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The Next Big Autism Bomb?

28 Mar

Over on the Huffington Post, David Kirby has posted about The Next Big Autism Bomb. Its a very long post so take a sammich.

The gist (with apologies to Mr Kirby) of it is that there was a conference call to discuss the autism/mito issues:

On Tuesday, March 11, a conference call was held between vaccine safety officials at the US Centers for Disease Control and Prevention, several leading experts in vaccine safety research, and executives from America’s Health Insurance Plans, (the HMO trade association) to discuss childhood mitochondrial dysfunction and its potential link to autism and vaccines.

The purpose of the call was:

“We need to find out if there is credible evidence, theoretically, to support the idea that childhood mitochondrial dysfunction might regress into autism,” one of the callers reportedly told participants.

To that end, Mr Kirby mentions four studies throughout the rest of his piece. Three are accessible but the fourth is a total mystery. This is unfortunate as it is this fourth one which the majority of his blog post relies upon for its conclusions.

The first three are discussing what the prevalence of mito _within_ autism might be. Kirby states:

CDC officials were made aware of a Portuguese study, published last October, which reported that 7.2% of children with autism had confirmed mitochondrial disorders. The authors also noted that, “a diversity of associated medical conditions was documented in 20%, with an unexpectedly high rate of mitochondrial respiratory chain disorders.”

There is a slight point of confusion to clear up here. The figure of 7.2% is from a 2005 study ‘Mitochondrial dysfunction in autism spectrum disorders: a population-based study‘.

The study (by the same author) that Kirby mentions as being published last October is ‘Epidemiology of autism spectrum disorder in Portugal: prevalence, clinical
characterization, and medical conditions‘ declares a 4.1% figure.

The reason for this is that the lead author re-examined his data from the 2005 study and adjusted it downwards in the 2007 study. So Kirby is not correct to state that the authors believe that the rate is 7.2%. The latest figure from these authors is 4.1%.

The third study that discusses prevalence is referenced by Kirby as:

They also know that some reports estimate the rate of mitochondrial dysfunction in autism to be 20% or more. And the rate among children with the regressive sub-type of autism is likely higher still.

Kirby links to a web page that is the web interface to a mail list.

Upon searching for this paper I couldn’t find it anywhere. It is not in PubMed or Google Scholar and in fact I can only find three references to it online at all.

It since transpires that this paper is not in fact a paper at all and has not been published anywhere. It is in fact a summary for attendees of a 2003 LADDERS conference in Boston, USA. Therefore it has not been subject to any kind of peer review. That’s not to say the figure is wrong, merely that it hasn’t been verified or undergone any kind of the usual scientific checks and balances a published piece of work must undertake to ensure quality.

Its also been explained to me that the percentage of “mitochondrial autism” reported by any group will vary with the percentage of regressive autism in their ASD population. So it is not true that the summary states a differential between autism and regressive autism. Rather that “mitochondrial autism” exists _within_ regressive autism.

And so we move on to the fourth study.

One doctor reported his findings from a five-year study of children with autism, who also showed clinical markers for impaired cellular energy, due to mild dysfunction of their mitochondria.

The biochemistry of 30 children was studied intensively, and in each case, the results showed the same abnormalities as those found in Hannah Poling, participants said. Each child had moderate elevations or imbalances in the exact same amino acids and liver enzymes as Hannah Poling.

All thirty children also displayed normal, healthy development until about 18-24 months of age, when they quickly regressed into clinically diagnosed autism (and not merely “features of autism”), following some type of unusual trigger, or stress, placed on their immune system.

……….

But what causes the stress? That is a very big question.

Apparently, in only two of the 30 cases, or 6%, could the regression be traced directly and temporally to immunizations, and one of them was Hannah Poling. In the other cases, there was reportedly some type of documented, fever-inducing viral infection that occurred within seven days of the onset of brain injury symptoms.

Mr Kirby makes this study the raison d’etre of the rest of his post.

I have some major concerns about this. Who is this doctor? What is this study? Where is it published? Where can we _read for ourselves_ what this study says? Without wishing to question the honesty with which Mr Kirby is posting, its obvious that – even in this post as I discuss above – errors and misinterpretations have crept in.

Lets be honest here. These are some *major* claims being made. Firstly that all 30 kids in the study regressed into clinically diagnosed autism as opposed to features of autism. All 30? That’s incredible.

Secondly that 6% of the regressions into clinically diagnosed autism are traced directly from immunisations. That’s big. That is about as big as it gets. I would really like to see this study.

I have asked (twice) in the comments section of Mr Kirby’s post to be pointed to this study. So far, no answer has been forthcoming from anybody.

However. I note that Mr Kirby states that one of the 6% is Hannah Poling. If this is so then it is not true to say that:

the…[autistic]…regression…[can]… be traced directly and temporally to immunizations

(insertions mine for clarity).

As I’ve discussed before, none of the listed symptoms attributed to immunisations can accumulate to a diagnosis of autism. So unless we can actually see this study, know who the author, see what checks and balances this paper has undergone, we’re in a bit of a limbo.

Dear CDC

26 Mar

I read with interest Dr Schuchat’s opinion piece in the AJC today.

Whilst it is gratifying to see someone of Dr Schuchat’s calibre responding to previous claims regarding vaccines in autism I would like to make a few points to Dr Schuchat and the CDC in general.

Firstly, this level of response is around eight years too late. What have you been doing on the media/PR front over the last eight years? I’ll tell you what your ‘opponents’ have been doing – they’ve been conducting protests outside your offices, outside the offices of the AAP etc. They’ve been setting up and organising vaccine/autism groups and heavily marketing them via the use of organic and paid for web based advertising.

The only people who have made any kind of attempt to counter these groups and the misinformation (deliberate or not) they publish is people like myself. I am not attempting to aggrandise myself at all. I am attempting to convey to you how one sided the ‘battle’ has been over the last few years.

Where were you? You were needed. You could’ve helped. Instead you sat back and hoped this would all go away. It didn’t. It won’t.

Secondly, the level of Dr Schuchat’s response is very close to condescending. Simply stating that:

Kirby’s column included many inaccuracies related to childhood vaccines. As such, it illustrates that when it comes to immunizations, child development and specific medical conditions, the best source of guidance is the child’s health care provider.

is patronising in the extreme. The level and quality of the debate has moved on in the last eight years. Bland assurances won’t cut it. You need to be specific and offer evidence. Autistic people, parents of autistic people and interested professionals are smart enough to know and understand a certain level of science these days.

Don’t be shy about providing people with science. You have some truly excellent science on ‘your side’ as I and others have attempted to blog about in the last five years to no small effect. For example, Googling mmr autism displays, amongst others, the blog of a friend of mine – also the parent of an autistic child and also convinced of the need to blog about the bad science surrounding the various vaccine/autism hypotheses. Googling thiomersal autism brings up _this_ blog. We’re doing your job for you!

You’re being left behind in this debate. Its time you caught up.

Autism vs features of autism

14 Mar

In sum, DVIC has concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder.

– HHS

If one has the right set of “features” of autism, one has autism……Hannah Poling has autism — as defined in every book, in every library, in every university in the world. Dr. Parikh’s insistence otherwise is perplexing.

– David Kirby, to EoH group in response to Dr. Parikh’s article in Salon.

Its a massively ambiguous point. Do ‘features of autism’ equate to a _diagnosis_ of autism? David Kirby and some commenter’s to this site say ‘yes’. I personally think ‘no’.

But I think we need to be clear here. In this particular case, Hannah Poling can still be autistic but the HHS are arguing (in my opinion) that the features listed as those being aggravated/caused by vaccines do not add up to enough by themselves to give a diagnosis of autism.

To illustrate this idea, I went through the symptoms given by Dr Zimmerman that he put forward as being vaccine aggravated in a previous post (green = hit with DSM (IV), red = miss):

1) Loss of previously acquired language
2) Eye Contact
3) Relatedness
4) disruption in CHILD’s sleep patterns,
5) Persistent screaming
6) Arching
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination

So, three of the symptoms given by Dr Zimmerman as being vaccine aggravated can be matched with the DSM (IV). This is way below what is needed for a diagnosis of autism.

But, we cannot discount the idea that she _could be_ autistic. To me, it seems likely that here is an autistic child who has her vaccines and who presents with nine symptoms following those vaccines, three of which tally with DSM (IV) criteria.

This presents two questions. First, is there a difference made by autism diagnosticians about autistic features vs a diagnosis of autism?

The best way to answer this is to ask autism diagnosticians. I wrote to some autism diagnosticians. They asked to remain anonymous, which I have to respect. The email I sent in essence asked them if they thought that:

a) ‘with features of autism spectrum disorder’ is directly equivalent to a diagnosis of autism?
b) ‘with features of autism spectrum disorder’ means that some elements of the DSM (IV) are present but not enough to diagnose autism?
c) ‘with features of autism spectrum disorder’ means that some elements of the DSM (IV) are present but not enough to diagnose ASD?
d) ‘with features of autism spectrum disorder’ means something else entirely?

The responses I got back stated that b) was most likely, maybe c) .

So according to these autism diagnosticians, some elements of the DSM (IV) are present but not enough to diagnose autism, or possibly ASD. This tallies with my own personal opinion.

The second question is; did Hannah Poling present with any diagnosable symptoms of autism _before_ her vaccines? Sadly, it seems we will never accurately know the answer to this question. The Poling’s will say no of course. David Kirby et al will say no of course.

I will remember the Cedillo’s however, who testified that their daughter (who they claimed was made autistic by vaccines) showed no symptoms of autism before her vaccines were administered. However, when home movies of their daughter taken before her vaccines were shown to several diagnosticians, they testified that she was indeed exhibiting symptoms of autism prior to vaccine administration. The Cedillo’s didn’t lie. Its simply not possible to remain clinically objective about one’s own child. Even for an employee of Johns Hopkins, it is not possible to remain objective about one’s own child.

That doesn’t mean Hannah Poling _did_ exhibit symptoms of autism prior to vaccines of course. It simply means that we need to be skeptical of the claim that she didn’t.

Is Hannah Poling autistic? Could be. Seems likely.

Did the vaccines cause the nine symptoms Dr Zimmerman found? HHS ‘concede’ they did.

Do the fact that three of those nine symptoms tally with the DSM (IV) mean that the vaccines are the cause of her autism? No, thats not logical.

Vaccines, Autism and the Concession

1 Mar

1) Concession Report (This document has been removed due to the possibility of it being illegally obtained). If people really wish to read the document for themselves it can be founf here, at the Huffington post
2) Zimmerman Case Study

When David Kirby wrote his piece in the Huffington Post, I’ll admit I read it with my jaw on my chest. Here was evidence I was wrong. I emailed David Kirby to get the whole report from him and he was kind enough to provide not only a PDF version but a plain text version as well.

This enabled me to contact a few people that I know are medical people and/or scientists and/or closely connected to this case. For example I contacted Dr Zimmerman and learned that it was not possible for him to offer any sort of opinion on this case due to the fact that his patients parents had not allowed him to discuss his thoughts and opinions with anyone except the court. I was told however that ‘the comments on your site with questions raised and loopholes pointed out about the way others are interpreting the facts of the situation, are right on track.’

It is clear to me then that there is some wordsmithing going on – either deliberately or unintentionally. What we need to do is look closely at the wording of two documents. The concession report and the case study performed by Dr Zimmerman.

The claim by David Kirby et al is, in essence, that the US Government have conceded that vaccines cause autism in this one case. Lets look at the so-called concession report in relation to what it says about autism.

Dr. Andrew Zimmerman, a pediatric neurologist, evaluated CHILD……on February 8, 2001. Dr. Zimmerman reported that after CHILD’s immunizations of July 19, 2000, an “encephalopathy progressed to persistent loss of previously acquired language, eye contact, and relatedness.” He noted a disruption in CHILD’s sleep patterns, persistent screaming and arching, the development of pica to foreign objects, and loose stools. Id. Dr. Zimmerman observed that CHILD watched the fluorescent lights repeatedly during the examination and would not make eye contact. He diagnosed CHILD with “regressive encephalopathy with features consistent with an autistic spectrum disorder, following normal development.”

Features consistent with. He did not diagnose her with autism. What were these features?

1) encephalopathy progressed to persistent loss of previously acquired language,
2) eye contact,
3) relatedness
4) disruption in CHILD’s sleep patterns,
5) persistent screaming
6) arching,
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination
10) would not make eye contact

Of these ten, one is repeated (eye contact issues) so I make nine clear separate symptoms there. Which of these appear in the DSM (IV)? Green equal matches, red equal misses.

1) Loss of previously acquired language
2) Eye Contact
3) Relatedness
4) disruption in CHILD’s sleep patterns,
5) Persistent screaming
6) Arching
7) the development of pica to foreign objects,
8) loose stools
9) CHILD watched the fluorescent lights repeatedly during the examination

To meet the DSM(IV) criteria a person must meet no less than 6 of the criteria. So, as described perfectly exactly by the Dr Zimmerman in the concession report, this child has features consistent with an ASD. But its clear she does not meet the criteria for autism.

Later on,

CHILD was evaluated by Alice Kau and Kelley Duff, on May 16, 2001, at CARDS. The clinicians concluded that CHILD was developmentally delayed and demonstrated features of autistic disorder.

Almost the exact same phrasing. Consistent with. But no one has said thus far that the child has been diagnosed with an ASD.

The concession report concludes with:

the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder….

This is the phrasing that caused the uproar. But when looked at in light of the previous, it is clear that far from suggesting that vaccines cause autism via a mitochondrial disorder, the vaccines worsened an occluded or underlying mitochondrial disorder which took on a few of the symptoms of autism _but was never actually diagnosed as autism at all_ . Because it wasn’t autism.

Before we switch to Dr Zimmerman’s Case Study, lets clear up a few things.

No one, I repeat, no one is saying this child wasn’t autistic. She may well have been. What we are doing is looking at the science reported in the concession report and Zimmerman’s paper and seeing if what the _science_ says in these two papers means that it was the vaccines that caused any autism. The concession report clearly says that no it wasn’t. Thats why this case was uncontested. She was affected by her vaccines but autism was not the result.

Zimmerman’s case study is entitled ‘Developmental Regression and Mitochondrial Dysfunction in a Child With Autism’ – this is further evidence against the case presented that it was the vaccines that caused the autism. This child is reported as being one with autism. Not one who develops autism as a result of vaccines.

However, it is clear that this child _does_ develop autism:

We describe a female patient in whom developmental regression and autism followed normal development…..Evaluation at 23 months showed …..[t]he Childhood Autism Rating Scale (CARS) score was 33 (mild autism range), and she also met Diagnostic and Statistical Manual for
Mental Disorders-IV criteria for autism

and yet this autism was so mild that at that exact same period (23 months):

the patient began speaking again at 23 months old

which means that expressive language was lost for a sum total of one month (it is reported being lost at 22 months). It should also be noted that CARS is _not_ designed for diagnosis but is an indicator only. Overall, we get a picture of a child who had an underlying mitochondrial dysfunction exposed by the illnesses following her vaccinations which caused developmental regression. This developmental regression presented with some features of autism.

Did the vaccinations cause her developmental regression? Seems likely. It is an undisputed fact that vaccines do cause injury, that is why after all there is a compensation program to claim from in the US and the UK.

Was her developmental regression autism? No. At no point in either the concession report is it claimed that the developmental regression the child went through _was_ autism. However, in the same way that Leukemia (weakness, paleness; fever and flu-like symptoms) can have the same symptoms as flu (weakness, paleness; fever and flu-like symptoms) but be totally different, this child’s developmental regression shared certain features of autism.

So was this child autistic. She might well have been. However, her autism was not caused by a vaccine.

Update

This column was forwarded to me by a friend. Thanks to him.

The practice of calling certain things near-autism, or even autism itself is not new. Here’s a quote from a Science article regarding HIV in 1989:

The signs of AIDS dementia in children are clear and, Pizzo says, “very painful to watch. Very young children lose words.” Words like “mommy” and “daddy” and “bear” are too hard to remember as the AIDS virus multiplies in the young child’s body and penetrates the central nervous
system.

An 8-year-old boy, once normal, was rendered practically autistic by HIV, Pizzo said. He stopped speaking. Asked to trace a simple
outline of an elephant, the boy could not. Painfully, he knew what a simple task it was, and he knew he was failing it. But he could not cry even though his doctors could see tears welling up in his eyes.

Pizzo has seen children lose IQ points one boy lost as many as 28-as AIDS ravages their brains. “Kids who used to do well in school really deteriorate,” says Pizzo who has “before and after” IQ data from school-age children.

But in a series of remarkable studies, Pizzo has seen AZT (azidothymidine) reverse these symptoms. The child who lost words like “mommy” and “daddy” “got them back,” Pizzo says. The boy who lost IQ points is restored to his former capacity.

The 8 year old cries. After just a couple of weeks of continuous AZT therapy, the boy who could not trace an elephant is successful at tracing a horse.

Now, we all know that ‘tracing an elephant’ and losing IQ points are not symptoms of autism but it is intriguing to see a doctor describe a regression as ‘practically autistic’. Note also, just like in this case, in Zimmermans case study, the child quickly loses, then very quickly regains aspects of their former regression. But HIV didn’t cause autism any more than vaccines did.

US government concededs vaccine/autism case

26 Feb

As per this story from David Kirby in the HuffPo.

I have some doubts about it but lets see. I’ve emailed David Kirby to ask him to provide me with a full copy of the concession. His willingness to provide this information as well as the information itself should tell us more about what this concession report contains.

Ya ken that hidden horde, aye?

24 Feb

So – the ‘Hidden Horde’ – the term that anti-vaccinationists like to smirk about as evidence of an autism epidemic. The logic goes like this: if there’s no autism epidemic then where are all the [insert age here] year old autistic adults? I’ve heard people asking for evidence of 75 year old autistics (conveniently forgetting that the average mortality age in the US and UK is around 70), 50 year olds – even 30 year olds.

Never mind that there’s been plenty of evidence for adult autistics. Thats not convenient for the anti-vaccinationist agenda so it gets ignored.

Anyway, todays Sunday Herald carries another story about adult autistics in Scotland called ‘Revealed: ‘invisible’ adults living with autism’.

According to the National Autistic Society (NAS) Scotland report, due to be launched this week, 52% of adults have not had an assessment of their needs since the age of 18…..It is estimated that more than 35,000 adults in Scotland have the condition, but campaigners said they were “invisible” to local authorities, who are failing to record the number of people with autism in their area.

The population of Scotland is 5,062,011. The latest prevalence estimates for the UK are 1 in 100. This means that 50,620 people are autistic. If 35,000 adults in Scotland are autistic then 69% of autistic people in Scotland are adults.

Hidden horde aye?

New mercury/autism paper to misrepresent

22 Feb

A new study on autism and mercury has been published:

Autism is a highly heritable disorder, however, there is mounting evidence to suggest that toxicant-induced oxidative stress may play a role. The focus of this article will be to review our animal model of autism and discuss our evidence that oxidative stress may be a common underlying mechanism of neurodevelopmental damage. We have shown that mice exposed to either methylmercury (MeHg) or valproic acid (VPA) in early postnatal life display aberrant social, cognitive and motor behavior.

Some people have reported on this study thusly:

New Study Implicates Mercury In The Development Of Autism

Um, right.

These same people, well known for their anti-vaccine beliefs, fail to note anywhere that this study says:

…., it is important to note that autism was not found to be associated with either pre- or neonatal exposure to organic mercury.

One form of organic mercury being, of course, thiomersal.

Might it be very uncharitable of me to suggest that this was a deliberate obfuscation? I guess it might but I still think it was. Especially when this same person says:

….will they all continue to proffer the lie that there is no convincing evidence linking vaccines to autism, while ignoring all the studies that are piling up on the hard drives of parents across the country?

Hmmm, so this study quite categorically states there is no link between organic mercury and autism and yet this person calls others liars? Projection is a terrible thing.

There will be more to say on the quality of this study – especially its references – but I wanted to get this clear as soon as possible.

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?

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.

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