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Autism's False Prophets

5 Sep
Autism's False Prophets. Bad science, risky medicine and the search for a cure - Dr Paul Offit

Autism's False Prophets. Bad science, risky medicine and the search for a cure - Dr Paul Offit

Available now – Amazon UK, Amazon US, Amazon Canada.

NB – Dr Offit is donating all profits from this book to autism research.

So. Here’s the short review: holy shit, this is a good book, you need to buy it and pass it on. Make your local library stock a copy or three.

Here’s the longer review.

The book begins – after a dedication that made me grin from ear to ear – with a quote so acutely apposite that its like Professor Szasz said it to perfectly sum up the book and the last ten years:

When religion was strong and science weak,
men mistook magic for medicine.
Now, when science is strong and religion weak,
men mistake medicine for magic.

I knew Dr Offit got a lot of hate mail. What I didn’t know was the extent and the utter viciousness of it. From the books prologue:

Whilst sitting in my office, I got a phone call from a man who said that he and I shared the same concerns. We both wanted what was best for our children. He wanted what was best for his son, giving his name and age. And he presumed I wanted what was best for my children, giving their names and ages and where they went to school. His implication was clear. He knew where my children went to school. Then he hung up.

I can empathise. I’ve had cowards directly or indirectly threaten my kids too. We know who I’m referring to.

Offit refuses to feel sorry for himself and goes on to describe in painstaking detail the circumstances surrounding the rise and fall of the two main vaccine/autism ideas: MMR and thimerosal. He paints a vivid and (in my experience) completely accurate portrait of Andrew Wakefield as a vainglorious but weak king who simply doesn’t have the courage to admit his own wrongdoing. Offit recounts an anecdote from one time Wakefield supporter, John March. The setting is a meeting between March, lawyer Richard Barr and Andrew Wakefield, called to discuss their litigation strategy.

[March]…presented his data….he told them there was no difference between the children with autism and controls, he suddenly found that the meeting had moved on to a different subject. It was a Damascene conversion for him. He realised that Wakefield could not hear negative results.

Offit (rightly) does not spare Wakefield at all. This is the man who is literally, the architect of the whole idea that vaccines cause autism. Offit quotes Wakefield in an interview with US show ’60 minutes’ in 2001:

I would have enormous regrets if [my theories] were wrong and there were complications or fatalities from measles.

In Feb this year, the Gaurdian reported:

There were 971 cases of measles in England and Wales in 2007 in contrast to 740 the previous year — a rise of over 30% and the highest jump since records began in 1995, said the Health Protection Agency (HPA).

Two teenagers have died of measles in the UK. One in 2006. One in 2008. Are there any signs of Wakefield’s profound regrets?

Offit goes on to study the thiomersal hypothesis from the beginning of the noughties to 2007 and the Cedillo hearings.

It is a strange feeling reading an account of events that you have been so intimately involved in talking about for the last five years. From the bizarre Bernard et al paper and the outright insistence of certain writers and founders of autism/anti-vaccine groups that autism was just another name for mercury poisoning, through Kathleen’s demolition of the Geier’s credibility and science, all the way to Jenny McCarthy’s Oprah showboating.

The main feeling I got was how much a lot of this was now _history_ – as Offit clearly and devastatingly argues, the science has spoken. Vaccines don’t cause autism. And as I blogged about recently, it seems pretty clear that the US public are (rightly) more concerned about the possible resurgence of killer diseases such as measles than they are to keep flogging the dead horse of autism anti-vaccinationism.

But my all time favourite part of the book was the final section. My friends were interviewed at length and the clearest feeling I had from this section was – you threw everything at us. Your money, your influence, your political power. We’re still standing. You threatened us with legal action – we’re still standing. You called us and our children names and threatened their well being. We’re still standing.

Paul Offit has written a real page-turner of a book here. One that should matter to every single autistic person and every single parent of an autistic person. Ultimately, its a book written to support autistic people. Why? because it seeks to close the door on a debate with no scientific merit. Will it do that? Possibly not, we are not dealing with rational people by and large. But what it will do is once and for all dispel the notion that ‘the parents’ who believe vaccines cause autism must be listened to solely because they are parents. Amen to that.

Before the MMR science, the press conference

4 Sep

As I’ve already posted not once but twice, yet one more study has been published showing yet one more time that the MMR doesn’t cause autism.

Prior to the lifting of the embargo on the study itself, there was a press conference featuring some of the study authors (Lipkin and Hornig were both in attendance) and several journalists as well as ‘freelance writer’ David Kirby.

Most of the questions concentrated on what this study showed, however someone there wanted to try and use this new study to (somewhat bizarrely) exonerate the O’Leary lab’s role in the poor science done by Wakefield and in the lab’s role in the Cedillo hearing (where it was trounced for poor science).

The whole press conference is here.

As an example, here is David’s first question.

http://webjay.org/flash/dark_player

Now thats more a set of questions than _a_ question, the initial question regarding Hannah Poling is both inaccurate and pointless. Inaccurate as, regardless of what David claims, no statement has been published by anyone that states Hannah Poling’s autism was caused by a vaccine. Pointless as this science has absolutely no bearing on her case. It has never been claimed she had measles virus in her gut.

David’s second point regarding O’Leary is fascinating. Because one of the labs used in this new paper was O’Leary’s and because the lab performed well, David seems to be claiming that that exonerates the O’Leary lab from past errors. I’m not sure how that can be true. As Stephen Bustin clearly showed during the Cedillo hearing, the errors of the O’Leary lab were twofold. The first was one of methodology. They forgot to do an RT step. Now I don’t know what that means but it was clear that it was a fairly serious (and basic) error. What it caused was the O’Leary lab to falsely identify contaminants as measles RNA. The second error was failing to pick this contamination up. So its not just a case of contamination, its a case of poor procedure.

I’m going to hazard a guess here and suggest that since the time of Bustin’s initial investigation (some years ago now) the O’Leary lab have figured out how to do an RT Step.

David’s second question followed:

http://webjay.org/flash/dark_player

So, we’re back to the very small sub-population argument. I really want to know – if the leading supporter of the vaccine hypotheses is now angling towards this ‘sub-sub’ group, what impact does that have on the autism epidemic idea? I mean, how can you have an autism epidemic generated by a very small sub-sub group?

Anyway, the answer to David’s question from the assembled scientists was ‘uh, who knows? That’s not what our study was about’. Or words to that effect.

David’s third (and fourth) questions followed. Please listen carefully to the answers which I’ve left on. You might also want to note the (somewhat amusing) deep sigh from the guy answering David as David keeps trying to make him say that MMR isn’t totally 100% safe.

http://webjay.org/flash/dark_player

And then by the time of David’s attempted fifth question, the answering team were obviously getting a bit fed up.

http://webjay.org/flash/dark_player

So that (to me) is a pretty fascinating insight into the denial that exists even at the very highest levels of the autism/vaccine hypotheses.

Just as a postscript, David asked them (totally randomly it seemed) if the best study would be one of vaccinated vs unvaccinated kids. Here is the reply. A reply grounded in real science.

http://webjay.org/flash/dark_player

New MMR study makes the NAA angry

4 Sep

Oh dear.

As I posted yesterday, MMR still doesn’t cause autism – as reported by yet another group of researchers.

And yet there was something special about this group of researchers. The lead author is Dr Mady Hornig who it seems is trying to turn over a new leaf and recapture her place as a good scientist.

As the link I supplied shows, it was not always thus and for a long time Dr Hornig was a card carrying member of the mercury militia. In fact, she was a regular speaker at conferences organised by SafeMinds and the NAA.

Which makes the press release about this new MMR study by the NAA all the more painful to read.

A Centers for Disease Control and Prevention (CDC) study released today claims there is no link between the MMR vaccine and autism

Thats how the NAA refers the Hornig study all the way through its press release. ‘The CDC study’. Its a little like reading the decree nisi in the lead up to a divorce you just know is going to be long and bitter.

Anyway, lets have a look at the rest of the points the NAA try to make.

…In a 2002 paper where the majority of autistic children were found to have measles in their intestines, the children examined showed a clear temporal link between MMR exposure and regression. The CDC’s attempt to replicate the 2002 study fell far short of proving the safety of the MMR vaccine.

No reference is supplied for this ‘2002 paper’ so I have no idea what to talk about here. Thats not very smart NAA. Also, as discussed yesterday in the press conference, the intent was to replicate Wakefield’s original study. In 1998. Not 2002.

The CDC study was designed to detect persistent measles virus in autistic children with GI problems. The assumption being if there is no measles virus at the long delayed time of biopsy, there is no link between autism and MMR. But NAA says this underlying assumption is wrong. The questions should have been: Do normally developing children meeting all milestones have an MMR shot, develop GI problems and then regress into autism? Do they have evidence of measles and disease in their colons compared to non-vaccinated age and sex matched controls?

Ahhh, I _see_ – so when you don’t like the answer, change the question? Nice one. The NAA are obviously South Park fans, seeing as they just introduced the Chewbacca defense.

In the current CDC study, only a small subgroup of children was the correct phenotype to study……Only 5 of 25 subjects (20%) had received MMR before the onset of GI complaints and had also had onset of GI episodes before the onset of AUT (P=0.03).” The other 20 autistic children in the study had GI problems but the pathology developed before the MMR vaccine.

This really does take the piss in an extreme way. The NAA love the 1998 study by Wakefield which had a group of 12 participants. Now they suddenly don’t like small numbers?

And really, that is besides the point. The authors took some autistic kids with GI issues and then looked to match them to a hypothesis. The fact that the only found a very, very small number who actually fit the description that the NAA would _like_ them to fit is extremely telling. The vast majority of the kids had GI issues _before administration of MMR_ . Now, what does that tell you? Its not difficult to work out.

Inflammatory bowel disease in the absence of MMR RNA does not mean that MMR shot didn’t precipitate the GI disease and didn’t precipitate autism…

Oho…is that the rumble of some goalpost shifting I can hear? I think it is.

Lets be clear. For literally a decade now, the NAA and the groups like it have been claiming that their kids had the MMR, developed gastric issues, then developed autism all as a result of the measles vaccine RNA contained in the measles component of the MMR. This is the hypothesis that the Autism Omnibus plaintiffs are arguing for right now. This study has thrown yet another large, cold bucket of reality over that nonsense. So now, thats _not_ the hypothesis?

Public confidence in the safety of vaccines is at risk until safety studies are performed that are required by law, ethics, and science….blah blah blah

Is it? If that _was_ the case then the only people who have put the public confidence of vaccines at risk are groups like the NAA. There is no way to keep saying the same thing without appearing repetitive: what you believe is wrong. The MMR vaccine does not cause autism. Shut up. Start working _for_ autism.

And is it really the case that public confidence is slipping? I recently wrote about a phone survey that had found that:

….66 percent had heard that “some parents and researchers say vaccines have side effects that may lead to autism, asthma, diabetes, attention deficit disorder and other medical problems.” About 33 percent had not heard of these concerns, and 1 percent was uncertain.

Seventy-one percent of the adults said “the benefits of immunizations outweigh the risks,” while 19 percent “have questions about the risks of immunization,” and 10 percent were uncertain or gave other responses such as “it depends upon the kind of immunization.”

So, its clear that people (in the US at least) are beginning to get some confidence back in vaccines and see the need for them. That is backed up by an article by the American Academy of Family Physicians who report:

Although the alleged link between childhood autism and the vaccine preservative thimerosal still sparks occasional controversy, the good news is that by and large, parents don’t seem to be buying into the hype. According to the latest reports available from the CDC, overall childhood immunization rates in the United States continue to steadily increase.

This is good news. Partly anyway. It is good news for herd immunity and the general level of the health of the US.

However, this is never going to be good news for autism and for autistic people whilst we have the various conspiracy theory addled groups who claim to represent the autism community continually burying their collective heads in the sand whenever yet another study comes out to show them how silly they’re being. I urge two things to happen.

1) Doctors and scientists – please don’t stop talking about this issue once vaccinations reach safe levels. Your job is only part done at that stage. You *must* continue to talk to reach new parents and the parents who can be reached from the autism community. Don’t let these kooks get the control back.

2) So-called autism advocacy groups in the US and UK. You know who you are. You’re doing nothing to help autistic people. Change your ways or shut up.

MMR still doesn't cause autism

3 Sep

In shocking news, yet another study shows that the MMR doesn’t cause autism. The study (which is here for your edification Dear Reader).

attempted to replicate 1998 research by a team led by Dr. Andrew Wakefield, then of Britain’s Royal Free Hospital, in the Lancet medical journal that suggested the vaccine was linked to autism and gastrointestinal problems.

And how did that work out for them?

….they could not find any link and hope their study will encourage parents to vaccinate their children to combat a rash of measles outbreaks.

The ‘official’ study conclusion is:

This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Autism with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.

Interestingly, the lead author is one Mady Hornig whom you might remember from the infamous Rain Mouse debacle. Seems like she’s turned over a new leaf. Gone are the lurid descriptions of skull chewing and in instead are pleas to vaccinate children from a killer disease. Credit where its due Ms Hornig, well done.

“We found no relationship between the timing of MMR vaccine and the onset of either GI complaints or autism,” Dr. Mady Hornig, also of Columbia, said in a statement.

Another interesting aspect is that the methodology the team used means they utilised three different labs. One of which was the O’Leary lab. This time, they did a good job. Shame they screwed up so bad the first time. Maybe if they hadn’t, things would’ve been over a long time ago. Is it just me or does this paper feel like a few people trying to claw back some scientific credibility?

Anyway, the study also found:

But the study did find evidence that children with autism have persistent bowel troubles that should be addressed.

They still didn’t say whether these bowel troubles (which they found weren’t associated with the MMR) were occurring at a higher rate in autistic kids. Maybe someone will address that one day.

Oh and Rick Rollens was there too, teeth and buttocks clenched no doubt as he congratulated the scientists. He said:

No longer can mainstream medicine ignore parents’ claims of clinically significant GI distress.

Had they ever? I’ve never seen a study that shows that. He also said:

“This study by itself does not exonerate the role of all vaccines”

What a genius. He spotted the phrase ‘Measles Virus Vaccine’ in the study title and worked out the rest all by himself! Nothing gets past our Rick!

So, MMR doesn’t cause autism. No news and of course won’t convince the flat earthers but still – another welcome addition to the ever growing canon of evidence against MMR causation.

Further Reading Elsewhere
Mike at Action For Autism
Kristina at AutismVox
Anthony at Black Triangle
Orac at Respectful Insolence
Steve at One Dad’s Opinion
Phil at Bad Astronomy

"I don't believe that"

29 Aug

To promote his new book ‘Autism’s False Prophets. Bad science, risky medicine and the search for a cure’ (Amazon UK, Amazon US, Amazon Canada) – and look for a review here very, very soon – Dr Paul Offit went on the US radio show Talk of the nation ‘Science Friday’ earlier today.

It turned into a microcosm of exactly the sort of scenario that those of us who have blogged about this for some time have come to expect. A question, a reasoned response and then a flat statement of denial.

The show began with the show host (who’s name I didn’t catch) asking why people weren’t vaccinating. Offit gave the answers we all know.

Then the show took a turn into what could’ve been a blog argument on any one of a number of blogs – including this one. A caller called Chantelle/Chantal came on the line and essentially asked Dr Offit how it could possibly be safe for a newborn to receive up to 1250micrograms of Aluminium and that there hadn’t been any studies on how Aluminium could affect a child. She said –

that is why I will not follow the CDC’s guidelines….my child will be vaccinated on my own schedule.

(Her emphasis)

Dr Offit answered with a brief overview of Aluminium’s role in a vaccine is and then told Chantal the simple truth – one that I blogged about fairly recently – there’s more Aluminium in between 50 days to a years worth of breast milk than in the entire vaccine schedule:

We live on the planet Earth. If we choose to live on the planet Earth that means we’re going to be exposed to light metals like Aluminium and heavy metals like mercury.

Chantal then seemed (I wasn’t entirely clear) to want to compare kids with kidney issues (who clearly need to be careful with Aluminium) with _all_ kids. As Dr Offit stated – that’s hardly a valid or real-world comparison.

Then the host asked a great question:

Chantal, is there anything Dr Offit could tell you that would change your mind

.

The answer: “Absolutely not”.

And there we have it. That is the rock bottom of every single argument the autism/antivax brigade peddle. Screw the science, screw the facts. I just don’t want to hear it and I will put my fingers in my ears and make ‘la-la’ noises until you go away.

Chantal then goes on to justify this ridiculous stance by saying (a la Jenny McCarthy) that there is no independent science supporting vaccine safety. This is tosh. A study this is submitted for peer review to a science journal is peer reviewed by independent experts from the relevant field all over the world. And then, the ultimate test of impartiality takes place – the science is either replicated or it isn’t. Replicated science _has to be_ by definition be independent of its author. How could it not be? If we want to see the opposite of reproducible science, then that can be arranged.

Chantal goes on to say that Dr Offit ‘makes millions’ from speaking about the safety of vaccines. A bizarre claim that I’m pretty sure is not true. He then goes on to describe the ‘high bar’ that vaccine studies must pass. Studies with tens of thousands of participants.

Next, Chantal tries the ‘too many too soon’ dogma that we’ve become recently familiar with. She claims ‘six at one time is absurd’. Dr Offit gives Chantal some facts to play with on that score too:

…the bacteria that live on their nose [a newborn], or the surface of their throat are literally in the trillions. Those bacteria have between 2,000 and 6,000 immunological components and consequently our body makes grams of antibody to combat these bacteria….The number of immunological challenges contained in vaccines is not figuratively, it is literally a drop in the ocean of what you encounter every day.

(Emphasis his, slight paraphrasing)

Chantal then got a bit snappy.

So tell me…how many studies have been done on vaccine loading, which means five or six vaccines at one time. How many?

Dr Offit’s answer:

Somewhere in the vicinity of the high hundreds to low thousands.

Chantal:

I don’t believe that.

Boom! There it is again – she simply doesn’t believe it. Screw the facts, screw the evidence, my fingers are going right back in my ears…la-la-la-la…I can’t hear you…

Dr Offit explains further that any vaccine in the US has to undergo something called a ‘concomitant use study’. These are to establish that vaccines work OK together.

You have to show that vaccine does not interfere with the immune response or the safety of existing vaccines and similarly that existing vaccines don’t interfere with the immune response or the safety of the new vaccine

Dr Offit said ‘high hundreds to low thousands’ of studies (Chantal didn’t believe that remember). A simple Google search reveals over 1,800 results for that phrase. Searching PubMed for ‘concomitant vaccine’ returns over 700.

Dr Offit closes the interview by saying he doesn’t believe all parents are as close minded as Chantal. He uses a nicer phrase than that as he’s a gentleman but that’s how I see it. Close minded to the point of obstinate stupidity.

For some people, it truly doesn’t matter what the facts are, or what the science is. They just stick their fingers in their ears.

La-la-la.

John McCain starting to back away from vaccines?

28 Aug

I’m a bit hesitant to blog about political figures from other countries. I don’t know an awful lot about John McCain other than he was a Vietnam (I think) veteran and was a POW for awhile. I know the Bush team sledged him pretty badly in the run up to Bush’s current term and I know he tries hard to cultivate a old-fashioned-take-no-shit-youngster attitude. I neither like him nor dislike him.

However, back in February he did irritate me quite a lot when he said:

[Autism]….is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.

It irritated me because firstly, there’s no evidence its ‘on the rise’ in the sense I think he meant it. There’s no way of scientifically telling from current studies if it is or not. In fact, the best science done so far on the issue (Shattuck, 2006) states:

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

In other words, because autism has not been tracked well up until now, there is no way we can say with any degree of confidence that is increasing. It may be, but most scientists think that instead of an _increase in autism_ , we are seeing an increase in _accurate diagnosis_ of autism.

Secondly, McCain’s statement irritated me because, of course, there is _no_ evidence, strong or otherwise, that indicates autism is caused by preservatives in vaccines. And certainly McCain totally failed to provide any kind of evidence for this silly statement.

However, as election time draws nearer, it seems McCain’s statements are growing a bit more (he said with no trace of irony) conservative. Maybe someone explained the facts of life to him: after having someone of less than stellar brain power in office for the last eight years, it might be a good idea to evaluate things properly, rather than just sound off and come across as Dubya Part II.

Here’s what he said recently:

We don’t know what causes [autism]. There’s a huge debate going on now about vaccinations. And I’ve read and studied and gotten briefings, and I don’t know all the answers.

Thats quite a lot more circumspect than ‘there’s strong evidence that indicates that it’s got to do with a preservative in vaccines’. A simple statement of facts. After all, its true – we _don’t_ know what causes autism. And there _is_ a debate going on about vaccinations. And guess what? John McCain _doesn’t_ know all the answers.

I’m guessing McCain’s team have suggested to him that if he doesn’t want to be known as the also-ran who hyped up unfounded fears of vaccinations in the middle of a measles epidemic sweeping through the country he’s attempting to lead then it would be a good idea to engage his brain before opening his mouth.

Busy day at the Trib for vaccines

27 Aug

According to the Chicago Tribune’s “On This Day In History“, on this day in “1906 Albert Sabin, the Polish-American doctor who developed a polio vaccine, was born”.

Coincidentally, the Tribune had a couple of pieces on vaccines in the past few days. The main story, Kids’ vaccinations face risky resistance discusses how fears over vaccines and autism are causing a drop in uptake. This is worrying doctors given this year’s outbreak of measles in the U.S. The authors note:

Doctors say worried parents tend to find scientific data less persuasive than the horror stories they hear about vaccine side effects online or from friends. One expert said attitudes are likely to change eventually, but only after children start dying again of diseases parents have come to think of as obsolete.

Or, to put it another way:

“I think people have a hard time separating out what’s reliable information and what’s not reliable,” Dr. Ruben Rucoba, a Wheaton pediatrician. “What gets attention is not the statistics, but the story. All it takes is one friend of a cousin of a neighbor who they can point to who says, ‘My child got an immunization, and now he has a problem.’ “

Another page listed “Common Vaccine Beliefs“. Number one on the list being:

1. Vaccines cause autism.

The issue usually raised is thimerosal, a mercury-based preservative formerly common in vaccines. It has since been removed from most shots to reduce children’s exposure to mercury. Also, because signs of autism may appear about the same time children receive the measles, mumps and rubella vaccine, some parents think there is a connection. Many studies, including a report by the Institute of Medicine, have concluded there is no association between autism and vaccines that contain thimerosal or the MMR vaccine.

The Trib has included some good links on vaccine information.

Bloggers respond to news. No big deal there. But, I find it is interesting to see one of the Trib’s own bloggers responding to Trib stories. Especially since the blogger, Julie Deardorff, as you can imagine if you know her blog, doesn’t agree with the Trib.

Ms. Deardorff has a number of pieces on vaccines and autism. She also is one of the AutismOne convention’s panelists on the media. She’s the one that AutismNewsBeat caught on video complaining that she isn’t allowed to “attack” vaccines.

Ms. Deardorff’s piece is “Why some parents question vaccines.” A statement towards the end makes it clear some of the mindset of Ms. Deardorff:

Vaccines represent social health without regard to individuals. That’s how they work.

Ah. Yeah. It’s hard to comment well on such rubbish, other than to thank Ms. Deardorff for actually putting that in a public place so we can understand her position. OK, I’ll add this comment–that’s not how vaccines work. She would do well to peruse the links her own organization has provided for some education on how vaccines do, in fact, work.

Scrolling back to the beginning of her piece, we see her actual thesis:

In the past, most parents didn’t question childhood vaccinations because they inherently trusted medical officials and feared common childhood diseases.

She then goes on to discuss that this trust has eroded. She takes no credit for her small part in contributing to this erosion of confidence (nor does she mention any of the other people and groups actively working to erode confidence). Instead she places the blame on public health community:

But the real crisis is not that some parents skip or delay vaccination because they believe vaccines might pose health risks or are linked to autism. It’s that they’re losing confidence in public health officials and policy, partly because vaccines are being forced on them, regardless of their personal desires or beliefs.

She then, without any indication that she sees the irony, lists a number of events and adds her own odd interpretations in order to erode confidence. I pick a few out for example:

In Maryland, parents who didn’t vaccinate their children against chickenpox and Hepatitis B were threatened with jail time and fines.

This is a grand example of Ms. Deardorff facilitating the misinformation campaign of the vaccine rejectionists. Here is the form that people in Maryland have to submit on their children’s vaccine status in order to enter the children in school. The same form has the exemption clause. In other words–the parents could have avoided any and all pressure by filling out that form. Instead, the vaccine rejectionist parents decided to make a political statement by not submitting the forms in order to gain publicity.

The AAP issued a sample letter to pediatricians suggesting that physicians tell parents who refuse to vaccinate that they have a “self-centered and unacceptable attitude” since their child is getting protection from others who have chosen to vaccinate. Parents who absolutely refuse to vaccinate could be booted from your pediatrician’s practice.

I haven’t asked our pediatrician what his policy is on vaccine rejectionist clients. I hope that when I brought my children in at 1 month, 2 months, etc., that they weren’t being exposed to vaccine-preventable infectious diseases like some of the children in San Diego’s recent measles outbreak. Yes, some children caught measles in doctor’s waiting rooms. I have zero problem with pediatricians telling vaccine rejectionist parents to find vaccine rejectionist pediatricians.

I really hadn’t intended to discussing all her points. I started with just one. The one that really caught my eye was this:

Research suggests that America might be over-vaccinating its kids and that we might want to re-evaluate and adjust the immunization schedule. But not because of health concerns; the vaccines might just be unnecessary and waste a lot of money according to the study by researchers with Oregon Health & Science University published in the New England Journal of Medicine.

The article she is referring to (I believe) is a favorite of rejectionists groups and websites. The abstract is here, and the full paper is available free.

I have a lot of concerns with the above statement by Ms. Deardorff, but I will concentrate on this on this phrase: “…the vaccines might just be unnecessary and waste a lot of money…”

Which vaccines, Ms. Deardorff? Which vaccines? Your phrase is very vague. I am often vague and don’t use language accurately, but I don’t have the Chicago Tribune’s name behind me. You see, Ms. Deardorff, your statement makes it sound like it is the “vaccine schedule” that is in question. Not a fraction of it, as the actual research would suggest. Sloppy writing is one thing. When it supports your quest to “attack vaccines” it makes me question whether it should be attributed to mere sloppiness.

Let’s take a look at the story that was scary enough to be quoted by JABS. “Report: Vaccine booster shots may be unnecessary”.

So, it isn’t the schedule in whole, it isn’t even really the pediatric schedule for the most part, it’s the booster shots. What they found is that in adults–most of whom had immunity from infections, not from vaccines, by the way–kept immunity for a long time. Half-lives of immune cells were longer than human life-spans.

They measured half-lives for both people with natural immunity and for people with presumed vaccine immunity The group with the presumed vaccine-induced immunity was quite small, as noted in the supplemental information given online:

However, it is important to note that this is based on a very small sample size (n = 2-5 subjects) and more studies on a larger group of vaccinated individuals will be necessary to determine statistically significant antibody half-life measurements.

Thus the data on vaccine-induced immunity are quite limited. But, taking the data that we have, they don’t say “… the vaccines might just be unnecessary and waste a lot of money…” as Ms. Deardorff interprets them.

I found the study rather interesting, actually. I found it interesting since one of the tried and true arguments promoted by vaccine rejectionists is that vaccine immunity is short lived and “natural” immunity is somehow better. I find it interesting that JABS, GR (they host the paper on their website) and other groups latched on to this study, yet, they seem to neglect what it may actually teach.

What I also found interesting was some information I found searching for Dr. Slifka (the anchor author on that study). Turns out he wrote a review of Dr. Offit’s book “Vaccinated”. I’ll leave you with two quotes from that review:

More recently, unfounded concerns over theMMRvaccine and the use of mercury-containing preservatives have fueled a fiercely debated controversy over childhood vaccines and their suspected links to autism

and

Offit ends by emphasizing the power of preventive medicine and hopes that the great strides in vaccinology, in large part due to Maurice Hilleman, will not fall to complacency and ignorance.

Endemic in the UK

25 Aug

Endemic:

Adj. 1. endemic – of or relating to a disease (or anything resembling a disease) constantly present to greater or lesser extent in a particular locality; “diseases endemic to the tropics”; “endemic malaria”; “food shortages and starvation are endemic in certain parts of the world”

Or, another example is measles in the UK.

How very shameful in the year 2008 that we have allowed one person to create an all-encompassing atmosphere of fear – groundless fear at that – that has allowed a disease that 10 years ago was virtually unheard of to return with such vengeance that two children have died in the past two years and many more have been hospitalised.

There are two reasons I find this shameful. Firstly, there is the fact that as an autism parent I am ‘judged’ every time I leave the house. We all are. The people who stare, the people who do double takes, the people whispering behind their hands. What are they saying now? How long will it be before the general public cotton on to the fact that measles _is_ now endemic is largely due to autism parents and the quacks they pay huge amounts of money to? As a community of parents we are divided and when people ask why that is or ‘can’t we just come together?’ on this issue, this is why.

*I cannot condone or stand by quietly whilst the autism community sinks into becoming a convenient media scapegoat. Neither can I stand by and say nothing whilst autism parents sink deeper and deeper into anti-vaccinationism and pretend that hospitalisation and death in the name of chasing a belief for which there is no proof is OK.*

The CDC’s Jane Seward (deputy director of the division of viral diseases) is interviewed today by Scientific American.

…in the 1960s, right before the vaccine was developed, it killed 400 to 500 children every year out of 500,000 reported cases at that time.

That’s a death every 1,111 reported cases. The current US measles epidemic has 163 cases. You’re nearly 15% there already.

Seward also says there were 4,000 cases of encephalitis a year resulting from measles in the 60’s and goes on to describe some of things that can follow on from encephalitis. Quite a lot of anti-vaccine believers say that encephalitis can lead to autism. Taste the irony.

Kelli Ann Davis doesn't get it

23 Aug

Over on Orac’s blog, a discussion is ongoing about (you guessed it) thiomersal.

One of the usual antivax canards is played beautifully by Kelli Ann Davis when she says:

So Phoenix Woman [another commenter], can you explain to me what the skull and crossbones is doing on the Material Safety Data Sheet (MSDS) if thimerosal is not a poison

This is top notch antivax stupidity. Not only does she entirely miss the point of ‘Phoenix Woman’s’ comment (which was not that thiomersal was not a poison) she also infers that the fact that thiomersal is a poison means that its automatically going to cause damage. She conveniently forgets – or doesn’t care – that the adage ‘the dose makes the poison‘ always applies.

And of course we have the scare tactic of mentioning the skull and crossbones.

Thing is, there are plenty of other Toxic substances used routinely in medicine. Lets have a look at Warafrin – which is at one level rat poison and at another level an anticoagulant. And hey – look at that – the MSDS sheet has a skull and crossbones on it.

Common clinical indications for warfarin use are atrial fibrillation, the presence of artificial heart valves, deep venous thrombosis, pulmonary embolism, antiphospholipid syndrome and, occasionally, after myocardial infarction.

And also

To this day, coumarins are used as rodenticides for controlling rats and mice in residential, industrial, and agricultural areas. Warfarin is both odorless and tasteless, and is effective when mixed with food bait, because the rodents will return to the bait and continue to feed over a period of days until a lethal dose is accumulated.

So, lets spell it out nice and slow for Kelli Ann – the dose makes the poison.

And so, lets have a look at the current dose levels of thiomersal in vaccine shall we?

For an ‘average’ person of 154 pounds, there is 6mg (miligrams) – or 6000 micrograms(µg)) of mercury occurring naturally in the body. So, roughly, a person of 25 pounds has 1mg (1000µg) of mercury (or, to put it another way, 1 pound of body mass gives us 40µg). A healthy newborn weighs on average about 7.5 pounds which gives a mercury body burden of approximately 303µg of mercury.

When we look at the FDA thimerosal content of vaccines currently mandated and add them all up we see that we get 239.2µg of mercury – way under what occurs naturally in the body of a healthy 7.5 pound newborn.

Now, this is not even a fair comparison. I have added up all the vaccines for a child of 6. Including doubling up on doses of a vaccine made by different manufacturers. Quite obviously a child won’t get a Td jab from two different manufacturers at one time. I have also included all the flu jabs – again, no one will get all flu jabs in a single flu season.

The maths is quite clear. There is more mercury existing naturally in our bodies – even those of a 7.5 pound newborn – than the combined total of every single thiomersal containing vaccine on the market.

Leaky gut aka intestinal permeability

18 Aug

Leaky Gut syndrome is a hypothesis associated with autism by people who believe that toxins (particularly those caused by vaccines – notably the MMR) weakens the lining of the bowel letting various rubbish thorough (undigested food, toxins, whatever) and triggering an immune response and/or leading to Wakefield’s much-hyped but never backed up Autistic Enterocolitis.

This unverified condition has (of course) been found by any number of Wakefield supporters and yet, curiously, no researchers external to Wakefield’s peers have found any evidence for it and the phrase exists as a diagnosis within that AltMed community.

In fact, its not curious at all as the only groups that _did_ find evidence for ‘Autistic Enterocolitis’ used the now discredited Unigentics lab run by John O’Leary.

Anyway, in Feb of this year a team from the University of Calgary published a Pilot study into the ‘leaky gut’ (posh name: ‘intestinal permeability’) issue.

They enrolled 14 autistic kids (all of whom had parents who reported gastric issues), 7 NT siblings of these kids, and 8 NT non-related controls.

In the ‘leaky gut’ opioid-excess theory, it is proposed that increased intestinal permeability in children allows for increased absorption of dietary peptides, which ultimately leads to disruption of neuroregulatory mechanisms and normal brain development.

The reason for choosing autistic kids who were reported by parents to have gastric issues is that the researchers reasoned that these kids would be more likely to have ‘abnormal gastrointestinal tests’.

In this population, the researchers found:

we neither demonstrate abnormal small intestinal permeability, nor abnormal postprandial responses of the enteroendocrine peptide GLP-2.

…..

It has been suggested that increased permeability may be causally related to the onset of the inflammatory bowel disease and not just a consequence of inflammation. Our data does not support a similar hypothesis in autism.

…..

Our study did not detect differences in the functional gastrointestinal parameters measured in a group of children with autism. Although there may be a subset of children with autism with a specific gastrointestinal abnormality there is no firm evidence yet of a role for gastrointestinal dysfunction in
the etiology of autism.

One of the things the authors reported that struck me was:

The subtle endoscopic and histological findings of lymphonodular hyperplasia in the colon and ileum previously described in ‘‘autistic enterocolitis’’ (Wakefield et al. 1998, 2005) are also seen in normally developing children with similar gastrointestinal symptoms (Furlano et al. 2001).

This is only a pilot study of course so not too much can be read into the results but if the study is expanded upon and replicated then the results would be interesting to see. Its certainly a smallish spanner in the works of the ‘autistic enterocolitis’ believers.

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