndrome can be found at the NIH website, and dravet.org

Ancestry of pink disease (infantile acrodynia) identified as a risk factor for autism spectrum disorders

30 Jul

One of the arguments for the mercury-causes-autism hypothesis is that there are subgroups more susceptible to harm from mercury exposures. It is argued that pink disease gives an example for such a susceptibility group.

Pink disease was a reaction to a teething powder which contained mercury. About 1 in 500 children exposed to the powder reacted with pink disease. Two points are important to keep in mind. First, the levels of mercury exposure from the powder were far greater than from vaccines. Second, the exposures were not the same for all children. Some parents would use more teething powder at a time. Some might use it for longer times. This makes it impossible to claim a susceptibility group as the children who showed signs of pink disease could very likely be the ones who had higher levels of mercury exposure.

In a paper just released, a team of researchers interviewed people who had a history of pink disease. Since that teething powder has been gone for decades, these individuals are now old enough to be grandparents.

This is, at best, a very strange paper. Consider these questions:

1) why aren’t they reporting a high autism prevalence in the people who had very high mercury exposures and who showed signs of pink disease? If there is a genetic susceptibility, why isn’t it seen in those with the greatest exposures?

2) why isn’t there a report of high autism prevalence in the children, just the grandchildren? My guess is that the response from some will be that the grandchildren received higher doses of mercury in vaccines than did their parents. Which again would beg the question of where is the high rate of autism in those exposed to the teething powders, especially those who developed pink disease.

The conclusions of this paper have some major logical hurdles to overcome, to say the least. And this is even before the methods are addressed. For example, this all hinges on reports by the grandparents. Not on an actual prevalence measure of the decendents.

If is already well established that the rise in mercury exposures from childhood vaccines was not the cause of the rise in autism prevalence estimates. It has always been clear that autism is not similar to mercury poisoning symptoms. The mercury hypothesis has been harmful, both to public health and the autism communities The time for papers which pose intriguing questions on this subject has past. Studies with weak methods and poor logic are irresponsible in today’s world.

Here is the pubmed link:
Ancestry of pink disease (infantile acrodynia) identified as a risk factor for autism spectrum disorders.

Here is the abstract:

Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children. The differential risk factor was identified as an idiosyncratic sensitivity to Hg. Autism spectrum disorders (ASD) have also been postulated to be produced by Hg. Analogous to the pink disease experience, Hg exposure is widespread yet only a fraction of exposed children develop an ASD, suggesting sensitivity to Hg may also be present in children with an ASD. The objective of this study was to test the hypothesis that individuals with a known hypersensitivity to Hg (pink disease survivors) may be more likely to have descendants with an ASD. Five hundred and twenty-two participants who had previously been diagnosed with pink disease completed a survey on the health outcomes of their descendants. The prevalence rates of ASD and a variety of other clinical conditions diagnosed in childhood (attention deficit hyperactivity disorder, epilepsy, Fragile X syndrome, and Down syndrome) were compared to well-established general population prevalence rates. The results showed the prevalence rate of ASD among the grandchildren of pink disease survivors (1 in 22) to be significantly higher than the comparable general population prevalence rate (1 in 160). The results support the hypothesis that Hg sensitivity may be a heritable/genetic risk factor for ASD.

Lack of association between autism and four heavy metal regulatory genes

30 Jul

One question that has been discussed for some time is the hypothesized role of mercury as a potential cause of autism. The basic idea is that administrative prevalences of autism went up coincident with increases in mercury exposure from vaccines. Plus, it was asserted that autism symptoms are similar to the symptoms of mercury poisoning (they aren’t).

Part of the mercury model held that there could be a genetic susceptibility to mercury in a subset of children.

Researchers at Vanderbilt University have explored the question by testing autistics for genes involved in how the body processes mercury. They did not find any link between the four genes they screened and autism.

Of course one could argue that some other gene or genes are important. One would then need to explain why mercury exposure from vaccines does not increase the risk of autism.

The paper:
Lack of association between autism and four heavy metal regulatory genes.

Here’s the abstract.

Neurotoxicology. 2011 Jul 20. [Epub ahead of print]
Lack of association between autism and four heavy metal regulatory genes.
Owens SE, Summar ML, Ryckman KK, Haines JL, Reiss S, Summar SR, Aschner M.
Source
Department of Pediatric Toxicology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Abstract
Autism is a common neurodevelopmental disorder with genetic and environmental components. Though unproven, genetic susceptibility to high mercury (Hg) body burden has been suggested as an autism risk factor in a subset of children. We hypothesized that exposure to “safe” Hg levels could be implicated in the etiology of autism if genetic susceptibility altered Hg’s metabolism or intracellular compartmentalization. Genetic sequences of four genes implicated in the transport and response to Hg were screened for variation and association with autism. LAT1 and DMT1 function in Hg transport, and Hg exposure induces MTF1 and MT1a. We identified and characterized 74 variants in MT1a, DMT1, LAT1 and MTF1. Polymorphisms identified through screening 48 unrelated individuals from the general and autistic populations were evaluated for differences in allele frequencies using Fisher’s exact test. Three variants with suggestive p-values <0.1 and four variants with significant p-values <0.05 were followed-up with TaqMan genotyping in a larger cohort of 204 patients and 323 control samples. The pedigree disequilibrium test was used to examine linkage and association. Analysis failed to show association with autism for any variant evaluated in both the initial screening set and the expanded cohort, suggesting that variations in the ability of the four genes studied to process and transport Hg may not play a significant role in the etiology of autism.

← Older Entries
Newer Entries →