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Wakefield, Baird, Archives

20 Feb

This is a Guest Blogged post, written by an author with a keen interest in Wakefield related issues. My gratitude to Nigel for writing the post which follows.

Wakefield and his colleagues were fast off the mark (http://www.thoughtfulhouse.org/pr/020608.htm) to criticise the study by Baird et al which recently appeared in Archives of Disease in Childhood. This was a well conducted study which failed to detect measles virus (MV) or elevated measles antibodies in the blood of autistic children. There is a general feeling that even if the almighty Jehovah himself, collaborating with the top researchers at the Universities of Oxford, Cambridge, Harvard and Yale, and with an advisory board of all recent Nobel laureates in medicine, produced a negative study on measles virus in autistic children, Wakefield would still find flaws in the work; remarkably rich from the single largest purveyor of junk science in the last 20 years.

As a criticism of the study Wakefield states “It is a major error to have presumed that peripheral blood mononuclear cells are a valid ‘proxy’ for gut mucosal lymphoid tissues when searching for persistent viral genetic material” and later states “ We are increasingly persuaded that measuring things in blood many years down the line tells us very little about the initiating events in what is, in effect, a static (non-progressive) encephalopathy unlike, for example, subacute sclerosing panencephalitis, which is a progressive measles encephalopathy” .

The hypocrisy of this statement is quite breathtaking, but unsurprising from someone whose relationship with scientific honesty and integrity is somewhat elastic. For those who don’t have long memories, the first “alleged “ evidence of MV in autism came from Wakefiled’s collaboration with Kawashima where using standard methodologies which were highly effective at detecting MV laboratory contaminants, Wakefield claimed that blood cells from 3/9 autistic children gave positive results ( Dig Dis Sci 2000 45:723-9). This paper formed a key part of the UK MMR litigation from 2000-2003 driven by Wakefield himself until it was mysteriously dropped from the final claimants witness reports by Wakefield himself. Perhaps the realization that blood is a poor proxy for gut came to him in 2003, or more likely, that he knew the Kawashima data were junk and would not stand up in court.

Even more staggeringly, the vast majority of samples from autistic tested for MV by O’Leary in the Unigenetics lab in Dublin were from blood; including the now infamous blood samples taken from healthy children at Wakefield’s own child’s birthday party. Steve Bustin in his testimony on the US Cedillo case comprehensively shredded all of the work that came out of that lab. All of this data on blood has never appeared in the public domain although the junk science on MV in the gut did appear in the Uhlmann paper, in a low impact factor journal which promptly rolled over and died.

As always however, you cannot believe anything Wakefield says as being scientifically valid. In the blood there are cells which are representative of the gut lymphoid tissue. This is very well established and non-controversial. When T and B cells are activated in the gut associated lymphoid tissue, they acquire the alpha4beta 7 integrin and migrate via the mesenteric lymph nodes, and the thoracic duct into the circulating blood and then home back into the rest of the gut using the mucosal addressin, MAdCAM-1.. This happens in all healthy people constantly and it is possible to identify these gut-homing cells in blood. Since Wakefield claims that MV persists in the allegedly large lymph nodes in the gut wall, cells should be infected with MV at source and carry the virus with them into the blood. So come on Andy, with O’Leary’s supersensitive PCR, you should be able to detect at least some of these cells migrating to the gut via the blood. After all, the PCR is so sensitive it can detect MV in samples of distilled water, now that is really amazing!

I suppose one should always rejoice in the repentance of a sinner, and if Wakefield has now come to the conclusion that blood is not a proxy for gut lymphoid tissue, we should be happy he is now happy to recant on all his previous claims about blood cells being positive for MV in autism. I have a sneaky feeling however that this is just another “wriggle” to keep the show on the road. If one of his acolytes claims to find MV in blood of autistic children, you can bet that blood will once again become a valid proxy for gut lymphoid tissue.

Andrew Wakefield Responds

14 Feb

Andrew Wakefield has responded to the latest MMR Study showing no link between the vaccine and autism.

Just to recap, the latest Baird et al study looked at whether autistic kids and non-autistic controls showed any variance in their measles antibody response. They don’t.

The measles aspect of the MMR vaccine is what Wakefield’s hypothesis relies on. He says because its a live virus its casing gastric issues and then autism in some kids. This study looked to see if there was any evidence of measles-virus in the blood of these kids. There wasn’t. They looked to see if any of the autistic kids had evidence of gastric issues over and above the average. They didn’t.

But Wakers thinks this isn’t good enough.

The study is severely limited by case definition in the context of the crucial ‘possible enterocolitis’ group………….We have over the last 10 years evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children. Almost none of these children with biopsy-proven enterocolitis would fit the criteria set out above………….The requirement for the current presence of these symptoms, for 14 or more days continuously, shows a singular lack of understanding of the episodic, fluctuating, and alternating (e.g. diarrhea/constipation) symptom profile experienced by these children

Wakers thinks that the criteria for defining enterocolitis that Baird et al used was too strict. He says it will occlude the group he’s identified.

He’s probably right. But not in the way he thinks he is. Could it maybe be that _his_ definition of enterocolitis is too slack? His definition includes:

In our experience, ASD children with histologic enterocolitis typically have 1 to 2 unformed stools per day that are very malodorous and usually contain a variety of undigested foodstuffs. This pattern alternates with that of “constipation” in which the unformed stool is passed after many days of no bowel movements at all, and with excessive straining.

With which he claims is ‘identified mucosal inflammation in excess of 80%’ of his kids.

Thing is, a PubMed search for ‘mucosal autism’ returns 20 results. Of which only one support the idea of inflammation – One of Wakers own papers. In fact the only person I could see using the term ‘histologic enterocolitis’ was (you guessed it) AJ Wakefield.

The question immediately occurs: Of the ‘several thousand children on the autistic spectrum who have significant gastrointestinal symptoms’ why hasn’t there been any published, peer-reviewed, replicated, science written up by Wakefield? Why hasn’t anyone else managed to find 80% positive results and published peer reviewed science about their results?

Could it be that its only the team who have screwed up their results that find what they want to find? I think so. Lets quote Stephen Bustin once more.

Now, these are from samples that should have been discarded according to the SOP from Unigenetics because there was no GAPDH present, i.e., the RNA is degraded. If you look at the Cts for the F-gene which they reported as positive you can see they’re the same. Now, if this is degraded RNA yet I’m getting the same Cts for my F-gene target this can’t be RNA because it would have been degraded.

That’s what the GAPDH showed me. Now, if it isn’t RNA it has to be DNA. If it is DNA it can’t be measles virus it has to be a contaminant.

Plain English – Wakefield scoped kids. Sent samples to Unigenetics. They should’ve told Wakers the samples were rubbish. They didn’t. They analysed rubbish samples which were contaminated. What they found wasn’t measles virus.

A frequent complaint from the Wakefield apologists is that by analysing blood samples rather than gut tissue, science teams are not comparing like-for-like. There are a number of reasons why this is questionable.

Firstly, there has to be a _reason_ for scoping children. It is not a straightforward procedure.

Towards the end of last year, an autistic child who was scoped following a recommendation by Simon Murch, a colleague of Andrew Wakefield’s, was awarded £500,000 damages after his bowel was perforated in 12 places.

An autistic boy has won a £500,000 payout after the hospital at the centre of the MMR scandal carried out an operation that was ‘not clinically justified’.

Jack Piper, then five, was left battling for life after the procedure, which his parents claim was carried out to establish links between his condition and bowel problems.

His bowel was perforated in more than 12 places during surgery at the Royal Free Hospital in North London.

…………

The colonoscopy was suggested by Professor Simon Murch. He is being investigated by the General Medical Council over allegations that he carried out invasive tests including colonoscopies on 11 other children contrary to their best clinical interests.

It is an ethical issue – is a scoping procedure ethically justified? The answer is ‘no’ – that hasn’t stopped Wakers doing ‘thousands’ though apparently.

Secondly, is there any reason why looking blood is not good enough? Awhile ago, I asked a Doctor (who wished to remain anonymous) who told me:

measles is a lymphotropic virus, even more so for the vaccine strain which has been selected to exploit the CD46 cellular receptor. If there is a persistent MV infection the most logical place to detect it is in cells that it is most adept at infecting. Lymphocytes [a type of blood cell]

(Insert mine).

So, there’s not really any reason why blood cells wouldn’t be suitable to check for measles virus, despite Wakefield’s opinion.

And in fact, at least one team _wanted_ to use Wakefield’s samples but their request was ignored:

The groups of investigators that either had access to original autism specimens or investigated them later for measles virus detection were invited to take part in the study but failed to respond. Similarly, it was not possible to obtain clinical specimens of autism cases from these investigators for independent investigations.

Now I have to wonder why, if Wakefield et al are claiming that only scoped samples are any good, or that blood is no good they didn’t hand over the samples they had harvested with the gratitude of a team expecting to be replicated.

Maybe they didn’t really want another science team looking at these samples. Maybe they feared what another team would find.

And what about this inflammation Wakefield alleges to have found? Turns out that its possible to screen for inflammation without the need for scoping.

Fecal calprotectin is a marker for a range of gastric issues, notably IBD (irritable bowel disease) and Crohn’s which it has positive results for.

A 2002 study Effect of Pentavac and measles-mumps-rubella (MMR) vaccination on the intestine looked at:

if MMR vaccination is associated with subclinical intestinal inflammation, which is central to the autistic “enterocolitis” theory

To do this, the team:

….studied 109/58 infants, before and two and four weeks after immunisation with Pentavac and MMR vaccines, for the presence of intestinal inflammation (faecal calprotectin).

The results were:

There were no statistically significant differences in faecal calprotectin concentrations at any time points (p>0.25) or when assessed in subjects studied before and after Pentavac (p>0.2) or MMR (p>0.3) vaccination

and

There was no evidence that either Pentavac or MMR vaccination provoked subclinical intestinal inflammation in any of our apparently healthy children during the four week post-vaccination period. This lack of a detectable intestinal inflammatory response suggests that the measles vaccine virus itself is not enterotoxic in healthy infants which argues against the MMR induced autistic “enterocolitis” theory.

And so we come back to the bottom line. What direction does peer reviewed published science take us in? It takes us away from Wakefield.

There are no good reasons to believe that blood samples are not good enough to compare with gut samples and if Wakefield believes otherwise, why didn’t he provide the samples to the Afzal team when asked to?

There is no good reason to justify dangerous, invasive procedures such as the one Wakefield has used on thousands of kids and which left one child fighting for life with a massively perforated bowel. Fecal calprotectin is more than adequate as a marker of intestinal issues and using this method reveals no association between MMR and autism.

MMR Smoke and Mirrors

8 Feb

In the days following the latest in an increasingly long line of studies repudiating the MMR/autism hypothesis, adherents to this belief system have clung wildly to the flotsam and jetsam that is pretty much all that is left to hang on to.

On the ADC Online forum, John Stone encapsulates this position with a letter I’ll go through point by point:

Of the original 1770 Special Educational Needs (SEN)cases in this study 255 were Autistic Spectrum Disorder (ASD). Of the 1770 735 dropped out, then a further 780 were excluded for reasons which are not transparent. 255 were left (a different 255 from before): some ASD, some just SEN but we do not know in what proportion. Then, exactly 100 were excluded because of inadequate blood tests. Of the remainder 101 had ASD (less the 40 per cent of the original 255 autistic cases). None is reported to have bowel disease (the sub-group of Wakefield’s study) or adverse reaction to MMR.

This is numerical hoopla and means nothing. The key to Stone’s frustration is the last sentence of this paragraph and the first one of the next:

It is not clear what the scientific purpose of this study is…….None is reported to have bowel disease (the sub-group of Wakefield’s study) or adverse reaction to MMR. This, of course, makes this a distinct group from the children referred to Andrew Wakefield and his colleagues at the Paediatric Gastroenterology department of the Royal Free Hospital in the 1990s and slighlty beyond.

Stone is arguing that because none of the ASD subjects were found to have bowel issues that disqualifies them as being like Wakefield’s subjects.

Methinks someone has missed the point.

The issue is one of clinical science. Wakefield claims to have found a clinical link between the measles live virus component of the MMR which causes bowel issues with associated autism. However, the Cedillo hearings drove a rather large nail into that particular coffin.

Professor Stephen Bustin is the worlds foremost PCR expert. Bustin uses PCR every day in his work, he has 14 papers in the peer reviewed literature on PCR, over 8 book chapters and is personally the author of the ‘A to Z of Quantitative PCR’ which is considered ‘the bible’ of PCR. One of his papers has been cited over 1,000 times. Another has been cited over 500 times. He both organises and speaks at international PCR conferences. His testimony regarding the Unigentics lab used to find the measles virus in the guts of these autistic kids was invaluable.

Bustin examined the Unigentics lab findings and procedures in great detail (spending over 1,500 hours in the lab itself) and found that the lab (which has now gone bust as a business) made a fairly basic error of science when looking at Wakefield’s samples:

“…Now, these are from samples that should have been discarded according to the SOP from Unigenetics because there was no GAPDH present, i.e., the RNA is degraded. If you look at the Cts for the F-gene which they reported as positive you can see they’re the same. Now, if this is degraded RNA yet I’m getting the same Cts for my F-gene target this can’t be RNA because it would have been degraded.

That’s what the GAPDH showed me. Now, if it isn’t RNA it has to be DNA. If it is DNA it can’t be measles virus it has to be a contaminant.”

In other words, the samples Wakefield provided to Unigentics were useless because Unigenetics own documented lab procedure says they were. But they used them anyway. The results were a bombshell. If the RNA is useless (which the lab process defines it as being) it can’t actually be RNA. If its not RNA then it must be DNA and if its DNA then it can’t be measles virus because measles virus doesn’t exist as DNA.

What the Unigentics lab detected in Wakefield’s samples were contaminants. There’s no way that Unigentics could possibly have been detecting measles virus.

This was backed up by Chadwick who checked Wakefield’s work (at his request). He also did a PCR test.

Q. What results did you receive from the gut biopsy materials for measles RNA?
A. They were all negative.

Q. They were always negative?
A. Yes. There were a few cases of false positive results, which I used a method to see whether they were real positive results or false positive, and in every case they turned out to be false positive results. Essentially all the samples tested were negative.

Q. Did you inform Dr. Wakefield of the negative results?
A. Yes. Yes.

So not only are the samples Wakefield provided useless, the testing he asked Chadwick to perform showed they were useless. And yet he went ahead anyway.

Its also worth noting that every subsequent piece of MMR science (save one unpublished poster presentation) went through Unigenetics lab and went through the same process as Wakefield’s.

So lets be frank – the idea that Wakefield found measles virus in the gut of autistic kids is plain and simply wrong. He screwed up.

The issue then becomes one of probabilities: given that there is no scientific reason to believe MMR causes autism with bowel disorders, it is nonsensical to only look at autistic kids with bowel disorders. And in answer to Stone’s question ‘It is not clear what the scientific purpose of this study is…’ the answer is plain – it has scientifically illustrated that autistic kids had exactly the same measles antibody response as non-autistic kids. No difference. At all.

Stone continues to attempt to muddy the scientific waters:

There is presently not enough consensus about the etiology of ASD to assume there is any single origin, nor anything to rule out ASD subjects having gut symptoms which justify on occasion invasive procedures. The NAS apparently consider that there is a sub-group which is being denied sympathy, investigation or treatment, and this is in itself troubling. It also suggests that this study is not representative since no such cases are included, and it does not address their problems.

This is slipperiness taken to almost artistic levels. Stone is quite right there is no consensus about etiology of autism. That does not mean we cannot say what doesn’t cause it though. And based on the available science, MMR ain’t it.

The paper further does not attempt to claim that autistic kids don’t have gastric issues and Stone’s implication that it does and his attempt to gain the mainstream ground by invoking the name of the NAS is grasping and dishonestly representative of the NAS’s statement. They do _not_ claim, infer or consider that there is any such sub-group. What they suggest is that the MMR debacle has led to some doctors dismissing some parents fears about their kids bowel issues as hysteria. This is, of course, unacceptable but Stone is simply attempting to manipulate the NAS statement for his own ends.

“The NAS warning relates to the GMC hearing involving doctors Wakefield, Walker-Smith and Murch which is set to resume on 25 March approaching. I do not think it is being unduly cynical to query the publication of this study at the present time as a media event, bearing in mind that it seems to have been carried out five or six years ago.”

This is either again deliberately misleading or an example of conspiracy hysteria. From what I can tell the study was commissioned five/six years ago. Not carried out.

Stone concludes:

Meanwhile, the plight of autistic children with gastro- intestinal symptoms is excluded both from the study and public attention, as if they did not exist. The NAS statement warned of “creating further confusion” and this is precisely what this study and its media exposure has done.

Children with gastro issues and autism were not ‘excluded’ they just weren’t found. Maybe they really don’t exist? Maybe Stone would’ve preferred that the study authors fabricate a few subjects?

The bottom line of this gastro/autism issue is that there is no science to back up the opinion Stone has. On the other hand there is plenty of science that indicates there is no link between MMR and autism. Far from this study creating confusion, it has simply shown up the shortcomings of Wakefield’s bad science and Stone and his ilk are in reality the people desperately attempting to create enough confusion for Wakefield to escape unscathed.

Brad Handley Offers Us A Chance To Evaluate

6 Feb

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

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

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

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

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

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

First off he cites:

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

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

The second (and last) paper he cites is:

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

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

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

and Shattuck says:

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

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

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

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

David S. Mandell, ScD; Raymond Palmer, PhD

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

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

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

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

Brad continues:

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

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

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

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

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

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

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

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

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

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

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

and

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

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

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

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

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

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

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

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

Brad continues:

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

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

And yet there’s more.

You never mention recovered children.

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

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

Brad continues:

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

———————

Dr. Minshew:

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

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

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

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

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

Sincerely,

JB Handley

——————–

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

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

——————–

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

Says who?

And, tough shit.

J.B. Handley

——————–

Nice guy huh?

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

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

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

Anyway, Brad concludes:

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

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

MMR Still Doesn’t Cause Autism (and never did)

4 Feb

Yet another study will shortly be published that yet again shows no link between autism and MMR:

There is no evidence for a link between the MMR (measles, mumps, rubella) jab and autism, finds research published ahead of print in the Archives of Disease in Childhood.

The authors took almost 250 kids born between ’90 and ’91. 98 were ASD. 52 had special needs with no ASD. 90 had no special needs and were developing within ‘normal’ parameters. All the children had been vaccinated against MMR, but not all of them had been given both doses.

The team took blood samples and found no persistent measles infection, no abnormal immune response.

Results of the blood sample analysis showed that there was no difference in circulating measles virus or antibody levels between the two groups of children.

Tellingly, it didn’t matter which of three groups the team looked at – none of them exhibited any ‘bad blood’ whether they’d had both MMR shots or not. Or if the autistic kids had experienced regression or not.

The team further found no evidence of any kind of so-called ‘autistic enterocolitis’ – in fact no evidence of any bowel disorders of any kind were found among the autistic kids.

The alst line of the news report is very pointed:

The authors point out that theirs is now the third, and largest, study that has failed to show a link between the MMR jab and autism.

Quite.

Repeat after me – MMR doesn’t cause autism. It never did.

Awhile ago I wrote a piece on the history of the MMR hypothesis. You can read it here.

Mark Blaxill Thinks Bloggers Are Mean

4 Feb

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

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

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

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

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

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

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

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

They’re cowards.

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

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

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

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

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

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

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

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

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

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

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

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

Or Paul Shattuck, also from the mercury militia:

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

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

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

these people need to be horse whipped…

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

Dear ****:

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

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

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

Ray Gallup

Or what about this Marky Mark?

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

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

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

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

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

Sarah Parker

How about Brad Handley of Generation rescue saying to me:

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

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

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

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

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

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

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

The evolution of Eli Stone

1 Feb

This is a Guest Blogged piece written by new bloggers from Hollywood Spectrum.

For those who don’t know (I wish I were one of you), there is a TV show about to premiere called "Eli Stone". It was likely going to be a pretty run-of-the-mill premiere. Possibly, it was going to be a total non event.But, the plot includes autism. Not only does it include autism, but it involves a lawyer doing what has never happened in real life-he win’s a case about how mercury in vaccines caused autism in a child. This led to a number of news stories, internet discussions and blog posts.

Well, after the initial press on this, the American Academy of Pediatrics (AAP) sent a letter to ABC/Disney asking them to pull the show since it could erode confidence in vaccines.  Somehow this was characterized as big-bad AAP trying to bully ABC/Disney.  Now, Disney is a company that has revenues of nearly $9B per quarter.  Yeah, AAP was twisting their arm by giving them free publicity.

Did anyone really believe that ABC/Disney would pull the show?  I mean, really, they just got a lot of free publicity for what was likely to be a pretty forgettable show.   How can I say this was going to be forgettable?  Because the original script was something worth forgetting.  Consider when Eli Stone visits a Chinese acupuncturist (who somehow brings about visions in Stone).  The good Dr. Chen was given such amazing lines in pigeon English as:

"You go regular doctor? Dr. Chen not MRI."

and

"I have patient, you come back half hour."

and

"No good hate dead people. Relah. Think good memory father. Dr. Chen help ungrateful son" 

OK, so, the dialogue was lame.  And, believe me, this isn’t the only example.  A whole blog post could be devoted to it, but this is an autism blog not a TV critic blog.  Maybe Dr. Chen is  supposed to be "comedy".  But, is it OK to stereotype for comedy?  If so, how about stereotyping (incorrectly) autism for drama.  Let’s look at how about the "autism" part of the script is portrayed. Here is their stage direction for the William character from the script:

William doesn’t smile. His autism doesn’t permit it.

What?!?  Autism "doesn’t permit" smiling?  So, people who smile aren’t autistic?  That should bring down the autism "epidemic"!  Just reject the diagnosis for all the people with autism who smile.  My guess is that it would be a pretty rare condition then. 

In the original script, the fight is with an insurance company who won’t pay for the treatments of the young "William", who is autistic.  The first mention of the word "autism" comes when the mother is describing this situation:

My son has autism. He needs Risperidone every day..

Whoa.  Was that about mercury?  Nope.  It’s about Risperidone.  Yep, instead of mercury causing autism, the story was about how the fictional kid needed an off-label prescription for an antipsychotic drug and the insurance company wouldn’t pay.

How does that jive with the writer’s idea of autism?  Well, the mother describes the value of Risperidone as:

After a month on the drug, he actually smiled.

For the record, Risperidone is pretty serious medication.  It has been shown to benefit some people with autism.  But, "smiling"?  I guess that scripts don’t need science advisor approval before being approved.

Somewhere between first and, let’s face it, lame final draft and premiere, the story shifted to vaccine/mercury caused autism.  A story line guaranteed to generate controversy.  A story line guaranteed to get publicity.

It’s too bad.  Yes, the reliance of the original script on Risperidone might have caused some consternation amongst the autism community.  Yes, the stereotype of the kid "whose autism prevents him from smiling" was lame at best, damaging at worst.  But, insurance coverage for autism is a big deal right now.  A good presentation of how insurance companies deny claims for autism could have actually helped people and families with autism.

Autisms Poor Excretors

31 Jan

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

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

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

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

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

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

Source

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

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

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

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

……

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

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

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

Jenny McCarthy Again

2 Oct

McCarthy was at the latest TACA bunfight recently and took to the stage to give the crowd some of her patented Sale Increasing Controversial Big Fat Mouth. Her victim was a long time favourite of American news, Barbara Walters (whos now deceased sister was born ‘developmentally disabled).

About 3:15 today at the picnic on main stage jenny mccarthy in the most lisa ackerman style of feisty adorable commented that barabara walters said our kids CANT EVER GET BETTER and called her a bitch and said something about naysayers can stick her microphone up their BUTTS!
PRICELESS. This is perfect way to get sensationalistic 6:00 news attention to get this aired NOW!!!!!!!

Isn’t that lovely? I hope all those who were puzzled by the series of posts on here decrying Mccarthy’s self-appointed role as autism advocate can begin to appreciate why I – and plenty of others – feel as we do. That McCarthy is doing no favours to the autism community with this sort of behaviour. of course, some people, even within TACA realize this probably isn’t the best course of action:

What Jenny said at the picnic was for the benefit for TACA families, not for the 6 o’clock news or Entertainment Tonight. Jenny is doing a beautiful job of being our spokesperson, so let’s let her publicist and TACA’s publicist handle the media for right now. I know it was exciting stuff but let’s let this issue rest for now.

Well, no, actually. I don’t want to let the issue rest. This person has appointed herself spokesperson not just for TACA but apparently for autism itself. She needs to back off, grow up and start thinking about her actions for those of us without a celebrity income. Calling someone ‘a bitch’ at en event that you _know_ will be covered by the media is a stupid thing to do and gives the general public the idea that we’re all as childish as Jenny McCarthy. I would like once again to distance myself from this person publicly.

In the meantime, please enjoy this blog entry I found today. I don’t know who it is but I liked it.

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

30 Sep

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Another complaint:

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

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

This complaint is not really stupid, but definitely overblown:

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

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

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

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

Next complaint:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Just wait.

ADDENDUM: Some more commentary on this study:

From Left Brain/Right Brain:

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

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

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

From AutismVox:

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

From Autism Natural Variation:

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

From Arthur Allen on The Huffington Post:

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

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

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

From Derek Lowe at In the Pipeline:

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

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

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

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

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

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

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

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