Social Demographic Change and Autism: part 1

3 Oct

I’ve been meaning to blog this for a long time. Ever since it came online, which was months ago. I’ve wanted to do a good job on this paper and so I’ve kept putting it off while I wait for the time to really dig into it. Kev’s recent post about Prof. Bearman got me thinking it is time to get this out. I knew this would be long and it has grown longer than I expected, so I have split the post up. Here are some introductory thoughts. Much as people like to paint me as being in the “genetics” camp, it isn’t really my interest. Someone like Prometheus would do a far better job on an intro and discussion that I can. But in Prom’s absence, I will say what I can.

Prof. Peter Bearman is a researcher at Columbia University. His team has taken a very careful look at the California Department of Developmental Services (CDDS) data and combined this with California birth record data and come up with what are likely some of the best papers to come from those data. The CDDS provides services to the developmentally disabled in California through a series of “Regional Centers”, which are private corporations which administer the state’s funding through largely non-governmental agencies in the state. They have records on the people (consumers) whom they have served over the years and these data include information on how the consumers qualify for services.

There are five eligibility categories for regional center support:

1) Mental Retardation: Significant deficits in general intellectual functioning (generally an IQ of 70 or below) and significant deficits in adaptive functioning.

2) Cerebral Palsy: A neurological condition occurring from birth or early infancy resulting in an inability to voluntarily control muscular activity, and resulting in significant deficits in motor adaptive functioning and or cognitive abilities.

3) Epilepsy: A disorder of the central nervous system in which the major symptoms are seizures. Eligibility is based on a seizure disorder that is uncontrolled or poorly controlled , despite medical compliance and medical intervention.

4) Autism: A syndrome characterized by impairment in social interaction (withdrawal, failure to engage in interaction with peers or adults), delays in both verbal and nonverbal communication skills, deficits in cognitive skills, and impairment in the ability to engage in make-believe play. Individuals may engage in repetitive activities or a limited repertoire of activities.

5) Fifth Condition: This category includes disabling conditions found to be closely related to mental retardation or requiring treatment similar to that required for individuals with mental retardation.

As a side note, a lot of people forget the “Fifth Condition” category. People will say that people with Asperger Syndrome or PDD-NOS don’t qualify for Regional Center services. Well, they don’t under the “autism” category, but they can under the fifth condition if they meet the requirements for a “substantial disability”. But, I am digressing.

The CDDS data have been extensively used to demonstrate the very large increase in autism prevalence that has occurred over the last 20-30 years.
Prof. Bearman’s group has studied the CDDS data and found that some of the increase can be found to attributed to factors such as changes in the way people are diagnosed (diagnostic accretion) and lower ages of identification.

In a recent paper, Social Demographic Change and Autism, Prof. Bearman’s group argues that about 11% of the rise in autism prevalence can be attributed to genetics.

Sorry to give away the conclusion so early but this is going to be long and I know a lot of people won’t read it all.

Genetics is a hot-button issue with a lot of people in the online autism community. Sometimes people will divide the world into two camps: those who believe autism is caused by vaccines and those who believe autism is caused by genetics. It is a major oversimplification but it happens.

Another oversimplification is to confuse genetics and heritability. As in, “I’m not autistic and my wife isn’t autistic, genetics doesn’t account for my kid being autistic”. This is wrong on so many counts. Heritability implies genetics, but not all genetics is heritable.

In high school or even earlier you probably learned about a monk and pea plants and later studies on fruit flies and the color of their eyes. This is Mendelian inheritance. You learned that some traits are recessive and some are dominant.

From this framework, you can’t get a genetic epidemic.

Whenever the argument about genes and changing prevalence comes up, you can be sure someone will eventually bring up Down Syndrome. Down Syndrome is a developmental disability (possibly an example of the sort that comprise the “fifth category” in the DDS). Down Syndrome is genetic. Not always Mendelian inheritance genetic, but genetic all the same.

The risk factors for having a child with Down Syndrome are

1) Advancing maternal age. A woman’s chances of giving birth to a child with Down syndrome increase with age because older eggs have a greater risk of improper chromosome division. By age 35, a woman’s risk of conceiving a child with Down syndrome is 1 in 400. By age 45, the risk is 1 in 35. However, most children with Down syndrome are actually born to women under age 35 because younger women have far more babies.
2) Having had one child with Down syndrome. Typically, a woman who has one child with Down syndrome has about a 1 percent chance of having another child with Down syndrome.
3) Being carriers of the genetic translocation for Down syndrome. Both men and women can pass the genetic translocation for Down syndrome on to their children.

Part 2 and 3 are what we usually think of as “genetic”, as in “Mendalian”. But what about (1) advancing maternal age? A 10 times greater risk for older mothers? Keep in mind, there is a clear genetic difference behind Down Syndrome.

In humans, the egg cells and sperm cells have 23 chromosomes. The rest of your cells normally contain 23 pairs of chromosomes — one from your father and one from your mother. Kids with Down syndrome usually have three copies of chromosome 21 — called trisomy 21 — instead of two copies.

There is a difference, some might call it an error, in the genetic sequence which leads to Down Syndrome. The parents don’t need to have it. It can be genetic and not heritable. Or, at least, not heritable in the way most people think.

Parental age is increasing. We would be seeing an epidemic of Down Syndrome if it weren’t for the genetic test that is available and offered to most pregnant women.

There are already studies out discussing increased risk for having an autistic child with parental age. If parental age is increasing (and it is), why don’t we see an epidemic of autism from this?

Add to this the recent study from the Autism Genome Project (which came out after this paper by Prof. Bearman’s group). That study, and others, are showing that rather than an autism “gene”, that copy number variations (CNVs) may be one source of genetic risk for autism. These are not heritable in the usual sense as usually they exist in the child and not the parent.

According to Prof. Bearman, we are seeing it. It accounts for about 11% of the increase in autism prevalence in the CDDS data. It is a big effect, but small compared to the other factors going on (the other 89%). So without a careful look, one can’t show it.

Prof. Bearman’s group *is* taking a careful look. The result is their paper Social Demographic Change and Autism. There are a lot of very interesting results, like twin concordance being much smaller than has been previously reported. Another recent paper confirms that. Strangely, no one seems to have noticed.

I’ll try to rectify that in the next installment when we look closer at the paper. Until then, here is the abstract:

Parental age at child’s birth—which has increased for U.S. children in the 1992-2000 birth cohorts—is strongly associated with an increased risk of autism. By turning a social demographic lens on the historical patterning of concordance among twin pairs, we identify a central mechanism for this association: de novo mutations, which are deletions, insertions, and duplications of DNA in the germ cells that are not present in the parents’ DNA. Along the way, we show that a demographic eye on the rising prevalence of autism leads to three major discoveries. First, the estimated heritability of autism has been dramatically overstated. Second, heritability estimates can change over remarkably short periods of time because of increases in germ cell mutations. Third, social demographic change can yield genetic changes that, at the population level, combine to contribute to the increased prevalence of autism

Is the end of the Omnibus Autism Proceeding near?

2 Oct

The Omnibus Autism Proceeding (OAP or omnibus) is the way the Court of Federal Claims (vaccine court) has been handling the now 5,000+ claims submitted for autism as a vaccine injury. The Omnibus started officially in July of 2002 with Autism General Order #1. Along the way it was decided that the best way to handle the large number of claims was using “test cases”. Three test cases were heard for each of two “causation theories”. The idea was that “general causation” arguments could be made once, and very thoroughly, and the other cases could be decided on the outcome.

The first causation theory was that the MMR vaccine in combination with thimerosal could result in autism. The test cases for this theory were those of Michelle Cedillo, William Yates Hazelhurst and Colten Snyder. Attorneys for the families presented evidence for a mechanism where thimerosal was proposed to reduce the immune response and the MMR vaccine led to a persistent measles infection which, again as proposed, led to symptoms of autism. In all three cases the special masters (judges) ruled against the petitioner families. They found that the evidence did not support the mechanism proposed.

The second causation theory held that thimerosal in vaccines could result in autism. Three test cases were presented, again with individual and general causation evidence. The test cases, Jordan King and William Meade, and Colin Dwyer were heard. Their attorneys argued that mercury from the thimerosal in the vaccines accumulated in the brains and resulted in neuroinflammation which, in turn, resulted in autism. As with the MMR case, the special masters ruled against the petitioner families.

To put it simply: all the data and all the experts that could be put together to support the idea that vaccines cause autism weren’t persuasive. They came up with two stories (MMR and thimerosal) and neither story made a case that was even close (the special master’s word).

Some of the petioners appealed. Some appealed to multiple levels. The appeals were denied.

The Court recently issued an update letter. I quote part of it below:

As described above in part I of this Update, all of the court rulings in the six test cases described above have found no causal link between autism and MMR vaccines and/or thimerosal containing vaccines. Further, the PSC has informed the special masters that no additional OAP test cases are contemplated.

Therefore, the Office of Special Masters has begun discussions with members of the petitioners’ bar and respondent’s counsel about how best to conclude the approximately 4,700 autism cases remaining open on the court’s docket. To aid in that process, some petitioners’ counsel have contacted all of their OAP clients to advise them of the results in the test cases and to recommend a course of action with regard to their claims. Additionally, all petitioners who are not represented by counsel have been ordered to inform the court either that they wish to dismiss their claim or that they intend to proceed with their case. For petitioners who wish to continue with their claim, orders to identify a theory of causation, produce an expert report, and file additional evidence will follow. Petitioners’ counsel who have not yet done so are encouraged to contact their clients and determine how their clients wish to proceed.

The issue of attorneys’ fees and costs for petitioners’ counsel is part of the discussion about how to conclude proceedings on the OAP petitions. Mediation efforts are underway to develop methods to resolve the fees and costs issues, and a report on the progress in these talks is expected at the October judicial conference.

The special masters are assuming that no one will go forward with the MMR and thimerosal theories. Since those theories don’t hold up in court, it seems a good assumption.

Petitioners can still go forward as individual cases, as in any non-omnibus case. They will need to submit records and a theory of causation and support that theory in hearing.

The PSC (petitioner’s steering committee, a group of lawyers which has managed the Omnibus from petitioner’s side) has decided that no additional OAP (Omnibus) test cases are planned.

This is very important. They have no other theories to present. They don’t plan to present “too many too soon”. They don’t plan to present a Wakefield-like theory of persistent measles infections leading to “leaky guts”. They don’t plan to present a “mitochondrial autism” theory.

This last bit is very important. The Hannah Poling case made a lot of news when it was leaked that the government had conceded her case as a table-injury MMR encephalopathy. She was supposed to be one of the three thimerosal test cases. At the time of the concession and since, it was asserted that her case was “not rare” and that the attorneys were prepared to go ahead with the mitochondrial disorder story. It would appear that there are not many (if any) other “Hannah Poling” cases out there. There is at least one family pursuing a variation of the mitochondrial disorder theory. Alexander Krakow was scheduled to be a test case for the thimerosal theory and his family pulled out of the Omnibus to pursue the mitochondrial theory.

While there may be a case or two that we hear about from here on out, it appears that the Omnibus, the “class action” type phase, is over.

Katie Wright demonstrates AoA mentality

30 Sep

Over at the Clown Blog, Katie Wright pens a sulky screed targeting Peter Bearman. Lets go through it.

Dr. Peter Bearman, a professor of sociology at Columbia University, recently released a research paper alleging that half of the meteoric rise in ASD cases is an artifact. You know- “better diagnosis” and “greater awareness.” A blind, non-medical professional, could have diagnosed my son. Nevertheless in the case of HF ASD and aspergers (which comprise a small % of overall ASD) certainly greater awareness has played a role in the increasing number of those diagnoses. Still- 50%? Ridiculous.

And why ridiculous? Well….just because. Wright offers no evidence to counteract Bearman’s. No science is referenced to challenge Bearman’s work. It simply is ridiculous apparently. One can almost hear the foot stomp of a poor little rich girl out of her league intellectually.

After Dr. Bearman concludes that 50% of the increase cannot be attributed to greater awareness Insel asks what Bearman believes is driving the other 50%. Bearman answers: “genes, old parents and possibly a virus.” This is the best he has got? The NIH gave this guy millions to come with that?

Well no Katie, thats not what the NIH gave him his research money for. According to _you_ Insel asked Bearman what he _believed_ was driving the other 50%. He gave his answer as to what he _believed_ . But these beliefs were just that – beliefs. He presented the science he had done and then shut up on the evidence and opined and on what he was asked to opine on by Insel.

And even his opinion, his beliefs, are rooted in science. There _is_ a genetic component to autism, thats simply a fact. There _is_ research that links ASD to older parents. Katie Wright’s beliefs revolve around one extremely unscientific thing. Vaccines.

Yes, Bearman does acknowledge the possible role of some kind of toxin. Bearman is not sure what that toxin is but he is sure what it isn’t. Take a guess.

See what I mean. If it ain’t a vaccine, it ain’t worth considering according to Katie Wright.

…unbelievably Bearman says: “it isn’t autism that parents are worried about. They know they can deal with that, they know they can help their child, (and he would know this a non parent of an ASD child?) but it is autism organizations scaring parents!” I had no idea that a bunch of stay at home Moms with no money, no federal backing, no million dollar grants- who are already busy parenting autistic kids- have this kind of extraordinary power! Wow, what’s next for us? Ending the recession, solving the mortgage crisis, creating electric cars?

And hot damn Katie Wright, guess what? In my opinion he _is_ right! I’m not scared of autism. I’m scared of one note zealots stealing away research monies, scaring away legitimate researchers with their threats of violence and scaring the public into believing that autism is some kind of tsunami of evil ready to engulf them all in a tide of social security claims.

As for Katie Wright personally, it makes me sick to think of this little rich girl, who’s children will want for nothing, playing the ‘poor little me’ card. There are families out there struggling to get by on a day to day basis and she has the temerity to liken herself to a ‘stay at home mom’. Feh.

As far as blaming the parents for the national crisis of confidence in vaccine safety- grow up Dr. Bearman. The problem is the problem- not people talking about the problem.

Nice quote from that intellectual giant Jim Carrey there. Oh and guess what Katie Wright? You and people like you *are the problem* . Whilst you play offended at legitimate science, there’s a whooping cough outbreak in California that is killing children. You do know that don’t you Katie Wright?

Here’s what you need to do Katie Wright. You need to accept the fact that the science is against you. You need to accept the fact that you are a small scaremongering minority of the autism community. Sounding off about stuff that you clearly have absolutely zero knowledge about (science) makes you look foolish and all it does is show you to be frightened. You are behind the times. Get out of the way of progress.

Florida access to service bill morphed into vaccine bill

30 Sep

A recent story in the Miami New Times caught my eye recently. The story is about how a wealthy Florida chiropractor was attempting to gain access to Florida Department of Health records so that Mark and David Geier could use them for vaccine/autism research.

In the story, Penn Bullock and Brandon K. Thorp write:

But Kompothecras has all but bragged of his ability, via generous giving, to enlist politicians in the anti-vaccine fight. The Sarasota Herald-Tribune reported last year that he donated more than $15,000 to state Rep. Kevin Ambler and state Sen. Mike Bennett; both have backed legislation that would weaken Florida’s mandatory vaccine regimen.

Kompothecras told the paper that his personal lawyer had helped Bennett write an anti-vaccine bill. When he sent the irate email to DOH, the doctor copied Bennett. Whether Kompothecras’s political friends can enforce his will at the DOH is unclear. What is clear is that the DOH is afraid they might.

I tried to find this bill. A news story from 2009, Major GOP political donor Gary Kompothecras backs bill to alter Florida’s vaccine rules, had this to say:

SB 242 would give parents more authority to delay the pace at which their children are vaccinated against illnesses like measles, mumps and polio — as long as they are up to date with their shots by the time they enter the public school system. (Florida law already provides for exemptions from school vaccine requirements in the cases of religious beliefs or medical risks determined by a physician.)

The proposal, sponsored by Tampa Republican Rep. Kevin Ambler in the House, also would prohibit the use of vaccines for pregnant women and young children if the vaccines contain even a small percentage of ethyl mercury. Better known as thimerosal, it is used as a preservative in some vaccines, including flu and tetanus shots that are made in advance and in large quantities. Some people, including Kompothecras, believe thimerosal is the vaccine ingredient that makes their initially healthy children become autistic.

Senate Bill 242 was entered into the record on February 26, 2009. Here is a segment of that version:

11 Section 1.?If the parent or legal guardian of a minor who
12 is an eligible individual, as defined in s. 627.6686, Florida
13 Statutes, believes that the minor exhibits symptoms of autism
14 spectrum disorder, the parent or legal guardian may report his
15 or her observation to a physician licensed in this state. The
16 physician shall immediately refer the minor to an appropriate
17 specialist for screening for autism spectrum disorder.

It is a bill expanding access to services for parents of young autistic children. I’m sure we could have some interesting discussions about that bill, but it died. Well, even before it died, it morphed. Here is the second version after a series of amendments on 4/15/2009. It amends the vaccine statutes in Florida. Here is an excerpt:

36 499.005?Prohibited acts.—It is unlawful for a person to
37 perform or cause the performance of any of the following acts in
38 this state:
39 (30)?The sale, purchase, manufacture, delivery,
40 importation, administration, or distribution of any human
41 vaccine used for children under age 6 or pregnant women which
42 contains any organic or inorganic mercury compound in excess of
43 0.1 microgram per milliliter.

and

51 (6)?In vaccinating his or her child, a parent, legal
52 guardian, or other authorized person, in consultation with his
53 or her pediatrician, has the right to choose an alternative
54 immunization schedule to the immunization schedule recommended
55 by the Centers for Disease Control and Prevention, as long as
56 the child completes the required immunizations before beginning
57 kindergarten or initial entry into a public or private school,
58 whichever occurs earlier.

So, a bill that would expand access to services is completely scrapped. In its place a bill is created which seeks to change the laws on vaccines.

Leaving aside whether thimerosal should be allowed in vaccines. Leaving aside the fact that parents already have the right to an alternative schedule. Leaving aside that the language of that second section is so vague that parents might argue that any alternative vaccine schedule (including none) could be used for admission to school. Leave out whether the bill in its original form is good or not.

Leave all that aside for the moment.

Someone scrapped a bill expanding services in order to take on vaccine legislation.

I’ve said it before and I’ll say it again: many “autism advocates” and “autism organizations” don’t really focus on autism or disability rights.

They are willing to abandon autism legislation in order to focus on vaccines.

Incidence of autism in Berkshire

30 Sep

A Reading Borough Council report has shown that the incidence of autism in a borough of Reading, Tilehurst has increased over a period of eight years (2000 – 2008) from 68 to 186, more than doubling.

Lets put these figures in context of a few things. Firstly, thiomersal. Thiomersal was removed from all UK vaccines in 2004. The average age of autism diagnosis is five and a half (PDF) in the UK. This would mean that if thiomersal caused autism, a significant drop off in autism incidence would have been reported to have been occurring during late 2009 early 2010. This was not reported. This could be because the report did not go beyond 2008 but again there’s no mention of that either and I can’t find the relevant document on the Reading Borough Council website

Secondly, the report seems quite clear to refer to diagnoses of ASD which includes PDD-NOS and Aspergers Syndrome. Kate Manton of Berkshire Autism Society says:

People are being diagnosed much earlier now than they were 10 years ago. Children at two and a half are being diagnosed, if the condition is fairly severe.

Thirty years ago [someone] who was disruptive in class but fairly bright would be called naughty.

All good points and ones which mitigate against the obvious simplistic claims that there is some sort of epidemic of autism. There may well be some sort of ‘epidemic’ of _recognition_ of autism in all its many forms but thats not the same thing at all.

I’m left wishing I could get hold of a copy of the same data that the BBC did so to that end I have requested that the BBC send me a copy of the report. Hopefully they’ll reply.

Crist backer Gary Kompothecras bullies Florida health officials

28 Sep

Crist backer Gary Kompothecras bullies Florida health officials, a story in the Miami New Times, discusses how a wealthy man is attempting to exert influence to get Dr. Mark and Mr. David Geier access to Florida Department of Health records.

Here are the first three paragraphs:

“This madness has got to stop. No more double talk. This should be a fairly straightforward study. I feel that there are hidden agendas going on and I will not stand by [and] let it continue!! I will not wait any longer,” reads an email dated August 6 from Dr. Gary Kompothecras to Dr. Julia Gill, director of the Florida Department of Health’s (DOH) Division of Disease Control.

Coming from anyone else, the blustery email threat might be easily dismissed. But “Dr. Gary,” as Kompothecras is known, is the self-styled “Rainmaker,” a Sarasota chiropractor who has raised more than $1 million over the years for Senate candidate and soon-to-be ex-governor Charlie Crist.

So it’s bound to turn heads when the man known to occasionally lend his private jet to the governor uses his political clout to try to bully Florida health officials into turning over scores of the state’s sealed immunization records. Especially when they’re for a father-son team, Dr. Mark and David Geier, infamous for injecting autistic children with Lupron, a drug used to chemically castrate prostate cancer patients and pedophiles.

Dr. David Gorski, who blogs at Science Based Medicine, was quoted:

According to Dr. David Gorski, founding fellow of the Institute for Science in Medicine and an NIH-funded cancer researcher, the Geiers’ Lupron treatment is “in essence, chemical castration in order to treat autism based on no reliable science.” Says Gorski: “The concept that [the Geiers] embraced isn’t even bad science. It’s just not science.”

As I commented on the webpage for the story, when it comes to thimerosal in vaccines and autism, the recent study in Pediatrics far surpasses anything the Geiers could accomplish with the data from Florida.

If the information I have is accurate, Mr. Kompothecras filed in the Court of Federal Claims (vaccine court) for two children. One case has been closed and the other is still pending. (correction–there appear to have been three cases opened. One has been closed)

The Age of Autism before thimerosal

28 Sep

Dan Olmsted and Mark Blaxill have written a book, The Age of Autism. It expands on Mr. Olmsted’s UPI series of the same name and uses the same logic: build a narrative that links mercury to illnesses and claim this as proof that mercury is the cause.

One can download the first 46 pages of the book for free on iTunes, buy the book, wait for it to come to your library or used book story (don’t count on the used bookstore route. Last report I got was only about 600 books sold in the opening time for this book). Or, one could just not read it ever.

If you want just an idea of what the book is about you can read a short excerpt on the publisher’s website. It starts with this simple statement:

We believe that autism was newly discovered in the 1930s for the simple reason that it was new.

Why was it new? If I understand the logic, the idea is that a new mercury compound was invented and tested around that time: thimerosal. From a recent interview, here are Dan Olmsted’s words:

What we did really was try to trace the rise of autism and that led us to look at the first eleven families who had children diagnosed in the 1930’s .. in the famous paper. We were able to identify seven of those first eleven kids, who were only known by their first name and last initial. When we did, we found what we thought was significant exposure of the family to mercury, in particular a new kind of mercury that came on the market .. that was used in fungicides for agriculture and in vaccines. So, we think as that happened, the first cases appeared. Then it seemed reasonable to believe that when the vaccine schedule that included much more mercury exploded in the 1990’s and so did autism .. there’s probably a connection that has been missed here.

First eleven kids? First studied or first with autism? They seem to be asserting that these are, indeed, the first autistics ever.


Thimerosal was invented in 1927. What strikes me odd about the position of Mr. Blaxill and Mr. Olmsted is that ten years before the invention of thimerosal, someone was born who would later be diagnosed with autism and receive support from the California Department of Developmental Services (CDDS) under the label “autism”. I know this because the data are publicly available. The CDDS data have been used for years to promote the idea of a vaccine-induced autism epidemic. Of course Mr. Olmsted and Mr. Blaxill are aware of these datasets as their colleague David Kirby made use of them many times over the years in his promotion of autism as vaccine injury, starting with his book “Evidence of Harm, Mercury in Vaccines and the Autism Epidemic: A Medical Controversy.”

Here is a list of the birth year and the number of people for each birth year who were getting services from the CDDS (note that these data were from the 1990’s. Some or all of these autistics may have passed on):

Birth-year number of CDDS consumers under the autism label
1930 1
1929 2
1928 3
1924 1
1923 1
1922 3
1917 1

There were not a lot of autsitics born before 1930 and still alive receiving services in the 1990’s, this is true. But, the oldest person in that group was 78 at the time. That’s one year older than Donald T. is this year, for those following that story. .Be that as it may, there are a number of CDDS consumers who were born before thimerosal was invented. It would be unwise to assume that these are all the people born before 1930 who were diagnosed autistic. They are but an example.

From what I’ve read, Mr. Olmsted and Mr. Blaxill spent about five years looking for the origins of autism (the time since Mr. Olmsted’s original UPI series of articles). They traveled internationally and, from their description at least, appear to have left no stone unturned in their search.

I wonder, did they ever challenge their assumption that autism was new? Did they seek out autistics who predated thimerosal and/or those who weren’t research subjects of Dr. Kanner? Or did they merely rework and expand on Mr. Olmsted’s previous work on Kanner’s subjects?

In their statement attempting to distance themselves from anti-vaccine groups, Mr. Olmsted and Mr. Blaxill state:

We don’t want crops to wither, or houses to rot, or children to die of vaccine- preventable illnesses. We simply want to stop an autism epidemic whose origin we believe can be discerned from a careful examination of its environmental history.

“Careful” examination. I wonder.

Donald Triplett – Autism’s Patient Zero

27 Sep

Donald Triplett is (for he is still alive) Kanner’s Case 1. Recently the story in a lovely portrait in The Atlantic, Donald has also had the sad misfortune to slowly but inexorably become a poster child for the autism/anti-vaccine movement. As one of the leading autism/anti-vaccine proponents, Ginger Taylor, writes:

While Kanner’s other cases had poor outcomes, Donald did not. It turns out Donald received a medical treatment that Kanner never recorded when, as a boy, he fell victim to crippling juvenile arthritis. Donald was treated with gold salts and his brother reported that as a result, Donald not only recovered from the arthritis, but “the proclivity to excitability and extreme nervousness had all but cleared up.”

Donald began to recover from “autism.”

This is highly relevant to the autism debate because gold has an extreme affinity for mercury and pulls it from the body. It is also significant because arthritis links his “nervous disorder” to his autoimmune disorder. It is historical evidence that the claims that parents have been making, that their children with autism had regressed after their mercury-containing vaccines, and that treating them for their autoimmune symptoms makes their “autism” better.

Sigh. And so we see the same old merry-go-round that has engulfed Hannah Poling – a determination to see one end and one end only for causing autism – vaccines.

And yet…theres no evidence Donald Triplett was ever vaccinated with anything. Certainly not thiomersal. Indeed, those who ‘discovered’ that Donald was treated with gold salts – Messers Blaxill and Olmsted, had to find another method of Donald being exposed to mercury. They claim that Donald:

…lived in an area where a water-soluble form of mercury was first used in forestry.

Bit of a stretch much?

There are a few reasons I really think this is debatable at best.

1) Why was Donald Triplett the _only_ person in Forest, Mississippi to ‘get’ autism from pesticides used in Forestry?

2) The only person who has suggested Gold Salts could theoretically chelate mercury is one Boyd Haley. In fact as Prometheus said way back in 2005:

The gold used to treat Donald T’s RA was a salt – the gold was an ion and not able to amalgamate with metallic mercury. In addition, mercury in animal tissue is also either ionized or chemically bonded with organic groups (e.g. methyl, ethyl, phenyl…) and also not able to form an amalgam.

3) Lets say that the gold salts performed the impossible and chelated the mercury. Why didn’t Donald Triplett simply ‘get’ autism straight away since mercury continued to be used in the Forestry industry? Chelation is not a preventative.

So here is this young boy who’s exposure to water soluble mercury seems in extreme doubt to me, who’s vaccination record seems to be zero but who was also autistic.

I’m afraid that only points one way to me.

Barbara Loe Fisher discusses her failed lawsuit against Paul Offit and Amy Wallace

22 Sep

Amy Wallace wrote an article on the vaccine/autism discussion entitled An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All. In it she quotes both Dr. Paul Offit of the Children’s Hospital of Philadelphia and Barbara Loe Fisher of the National Vaccine Information Center. As part of that article, Ms. Wallace quoted Dr. Offit discussing Ms. Fisher:

Offit is quick-witted, funny, and — despite a generally mild-mannered mien — sometimes so assertive as to seem brash. “Scientists, bound only by reason, are society’s true anarchists,” he has written — and he clearly sees himself as one. “Kaflooey theories” make him crazy, especially if they catch on. Fisher, who has long been the media’s go-to interview for what some in the autism arena call “parents rights,” makes him particularly nuts, as in “You just want to scream.” The reason? “She lies,” he says flatly.

Ms. Fisher sued Dr. Offit, Amy Wallace and Conde Nast Publications (who publishes Wired) over the statement “she lies”, claiming it was defamatory.

Ms. Fisher’s suit was dismissed before it could be heard. Ms. Fisher has now blogged her experiences as Amy Wallace & Yellow Journalism.

Much of that account struck me, but allow me to discuss a few here:

Ms. Fisher states in regard to Ms. Wallace’s response to the suit: Instead of providing one piece of solid evidence to support Offit’s defamatory statement, Wallace claimed I could not sue her because she is a resident of California.

Well, I looked up the MOTION TO DISMISS BY AMY WALLACE AND CONDÉ NAST PUBLICATIONS INC.. Yes, in point 4 they do state that there is a problem with jurisdiction. But that is not the whole story. Ms. Fisher seems to have forgotten point 3 of the “Motion to Dismiss”. I’ll quote it below:

It is evident, however, that plaintiff cannot obtain the relief she seeks even if all well-pleaded factual allegations are accepted as true and the reasonable inferences derived therefrom are viewed in the light most favorable her. Under controlling state and federal law in this jurisdiction, the challenged remark by Dr. Offit, about a matter of substantial public concern, is not actionable as defamation because it is neither capable of being understood as stating actual facts nor of being proven true or false. It is, therefore, an expression of opinion that is immune from civil liability under the common law of Virginia, the Constitution of this Commonwealth, and the First Amendment of the United States Constitution.

Ms. Wallace’s defense was not just that she is a resident of California.

Ms. Fisher conitinues:

And Offit, who has no trouble keeping a straight face when he states flatly that it is absolutely safe for a child to get 10,000 vaccines at once and 100,000 vaccines in a lifetime, claimed he was simply having an emotional meltdown when he hysterically told Wallace “flatly” that I lie. And to draw attention away from the seriousness of engaging in libel per se, the defendants’ attorneys argued that “the quoted remark ‘she lies’ is not capable of being proven true or false” because the civil court system cannot prove whether vaccines do or do not cause harm.

I don’t know what video Ms. Fisher is referencing when she states that Dr. Offit can’t keep a straight face. I mean, she wouldn’t say that unless she actually saw him talking (each and every time he has done it) and noticed that he had such troubles, would she? In Dr. Offit’s Motion to Dismiss, I don’t see any mention of the words “emotional meltdown”. Perhaps it was in some other document I was unable to pick up from PACER? I don’t recall the Wired article claiming that Dr. Offit was “hysterical”. I mean, this couldn’t possibly be an expression of opinion of Ms. Fisher in a heated debate and not a statement of actual facts? As such, wouldn’t Ms. Fisher’s statements be protected speech, even if they aren’t completely factual?

As to the actual statement “She lies” that is the basis for Ms. Fisher’s failed suit? In her blog piece Ms. Fisher writes:

Third, Hilton offered the opinion that Offit’s allegation “cannot be reasonably understood to suggest” that I am “a person lacking honesty and integrity” and that Wallace and Wired magazine were only reporting Offit’s “personal opinion” about my “views” and none of the defendants intended to make a “literal assertion of fact” that I lie.

In other words, they really didn’t mean it.

Is that really what was argued and decided? From a response Dr. Offit filed with the court:

Accordingly, the question is not whether Dr. Offit could provide a list of specific “lies” stated by Plaintiff in the past – an exercise he will undergo to establish “truth” if this case is not dismissed on this initial motion – but whether Dr. Offit’s vague statement in the context of the Article will merely be understood as a loose expression of disagreement with Plaintiff, not an assertion of specific actual fact, and thus constitutes protected opinion immune from suit.

He seems to be willing to provide a list of specific “lies” stated by [Ms. Fisher] in the past. I don’t see that as the same thing as “they didn’t really mean it.” (as an aside, why “they”? Amy Wallace wasn’t saying that Ms. Fisher lies. She was reporting what Dr. Offit said.)

In response to Ms. Wallace’s argument that Virginia was the incorrect jurisdiction, Ms. Fisher requested discovery information:

Plaintiff requests discovery concerning all facts germane to personal jurisdiction including, but not limited to, traffic on the defendants’ various websites, including, for example, the geographic locations of all who have transmitted comments in association with those websites; all who have sent correspondence in response to Wallace’s Wired article; the Virginia state Wired magazine subscriptions obtained through Wired.com; and Wallace’s communications with CNP concerning the Wired.com blog, as well as any and all interactions between Wallace and Virginia sources, Virginia media, and Virginia readers.

Yep. Any and all interactions between Amy Wallace and people in Virginia (the state of jurisdiction for this case) and all communications with CNP (Conde Naste Publications. Essentially her employer on this piece).

This sounds like a fishing expedition to me (is that protected speech?). Especially the part about “Wallace’s communications with CNP concerning the Wired.com blog.”

Ms. Fisher notes in her piece that she has been a proponent of vaccine education for many years. Earlier this year she put out a YouTube video discussing the presence of “fatal pig viruses” in the rotavirus vaccines. At that time I emailed them, seeking some education on the subject. I asked a simple question:

I saw your recent video. You mention “fatal pig viruses”. Could you please point me to your data indicating that these viruses are fatal in humans?

The email remains unanswered.

Safeminds comments on the latest thimerosal-autism study

21 Sep

SafeMinds is an organization which has long promoted the idea that thimerosal caused an autism epidemic. They may be the single greatest force that got the idea into the public’s eye, and got research funding focused on looking at the question.

SafeMinds has shown themselves to be very resistant to the very research they called for. Studies which show a lack of association between thimerosal containing vaccines (TCV’s) and autism are always rejected by SafeMinds. They are not alone in this, groups such as Generation Rescue and the National Autism Association (NAA) have also refused to accept the science.

So it was with no surprise that I read that SafeMinds had issued a statement against the study. The statement starts by pointing out that the study was funded and performed by those with conflicts–the CDC, Abt (an organization which does contract research for groups including the CDC), and HMO’s “which receive substantial funding from vaccine manufacturers to conduct vaccine licensing research”.

If we can’t use the HMO’s to work on such project, that sort of takes away the VSD as a tool. It certainly takes away the opportunity to do anything more than passive surveillance of the VSD data. One of the strengths of the Price study was the effort to do more than just review the medical charts. They worked with the children, both cases and controls, to verify that the autism counts were accurate. I bring this up because groups like SafeMinds frequently request access to VSD data.

SafeMinds also discusses the study methodology:

The study sample did not allow an examination of an exposed versus an unexposed group, or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates.

There is much wrong with the above statement. Let’s start with where they are close to correct. The study sample did not allow for a direct comparison (with good statistics) of exposed vs. unexposed. This is true. This is because there are few unexposed kids (unexposed=no thimerosal exposure in this study. Unexposed does not mean no vaccines). If you look at exhibit 9.1.4 from the technical reports by Abt associates (the detailed reports on the study), you will see about 20-30 “unexposed” children. I.e. children with no thimerosal exposure. Of those, about 3-4 (out of 1,000) had no HiB, HepB or DTP vaccine vaccine at all (MMR isn’t listed as it is not a source of thimerosal). This is in line with estimates by the CDC of how many children are unvaccinated (typically about 0.4%). (as an aside–this points out how difficult it would be to do a good study of vaccinated vs. unvaccinated children using the VSD. Seriously, with 99.6% of kids receiving at least one vaccine, you would need a huge number of kids to get the number of unvaccinated needed for good statistics).

Here is that exhibit, with the no-exposure kids circled. (click to enlarge)

It would appear to this reader that the issue of unexposed vs. exposed isn’t so much one of “study design” as the limitations of the VSD itself. There just aren’t that many autistic kids to make a good statistical comparison of unexposed vs. exposed populations.

And, it should be noted, an unexposed vs. exposed comparison wasn’t the purpose of this study. One big question posed by SafeMinds and later picked up by groups such as Generation Rescue was simple: did the increase in thimerosal exposure from vaccines in the 1990’s result in an “epidemic” of autism? This is the question this study addressed.

I am at a loss as to why SafeMinds wrote this: “….or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates”. Contrary to SafeMinds’ assertion, there is a large variation on thimerosal exposure in the study subjects. One of the surprising facts from this study was the number of children receiving thimerosal-free vaccines. This, together with variations in the number of vaccines administered, led to a much larger distribution in thimerosal exposures than one would expect based on the vaccine schedule alone.

Thus, the study was not on “timing” at all. It was, as advertised, on variation of exposure of thimerosal. The question is (at least to me), does the range of exposure amount to significant number of kids having “low” levels of exposure by SafeMinds’ definition?

The answer, it turns out, is yes.

Safeminds has the following statement on their website:

[Autism] remained rare (1 in 10,000) until the rapid escalation of vaccines beginning in the late 1980’s (from 10 shots of 7 antigens in 1983 to 36 shots of 15 antigens). Vaccines are a likely candidate to explain some, if not most of the rise in autism cases and possibly other chronic childhood disorders linked to immune system malfunction.

In one of the seminal papers on the thimerosal was co-written by SafeMinds founder Lyn Redwood Autism: a novel form of mercury
poisoning. In it, the authors state:

The discovery and rise in prevalence of ASD mirrors the introduction and spread of TMS in vaccines. Autism was first described in 1943 among children born in the 1930s (123). Thimerosal was first introduced into vaccines in the 1930s (7). In studies conducted prior to 1970, autism prevalence was estimated, at 1 in 2000; in studies from 1970 to 1990 it averaged 1 in 1000 (124). This was a period of increased vaccination rates of the TMS containing DPT vaccines among children in the developed world. In the early 1990s, the prevalence of autism was found to be 1 in 500 (125), and in 2000 the CDC found 1 in 150 children affected in one community, which was consistent with reports from other areas in the country (126). In the late 1980s and early 1990s, two new TMS vaccines, the HIB and Hepatitis B, were added to the recommended schedule (7).

I know I am spending a lot of time on this point, but it is important. The idea that there is a dose-response relationship between thimerosal and the presumed risk of autism is fundamental to the arguments made by groups like SafeMinds.

A sister organization to SafeMinds, Generation Rescue, says the same thing. In their take, “This is the schedule from 1983. If it worked for kids then, why doesn’t it work for kids now?”. Generation Rescue leader and spokesperson Jenny McCarthy wrote in her book, Healing and Preventing Autism: A Complete Guide, “In 1983, we had 10 shots on the vaccine schedule and autism was one in 10,000. Today there are 36 given and autism is nearing one in 100”. I.e. if we go back to the 1983 vaccine schedule, autism rates should drop to 1 in 10,000.

The 1983 schedule, as graphically presented in expensive full page newspaper ads by Generation Rescue, included 4 DPT shots (yes, the old whole cell pertussis vaccine). Each of those shots included 25 micrograms of mercury.

It strikes this reader that the thimerosal exposure from 4 DPT shots, the amount in the 1983 schedule that supposedly only resulted in 1 in 10,000 kids having autism, should be a “low” exposure amount. If groups are going to point to 1983 as a safer schedule and point to the increases in thimerosal exposure in the 1990’s as the major sign of the “epidemic”, we should be able to take their word that the levels in 1983 were somehow safer.

Let’s look at that figure from the Price study again, shall we? I will highlight how many kids have “low exposure” (i.e. comparable to the 1983 vaccine schedule) to thimerosal. Again, click to enlarge if you wish.

By my eye, something approaching 50% of the kids in the study received the thimerosal exposure of the 1983 schedule. Certainly more than 25%. Those highlighted in red have the same thimerosal exposure as kids did in 1983, so they should have the same autism prevalence that SafeMinds and Generation Rescue claim for that time period: 1 in 10,000.

If that group has a prevalence of 1 in 10,000–or even anything significantly lower than the prevalence of those with higher thimerosal exposure– this study would have found it.

In other words, a thimerosal-induced epidemic of autism didn’t happen. Even using the logic that SafeMinds used to hypothesize it in the first place:that, somehow, the thimerosal exposures in 1983 resulted in a low autism prevalence.

Yes, this is far from rigorous. But, so is the logic that claims that increased thimerosal exposure led to an autism epidemic.

If we read further into the SafeMinds response, we see some of the confusion:

The study sample did not allow an examination of an exposed versus an unexposed group, or even a high versus a low exposed group, but rather the study mostly examined the effect of timing of exposure on autism rates. There were virtually no subjects who were unvaccinated and few who were truly less vaccinated; rather, the low exposed group was mostly just late relative to the higher exposed group, ie, those vaccinating on time.

SafeMinds seems to be assuming this is a study on the number of vaccines, not the amount of thimerosal. They also don’t appear to have read the study thoroughly enough to note that, yes, there is a large fraction who were “less vaccinated” and, more importantly to this study, a large fraction who had lower thimerosal exposures. As noted above, the low thimerosal exposures result from the fact that many of the children received thimerosal free vaccines.

It is unfortunate that SafeMinds (and other groups like them) can not adapt to science as it comes out. Science which clearly shows that many of their hypotheses were wrong.

The Respectful Insolence blog also discusses some of the failings of the SafeMinds response.

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