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Oldstone letter in the Omnibus docket

25 Mar

When I found that the Autism Omnibus Proceeding expert reports were public, the first one that caught my eye was by Andrew Zimmerman. Obviously, it caught Kev’s attention too 🙂

But, I have only a brief time available today, so I will start with this letter by Dr. Michael Oldstone. It is brief enough that I have copied the body in its entirety below.

To summarize, Rick Rollens asked Dr. Oldstone to consider collaborating with Dr. O’Leary and Dr. Wakefield on the Autism/MMR question. It was a good move on Mr. Rollens’ part, as Dr. Odlstone is one of the preeminent researchers in viral pathogenesis. Has been for decades.

Before agreeing to collaborate, Dr. Oldstone wanted to check on the quality of the results coming out of the O’Leary laboratory. Dr. Oldstone sent tissue samples to Dr. O’Leary’s laboratory, some with measles virus, some without. Dr. O’Leary tested them–and got the wrong answer 20% of the time. Dr. Oldstone sent another batch of samples, some duplicates from the first batch. Not only did Dr. O’Leary’s laboratory get 20% wrong again but, in Dr. Oldstone’s words:

Most troublesome, some samples, when tested twice under different code numbers ‘switched’ from positive to negative or from negative to positive. On this basis of inaccuracies of their PCR test, I declined from further working with either Drs. Wakefield or O’Leary.

This goes directly towards the question of the quality of the data coming from Dr. O’Leary’s laboratory. This is a big question. The Hornig study came out last year, an attempt to replicate Dr. Wakefield’s research. In one of the strangest moves I have ever seen by a researcher, Dr. Wakefield claimed that this study actually supported his research by demonstrating that Dr. O’Leary’s lab is capable of making accurate PCR measurements. Dr. Wakefield neglected the obvious point–being accurate today doesn’t mean one was accurate yesterday. He also neglected the suggestion (made by Dr. O’Leary himself at the press conference for the Hornig study) that Dr. Wakefield’s samples could have been contaminated.

Well, here is a good example that Dr. O’Leary’s laboratory was not making accurate measurements. This was iin the “early 2000’s”. Note that the Uhlman paper (Dr. Wakefield’s team’s paper supposedly finding measles virus in gut tissue) came out in 2002–the same time period.

Below is the letter, dated Oct. 12, 2007, from Dr. Oldstone to Dr. Brian Ward.

Dear Dr. Ward:

I recently became aware that my work in the field of viral persistence is being quoted in support of the hypothesis that the measles virus component of the measles-mumps-rubella (MMR) vaccine is supposedly associated with the development of autistic spectrum disorder (ASD).

Measles virus has been a focus of my laboratory for many years so this autismlmeasles link has been of interest to me. Further, I should state up front that I see at present no evidence whatsoever for such a link.

In the early 2000s I was asked by Rick Rollens to consider a collaborative grant between my laboratory and that of Drs. Wakefield and O’Leary. Prior to making a decision, I decided to assess the performance of Dr. O’Leary’s PCR-based assays targeting measles virus. My laboratory generated samples from tissue culture cells infected with MV as well as tissue samples from our transgenic mouse model of MV infection (including gut and brain tissues), which were coded and sent to the O’Leary laboratory. Samples had varying titers of measles virus as well as appropriate negative control and measles virus positive samples. The arrangement was informal in that the samples were only sent to Dr. O’Leary for testing. After receiving Dr. O’Leary’s results, the code was broken and I discovered that approximately 20% of the samples were incorrect as to the
presence or absence of measles virus. I reviewed the results with Dr. O’Leary as well as his protocols for preparing his assay, which I found to be sound and decided that perhaps there may have been some unknown error and a second set of samples should be sent. This second set was again coded anew and contained both new samples and several original samples. The results of the second round were no better with again approximately 20% of the samples misidentified by Dr. O’Leary’s laboratory. Most troublesome, some samples, when tested twice under different code numbers ‘switched’ from positive to negative or from negative to positive. On this basis of inaccuracies of their PCR test, I declined from further working with either Drs. Wakefield or O’Leary.

Sincerely,
Michael B.A. Oldstone, M.D.
Head, Viral-lmmunobiology Laboratory

Andrew Zimmerman Finally Speaks

24 Mar

A year ago I tried to talk to Andrew Zimmerman about the Hannah Poling case and was told:

Dr. Zimmerman…….is not able to publicly discuss this patient. As a participant in this case, the family provided consent for Dr. Zimmerman to share information with the court, but we do not have parental consent to discuss the patient publicly – as we are bound by HIPAA privacy regulations, as in any healthcare setting in the U.S.

And in the year that has followed the Polings have not allowed Zimmerman to publicly comment once. Now I’m beginning to understand why.

Sullivan told me that yesterday the Expert Witness reports for the Respondents were made public and that Zimmermans was eyebrow raising to say the least.

Furthermore, there is no evidence of an association between autism andthe alleged reaction to MMR a nd Hg, and it is more likely than not, that there is a genetic basis for autism in this child.”

“Michelle Cedillo’s developmental regression was likely to have been
preprogrammed before birth to emerge, as it does in Rett syndrome, long after birth.”

“Autism, in most cases, begins before birth, and the maternal
“environment” in the womb is likely to be important in the process.”

“there is no scientific basis for a connection between measles, mumps and rubella (MMR) vaccine or mercury (Hg) intoxication and autism.”

“Autism is primarily a genetically determined disorder.” There is a
hypothetical basis, but very limited evidence, for environmental factors
(such as stress or the drug terbutalinel l) that may act together with
an individual’s genetic susceptibility to increase the risk of autism.
There is strong evidence that the origins of autism begin before birth,
based on genetic and anatomical studies as well as chemical findings at birth in children who go on to develop autism. The usual time
period when autism appears and is diagnosed during the 2nd and 3′” years of life reflects the dynamic nature of the child’s developing brain and the appearance of pre-programmed disordered expression of genes and preexisting cellular abnormalities that result in the child’s regression with loss of language and social skills.”

Recall once more that this is the man – along with Jon Poling himself and along with John Shoffner (who also doesn’t think much of Polings beliefs) who co-authored the only piece of science performed on Hannah Poling.

No wonder the Poling’s were so keen to keep Zimmerman quiet.

Thanks to Sullivan for some of this.

Anti-vaxxers rejoice! You got another one!

14 Mar

DANA Elizabeth McCaffery died at 4 weeks of age from Whooping cough, a totally vaccine preventable disease. She was the first to die from this appalling disease since 1997.

Local Paediatrician Chris Ingall said:

“The only way to stop babies getting infected with whooping cough is by vaccination, there is no other way,”he said.

“The vaccination rates on the North Coast are the worst in Australia. This is why we have so many incidences in this area compared with other parts of Australia.

“Parents should be alarmed, whooping cough kills little babies. We must get our vaccination rates up so adults don’t pass the disease on to babies.”

The local health authority acted responsibly by bringing forward the vaccine schedule – a move that many anti-vaxxers will be horrified at no doubt.

Meanwhile, over in Kittitas Secondary School in the United States, the local health authority:

…is requiring postponement of all field trips and scheduled activities or events that include other schools, school districts, and/or family members of students.

Why? Because of Whooping cough.

As of Thursday, March 12th, there have been 24 cases of Whooping Cough in Kittitas County; 21 of these cases have been Kittitas Secondary School students or staff members.

In addition to those who tested positive over 150 Kittitas County residents have been tested for Whooping Cough since the beginning of this outbreak…

And still more elsewhere in the US:

Two elementary school students in the Stevens Point School District are recovering from whooping cough…

and yet more in the US:

The warning comes after two students in the district have been diagnosed with the potentially fatal bacterial infection. The health department would only say they are elementary aged students and were being treated.

How terribly sad and tragic that the same situation is playing out across so much of the affluent world – kids dying of vaccine preventable disease – because a few idiots think they know best and are willing to put the lives of others children at risk, when in the third world countries people are still dying by the tens of thousands from vaccine preventable disease and are desperate to get ahold of vaccines.

Once more I’m shamed by the actions of those in the so-called autism community who perpetuate this ridiculous nonsense at the cost of the very lives of babies.

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Facebook is the new vaccines

11 Mar

I thought I’d maybe travelled a couple of weeks forward in time and was reading a particularly stupid April Fools joke news report when I saw the Daily Mail were reporting:

Of course, we do not know whether the current increase in autism is due more to increased awareness and diagnosis of autism, or whether it can – if there is a true increase – be in any way linked to an increased prevalence among people of spending time in screen relationships. Surely it is a point worth considering,’ she added.

‘She’ in this instance is Professor Susan Greenfield of Oxford University, which just goes to show that even a massively intelligent person can also be a monumental idiot on occasion too. Some other gems of wisdom include:

‘My fear is that these technologies are infantilising the brain into the state of small children who are attracted by buzzing noises and bright lights, who have a small attention span and who live for the moment.’

Buzzing noises and bright lights. I think these opinions reflect the lack of experience Professor Greenfield has with computers rather than any accurate reflection of how a PC or Mac actually works.

Note something about this totally ridiculous piece of journalism. They use buzzwords like Twitter and Facebook that the average uninformed Daily Mail reader might’ve seen but have no real idea about. They also clearly are talking about the opinions of one woman. At no point is any study or science referenced to support this Professors opinions.

In the eighties the Daily Mail was one of those newspapers convinced that ‘video nasties’ (straight to video low budget horror movies) would bring about the end of civilisation. In the nineties they were of course standard bearers for antivaccination beliefs. In the noughties they’ve published a few pieces on the evils of the nasty Intraweb.

But of course what really annoys me about this is the fastening on to autism. Its explained how naturally autistic people function online is a possible example of how the online environment (Facebook, Bebo, Twitter etc) are (oh dear god!) rewiring the brains of our children and making them autistic.

Never mind the fact that most new cases of autism are diagnosed in kids under three whos only interaction with a PC up to that point would be to try and push a rusk into the DVD tray. Never mind the fact that adult autistics are pretty wary of social networks at first. Lets just find another way to demonise autism and blame it on something else for which there is no supporting science whatsoever.

Did you think that was it? More MMR bull arrives

25 Feb

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

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

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

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

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

The case of Hannah Poling is a red herring.

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

Team McCarrey go on:

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

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

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

Kennedy jumps straight in:

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

Whereas David is a tad more circumspect:

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

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

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

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

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

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

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

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

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

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

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

David also lists some of the symptoms of ADEM:

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

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

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

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

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

One Click Hacks and Homophobes

22 Feb

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

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

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

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

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

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

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

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

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

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

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

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

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

Brian Deer Is Out Of Control

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

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

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

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

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

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

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

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

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

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

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

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

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

Brian Deer: “Of who?”

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

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

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

Brian Deer: “Are you a parent?”

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

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

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

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

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

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

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

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

She also says:

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

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

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

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Another misinterpreted study. This time they are misusing Israel data

22 Feb

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

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

Here’s the figure.

Figure 1 from Israel Autism Paper

Figure 1 from Israel Autism Paper

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

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

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

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

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

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

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

Other issues with the paper.

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

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

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

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

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

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

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

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

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

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

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

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

Who carries the authority?

19 Feb

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

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

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

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

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

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

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

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

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

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

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

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

Brian Deer, not a complainant

16 Feb

Just in case you didn’t see it–Brian Deer published more information about Dr. Andrew Wakefield recently. This has caused a lot of furor (we are over 160 comments on that thread already). No surprises there: saying anything which might suggest Dr. Wakefield is anything less than a hero, especially when Brian Deer is doing it, will do that.

Almost all (if not all) of the responses to Brian Deer’s piece has been one big diversionary tactic: attack the messenger. Everyone seems to be studiously avoiding facing the real tough questions. Let’s avoid the ethics questions for the moment. If the details Mr. Deer presented in his article are true, Dr. Wakefield’s autism research has lost any last shred of support. That is a tough pill to swallow for the Wakefield supporters.

David Kirby joined in on the Deer bashing. Seems he read an article by Melanie Philips and rehashed it for his fans on the Huffington Post. He found Ms. Philips’ story to be “very interesting reading”. You see, Ms. Philips postulated:

What the Sunday Times did not report was that the GMC investigation into Wakefield was triggered by a complaint from… Brian Deer, who furnished the allegations against him four years ago.

This was then spun into a story of supposed conflict of interest and a great avoidance of the direct and specific claims of possible misinformation in Dr. Wakefield’s papers.

But, back to Mr. Kirby. He states:

The point is an excellent one. Imagine if a US journalist sued a doctor for libel or misconduct, and then went to the NY Times and asked to be hired as a freelancer to cover the trial that they themselves had instigated in the first place. It wouldn’t happen.

I found that statement very ironic, coming as it did from someone who aided significantly in manufacturing the thimerosal controversy, and who now seems to owe some of his employment to servicing that same controversy.

That said, what about this notion, this postulate as I have called it, that Brian Deer initiated the investigation that he is now reporting on? Well, it turns out that Mr. Deer is not a complainant in the GMC hearings on Dr. Wakefield. Below is a letter to Mr. Deer explaining exactly that.

Strictly Private & Confidential
Mr Brian Deer

25 May 2005

Dear Brian

General Medical Council – Dr Wakefield, Dr Murch, Dr Walker-Smith

I write further to your telephone conversation with Peter Swain last Thursday seeking clarification in relation to your role in the above General Medical Council (“GMC”) proceedings.

I have now had the opportunity to review the GMC’s files. My understanding is that further to your articles appearing in the Sunday Times in February 2004 in relation to your investigation into Dr Andrew Wakefield and the MMR vaccine, you were approached by GMC case officer Tim Cox-Brown, who asked you to supply the GMC with further information regarding this matter.

Your situation as a journalist who has carried out an investigation into the conduct of the practitioners in question is unusual for the GMC. I note from the GMC and FFW’s correspondence files that there does appear to have been some confusion in relation to your role in these proceedings.

In GMC ‘complainant’ cases an individual will have approached the GMC with a complaint against a particular practitioner. If the GMC decides to hold an inquiry, legal representation is offered to the complainant for preparation and presentation of the case before the Professional Conduct Committee.

As stated in Peter Swain’s letter to you dated 16 December 2004, your role in this matter is that of ‘informant’ rather than ‘complainant’. This is due to the fact that the conduct of the practitioners in question has not affected you directly and clearly involves issues of a wider public interest.

As you are aware, your involvement the GMC’s conduct of this case prior to our commencing our investigation and subsequent to our meetings with you on 24 February 2005 and 7 March 2005 has been minimal. We are preparing this case for presentation at the Professional Conduct Committee on the instructions of the GMC. Moreover, we are not able to discuss draft charges with you for reasons
of confidentiality.

We apologise for any confusion in relation to your status in these proceedings and any difficulties this may have caused you. We have made it clear to all parties that your role is that of informant rather than complainant. Please find enclosed a copy of the letter sent to Dr Wakefield’s legal representatives clarifying your status in these proceedings.

We are grateful for information supplied by you and your assistance to date.

Yours sincerely

Matthew Lohn
Partner

So, Brian Deer didn’t initiate the investigation. He wasn’t a complainant. It isn’t like, as in Mr. Kirby’s analogy, Mr. Deer didn’t “sue a doctor for libel or misconduct”.

Let me take a page out of Mr. Kirby’s own playbook:

David, if you read this (and we both know you will), take the message to heart and write a correction to your blog piece on the Huffington Post. Better yet, put up a new one with an explanation and apology.

Omnibus: the decisions are decisive

13 Feb

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

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

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

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

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

TACA is less subtle:

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

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

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

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

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

emphasis in the original.

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

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

and

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

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

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

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

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

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

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

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

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

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

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

From the Snyder case,

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

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

From another section, specifically addressing the general causation question:

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

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

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

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

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

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