The anti-vaccine movement is nothing if not savvy about marketing their nonsense – at least in the last decade. One of their successful slogans has been “too many, too soon” – implying that children are receiving too many vaccines while they are still too young to deal with them. The result, anti-vaccinationists argue, is potential neurological toxicity or “overwhelming” the immune system.

The slogan also serves double duty, allowing anti-vaccinationists to argue that they are not “anti-vaccine” just “pro-safe vaccine.” This is just more marketing savvy, however – a deliberate deception, as many of the people who make this claim also state that they would never vaccinate. (Orac has pointed this out many times in great insolent detail.)

But there are some parents who have bought into this notion and have reduced and/or delayed the number of vaccines their children receive in the hopes that they can strike a better balance of risk vs benefit than the experts have struck. And there are fringe doctors, like Dr. Jay Gordon, who promotes his own evidence-free alternate vaccine schedule, playing into the “too many, too soon” meme.

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The anti-vaccine movement, as is probably typical for ideological movements, has natural enemies and allies. Once the notion that mercury in the form of thimerosal in vaccines might be responsible for neurodevelopmental disorders (it’s not) became popular in the anti-vaccine crowd, this made them natural allies with the “mercury-militia” – those who blame environmental mercury for a host of ills. The fact that some anti-vaccinationists seek to provide their children on the autism spectrum with unconventional biological treatments, based on their disproved “toxin” hypothesis, made them natural allies with the alternative medicine community. Both seek freedom from pesky regulation, and rail against the perceived deficiencies of science-based medicine.

Another ideological alliance is brewing – that between the anti-vaccine movement and extreme environmentalists. This post is not a commentary on environmentalism, and please do not take it as such – the purposes and claims of the two movements are quite distinct. But they share a common thread: distrust of scientific experts and government regulators who reassure the public that environmental exposures are safe.

Robert F. Kennedy Jr. has been the most prominent environmentalist to take up the anti-vaccine cause, in several articles and speeches. While he appears to be only a part-time anti-vaccinationist, his celebrity and street cred among environmentalists lend a great deal of weight to his paranoid musings about scientific fraud and government cover ups. It seems he wants to recapitulate the moral clarity that his uncles displayed in the 1960s, defending the little guy against abuses by the powerful and privileged. He is ready to see a conspiracy, and he wants to be the crusader for environmental justice – and if kids are the alleged victims, all the better. His article in the Huffington Post – “Attack on Mothers,” says it all.

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I love a good sequel. Aliens, of course, was the best sequel ever – that rare event when the sequel is actually better than the original movie (of course, the series went down hill from there, like Star Trek it peaked with the second movie).

Last year we heard the results of the Autism Omnibus – a special court with three special masters set up to resolve about 5,000 cases before the vaccine court claiming that autism resulted from vaccines – either the MMR vaccine or thimerosal (a mercury-based preservative in some vaccines, but removed from most by 2002). In the US there is a Vaccine Injury Compensation Program (VICP) which bypasses the regular courts and awards compensation to those injured by vaccines, paid for by a small tax on each dose of vaccine given. The purpose is to rapidly compensate those who might have been injured (the threshold for evidence is quite low) and to encourage pharmaceutical companies to manufacture vaccines (the threat of suit would make it not viable otherwise).

Over 2008 the Autism Omnibus heard three cases that were presented as the test cases (presumably the best cases they could come up with) for the theory that the  MMR vaccine (with or without thimerosal from other vaccines – MMR never had thimerosal) caused or contributed to autism in some individuals. They ruled against all three cases, stating in very strong terms that there is no evidence to back up the claims of a link between MMR and autism. Judge Hasting wrote of one case – Cedillo:

Considering all of the evidence, I found that the petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to causing immune dysfunction, or that the MMR vaccine can contribute to causing either autism or gastrointestinal dysfunction. I further conclude that while Michelle Cedillo has tragically suffered from autism and other severe conditions, the petitioners have also failed to demonstrate that her vaccinations played any role at all in causing those problems.

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This week on Science-Based Medicine I wrote an article about a new study looking at the onset of autism symptoms, showing that most children who will later be diagnosed with autism will show clear signs of autism at 12 months of age, but not 6 months. This is an interesting study that sheds light on the natural course of autism. I also discussed the implications of this study for the claim that autism is caused by vaccines.

Unfortunately, I made a statement that is simply wrong. I wrote:

Many children are diagnosed between the age of 2 and 3, during the height of the childhood vaccine schedule.

First, this was a vague statement – not quantitative, and was sloppily written, giving a different impression from the one I intended. I make these kinds of errors from time to time – that is one of the perils of daily blogging about technical topics, and posting blogs without editorial or peer-review. Most blog readers understand this, and typically I will simply clarify my prose or correct mistakes when they are pointed out.

However, since I often write about topics that interest dedicated ideologues who seek to sow anti-science and confusion, sometimes these errors open the door for the flame warriors. That is what happened in this case.

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Like my science-blogging colleagues, I get e-mail. I always appreciate it when readers (or listeners, in the case of the SGU) take the time to write. Sometimes the e-mails are questions from someone who disagrees with my position on a hot issue. I especially like these e-mails – they are good blog fodder, and I think the format of answering questions is more compelling and interesting than making a didactic argument.

Below is an example of the kind of question I most like to get – from someone who disagrees with me, but still manages to ask polite and cogent questions. This stands in stark contract to most hostile e-mail I get, which are just strings of ad hominems, straw men, and other logical fallacies. I get the impression (and some of my e-mailers have later even admitted this) that the e-mails were not meant as an opening to serious discussion, but as a venting rant into the ether of the internet.

Harold asks some very important questions about the alleged autism-vaccine link and research priorities, and I am happy for the opportunity to clarify my position. His e-mail begins below the fold:
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Politics is partly about setting priorities and agendas, and therefore it is impossible to keep politics out of science. Politicians are also in control of the public’s purse strings, and so funding science also cannot be free from politics.

But ideally we should have an atmosphere in which politicians and funding agencies set broad agendas, and then let scientists decide the details of which research should be funded based upon the science. It is, in fact, an important trust that public money that is spent on scientific research be utilized optimally, and not to promote someone’s narrow ideological agenda. Examples of abuses are legion; my favorite example is the National Center for Complementary and Alternative Medicine (NCCAM), Senator Tom Harkin’s pet project in which the usual standards of medical research have been subverted to promote sectarian medicine.

We want scientists to follow their noses – to research those questions they think are most fruitful. But scientists are often forced to follow the funding, and this distorts the direction of research. Industry funding distorts research in ways that are advantageous to industry – a real problem that is being examined and there are at least attempts to deal with it. Government funding should be neutral, and provide a counterbalance to industry funding, but is often subverted to ideology. Even well-meaning patient-groups can distort funding if they try to dictate what scientists should be researching in exchange for their fund-raising, with detrimental effects.

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I have been blogging this week about the Desiree Jennings case – the 25 year old woman who is telling the media that she developed a neurological disorder known as dystonia two weeks following a seasonal flu vaccine. However, the video of her movement disorder that was made public was not, in fact, consistent with the diagnosis of dystonia or any organic movement disorder, and therefore it is highly unlikely that her symptoms were a vaccine reaction. Every movement disorder specialist or neurologist who viewed the videos and voiced their opinion agreed that the signs she was displaying on the public video were most consistent with a psychogenic movement disorder.

We were also careful to point out that this does not mean she is “faking”, that her symptoms are not real, and that she is not suffering from a genuine and debilitating disorder. Simply that the nature of the disorder is likely psychogenic and not due to any specific brain pathology, caused by a vaccine or anything else.

Jennings claimed, however, that her doctors at Johns Hopkins diagnosed her with dystonia and concluded it was from the vaccine. We have only her word to take for this as her doctors, understandably (given the rules of confidentiality) have not made any public statements. Jennings could give them leave to do so, but apparently hasn’t.

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The anti-vaccine community are a loose collection of individuals and organizations who, at their core, are dedicated to the notion that vaccines are bad. There is some variation of opinion within the anti-vaccinationists, but not much. Some claim that vaccines do not work at all, while other acknowledge some benefit. Some try to be coy by saying they are just asking questions (sure, like the 9/11 truthers are “just asking”), while others come right out and make demonstrably false claims, like vaccines cause autism. But they all cluster around the opinion that vaccines are toxic (in some way) and that they cause harm.

What is remarkable about the anti-vaccine crowd is their consistency in talking points. One might call it message discipline (enough to make Republicans jealous) but I think that implies more deliberate coordination than there is evidence for. I may be wrong in this, but I think it is enough to say that they all travel in the same virtual circles and play off each other’s rhetoric and arguments. They are a political/ideological community, and such communities are more plugged in today because of Web 2.0 than ever before.

I’m not just talking about slogans, like “Green our Vaccines”, which are designed for widespread use. Reading the various anti-vaccine websites and authors you begin to see a pattern of specific talking points coming in waves.  Squalene has been in vaccines as an adjuvant for years, yet suddenly many of the anti-vaccine sites are squawking about squalene. I have not tracked down the original source of the squalene flap – it spread so quickly through the anti-vaccine blogs.

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A new study published online in Environmental Health Perspectives shows no correlation between blood mercury levels in 2-5 year old children and autism or developmental delay. This study adds to the growing evidence that environmental exposure to mercury, from any source, is not a risk factor for autism.

The study looked at 452 children aged 2-5 (which is a robust sample) with either autism spectrum disorder (ASD), other developmental delay (DD), or typically developed (TD). They found that children with ASD and DD had lower levels of blood mercury than TD controls. They further found that ASD and DD children tended to eat less fish, and as fish is by far the most significant source of mercury exposure, this explains their lower levels.

The researchers then adjusted for reported exposure to fish as well as other known sources of mercury and found that the adjusted level of mercury were the same for all groups. The levels were also similar to established national norms, meaning that the population being studied and the methods used are likely representative.

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The anti-vaccine community is tireless. As I wrote yesterday, they happily shift around their multiple goalposts as long as they have some working hypothesis about how vaccines are to blame for autism or some human suffering. They have moved from MMR to thimerosal to aluminum to “toxins” to squalene and now the HepB vaccine. They just spin the wheel and choose their next target – although they never really abandon their prior targets, they just back burner them a bit.

They also have their small dedicated group of researchers, like the father and son team of Geier and Geier, to produce crappy studies to support their anti-vaccine claims. Andrew Wakefield, who has been rightly vilified for starting the MMR scare with his now discredited Lancet study, has also apparently decided to make a career out of feeding bad studies to the anti-vaccinationists.

I acknowledge there is a certain symmetry to the situation now. The scientific community presents studies that show a lack of correlation between some aspect of vaccines and autism or other neurological disorders. They generally accept these studies as supporting vaccine safety, even while being open about their limitations. They also sharply criticize those studies that suggest there may be a connection between vaccines and autism as fatally flawed.

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