Dec 22 2008

Skeptical Battlegrounds: Part IV – Anti-Vaccine Hysteria

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There is a dedicated fringe anti-vaccine movement. They are dedicated to some permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim.

While anti-vaccine cranks have been around as long as vaccines, it is only recently that they have captured the attention of the mainstream media and the skeptical movement and the battle has really been engaged.

Anti-vaccinationists have focused much of their recent efforts on the claim that vaccines cause autism. At first the MMR vaccine was blamed, sparked by a now-discredited study performed by Andrew Wakefield. This led to declining vaccination rates in the UK and a resurgence of measles.

As the MMR claim was in decline (although by no means abandoned), attention shifted to thimerosal – a mercury-based preservative in some vaccines. There are many flaws with the thimerosal hypothesis, and numerous studies have shown no link between thimerosal and autism or any neurological disorder. But the fatal blow to the thimerosal hypothesis was struck when thimerosal was removed from the routine childhood vaccine schedule (thimerosal, incidentally, was never in the MMR vaccine) in the US by 2002. In the subsequent 6 years the rate of autism diagnoses kept increasing at their previous rate, without even a blip. Only the most rabid (or scientifically illiterate)  anti-vaccine fanatics still cling to the thimerosal claim.

So attention has shifted yet again. Now the anti-vaccine crowd are hedging their bets with the “toxin gambit.” They blame various “toxins” in vaccines for its alleged and unproven side effects. Mercury is still on the list, but they have added aluminum, which is added to vaccines to make them more effective. They cite hydrochloric acid, which they don’t understand is added to balance the pH of vaccines. They try to scare people by saying vaccines contain formaldehyde, but neglect to mention that formaldehyde is already naturally present in our blood in higher amounts than are found in vaccines. They even make up some toxins (aided by their limitless scientific ignorance) by misreading chemical names. Jenny McCarthy, for example, has repeated numerous times (despite being called on it) the canard that vaccines contain ether and anti-freeze – both untrue. They also try the scare tactic of saying that vaccines contain viral proteins – uh, yeah, that’s the point. And that they may contain fetal tissue – which is a gross distortion. Some vaccine components were cultured in cells that were derived years ago from fetuses.

(For a more thorough review of the science behind recent anti-vaccine claims you can browse through my many blog posts on the topic, or read this overview I wrote for the Skeptical Inquirer.)

The Anti-Vaccine Players

Active players on the anti-vaccine side include a number of organizations, such as Safe Minds and Age of Autism. They have been given an incredible boost by the internet, as the skeptical movement has, and have been tireless in spreading their misinformation and ideology on their websites and blogs.

Andrew Wakefield, despite being discredited, has not recanted his claim that there is a link between MMR and vaccines. He now portrays himself as a martyr to the cause. As a doctor and researcher he remains an icon of the anti-vaccine movement.

Other anti-vaccine researchers include the father and son team of Mark and David Geier. They have made a career publishing bogus studies claiming to show a statistical correlation between vaccine and autism. Their studies crumble under peer-review, however. They have also spent a lot of time as expert witnesses for attorneys suing over vaccine injury. Their worst contribution to anti-vaccine nonsense, in my opinion, is a recent study in which they are treating autistic children with Lupron and chelation therapy. They were only able to get approval for this ethically dubious study by putting together their own IRB board packed with cronies.

Dr. Jay Gordon is a “pediatrician to the stars” and prominent figure in the anti-vaccine pantheon, despite his coy and unconvincing protests that he is not anti-vaccine. He is notorious for relying upon his gut instinct as a clinician rather than actual published scientific evidence, and makes a slew of anti-vaccine claims that are completely unsupported by evidence. For example he is proponent of the notion that the childhood vaccine program gives too many vaccines too soon – without any scientific rationale or evidence.

J.B. Handley is the co-founder of generation rescue, a parent-based autism support group that is dedicated to the notion that autism is a vaccine-injury. His group also favors and promotes a number of biological therapies for autism, such as chelation therapy, all based either on the mercury poisoning hypothesis, or any dubious alternative therapy that comes along.

David Kirby is a journalist who gave the thimerosal hypothesis a huge boost with his 2006 book Evidence of Harm.  In it he puts forward the claim that there is a vast conspiracy among the pharmaceutical industry, the government (via the FDA and CDC) and the medical establishment to hide the evidence that thimerosal in vaccines causes autism. He has subsequently built his career around that book, and clings tenaciously to the thimerosal claim. He blogs for The Huffington Post, where he repeats his anti-vaccine propaganda on a regular basis. Kirby is most notorious for specifically claiming that autism rates should plummet following the removal of thimerosal from the vaccine schedule, and then subsequently moving the goalpost on his prediction.

Robert F. Kennedy Jr. is a lawyer and environmentalist who has championed the hard-core conspiracy theories surrounding the anti-vaccine claims. He wrote Deadly Immunity (published simultaneously Rolling Stone magazine and Salon.com), and followed up with a ridiculous screed called Attack on Mothers. He has been particularly shrill and paranoid in his writings, and just as scientifically clueless. This was the primary reason for the controversy that erupted when his name was floated for an Obama appointment to head the EPA.

The reigning superstar of the anti-vaccine movement is actress Jenny McCarthy.  After deciding that her son, Evan, was an indigo child (actually, she is an “indigo” and Evan is a “crystal” – divine manifestors here to save the earth, so they have that going for them) McCarthy later decided that Evan had autism caused by the MMR vaccine. So she shifted from crusading to spread the word of indigo children to the world to spreading anti-vaccine propaganda. She has subsequently been relentless in spreading her scientific illiteracy and fear mongering, and was the primary force behind the “Green or Vaccine” march earlier this year. She believes that we should listen to her “mommy instinct” rather than scientific evidence. Eager for a celebrity face to put on their movement, McCarthy was rapidly positioned as the de facto leader of the anti-vaccine crowd.

Her celebrity has indeed made her dangerous. She has also managed to rope in her boyfriend, Jim Carrey, who is also as clueless as he is famous.

Also a huge player in the anti-vaccine movement is the media. In general the mainstream media have been mixed in the quality of their approach to this issue. Sometimes a mainstream outlet does a decent job, but mostly they allow Jenny McCarthy and her ilk to have a free ride, with perhaps lame token skepticism thrown in.

But beyond mainstream media incompetence, there are several outlets that have actively promoted the anti-vaccine movement, and they deserve a large share of the blame for the harm that results. This includes the Huffington Post, which I already mentioned as the blog home of David Kirby. Larry King has also allowed his show to be used to promote anti-vaccine pseudoscience. But the queen of shilling for dangerous quackery is Oprah Winfrey. She has the largest and most adoring audience. She has promoted Jenny McCarthy and Dr. Jay Gordon on her show numerous times. She doesn’t even bother with the token science.

There are many others, but those are the names that have been prominent in the media recently.

Defending Science

The list of players opposing the anti-vaccine movement is not as long.  The most prominent opponent is Dr. Paul Offit, a pediatrician and researcher who recently published a book on the topic called Autism’s False Prophets. He has endured personal threats in order to tirelessly attack the pseudoscience of the anti-vaccine crowd. He is certainly their enemy #1. He understands the issue inside and out and is an effective public speaker and writer.

Recently actress Amanda Peet decided to go up against Jenny McCarthy in a celebrity death match over the issue (or at least that’s how the media likes to play it). She has become a spokesperson for the vaccine program, and has specifically targeted anti-vaccine propaganda. She also has made an effective swipe at McCarthy exploiting her celebrity to promote her own wacky ideas. Peet stresses that she is not an expert, and that she defers to the scientific consensus on vaccines. She is not trying to substitute her own opinion for that of experts, she is simply trying to get the word out that vaccines are a safe and effective public health measure.

But those who have been in the trenches countering anti-vaccine propaganda at every turn are skeptics and science bloggers. I have been writing about the issue since 2005, and in fact have been engaged directly by David Kirby and others. David Gorski, who blogs for Science-Based Medicine and Respectful Insolence, has also been blogging very effectively on this issue for years. Dr. Gordon, in fact, treats him as his personal nemesis. Our allies across the pond include Ben Goldacre who write the Bad Science column. Even non-physician skeptical bloggers will occasionally take on anti-vaccine nuttery. Phil Plait, for example, will take time away from astronomy to dismantle the latest anti-vaccine pseudoscience. There are others, and my apologies to anyone I did not specifically mention.

Some bloggers in the autism community, like the autism diva,  have also opposed the anti-vaccine crowd, partly because in order to bolster their fear mongering the anti-vaccinationists have portrayed autism as a universally “life sucking”disorder. It is not hard to understand why some autism parents would be offended at that characterization of their children, or why they would resent the use of autism to fear-monger about vaccines.

The government and mainstream medical community has been largely ineffective on the issue. They try, with occasional official statements about the science, but they simply don’t have the experience dealing with a dedicated pseudoscientific popular movement.

The Stakes

The consequences of this particular battle are quite high.  Obviously, everyone wants effective vaccine regulation and safety monitoring. There is broad support for the vaccine compensation program, that streamlines the process of financially compensating children and families that have suffered legitimate side effects from vaccines. On any particular claim, we want the scientific chips to fall where they may. If some vaccine ingredient is causing harm, we need to find out right away and make the necessary changes. Only a cartoonish, handlebar mustache-twisting villain would want to allow children to be harmed through compulsory vaccines. Anti-vaccine hysteria, however, hampers effective vaccine safety by diverting attention and resources to false claims.

The most direct consequence of the anti-vaccine movement, and their recent successes with Jenny McCarthy and Oprah, is stoking public fears about the vaccine program leading to declining vaccination rates. This has already resulted in increased outbreaks of measles and mumps.  Vaccine hysteria in Nigeria set back the goal of eradicating polio from the world for years.

Not having ones’ children vaccinated does not only put your children at risk but others as well. As vaccination rates drop, infectious diseases they would normally prevent are allowed to spread through the population. This puts everyone at risk, but especially those people who cannot be vaccinated because of a medical contraindication.

The anti-vaccine crowd has also opposed attempts to shield vaccine manufacturers from liability. No one is arguing that vaccine producers get a free pass – they are still responsible for their product, and are certainly tightly regulated by the government. However, if they were vulnerable every lawyer trying to make a buck off of anti-vaccine pseudoscience, it would quickly become impossible to produce vaccines. It would not be worth it for any company to sell vaccines – and of course that is the goal of the anti-vaccine movement. They want to end vaccines, and harassing lawsuits are just one method. This is partly why the government set up the vaccine compensation program – there is a small tax attached to every vaccine, and that tax goes into a pool that is then paid out to those injured by vaccines, as determined by a federal court.

This brings up another risk of the anti-vaccine movement. There are now about 5,000 cases before the vaccine injury compensation program by parents who allege that their children’s autism was caused by vaccines. The courts now have to spend time and taxpayer money legally settling a question that the scientific community already has.

Conclusion

The anti-vaccine movement is a recent skeptical battleground, and one that is still very active.  This is certainly one of the biggest issues from 2008, and likely will continue to be for the foreseeable future. Skeptics have been particularly effective in dissecting the claims of the anti-vaccinationists and pointing out the dangers of anti-vaccine hysteria. But the anti-vaccinationists have the momentum, due largely to Jenny McCarthy and Oprah Winfrey. Vaccine rates are declining.

It seems as if we may be seeing a momentum shift, however. Next year will be very telling.

One thing is clear – the skeptical movement has to keep vigilant and keep the pressure on. We have to oppose anti-vaccine pseudoscience at every turn. We need to make ourselves available to the mainstream media and be effective at the public relations end of the game. We need to get the mainstream scientific and medical communities more active and show them how it’s done.

This is a fight we can win, and I think we are making headway.

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28 responses so far

28 Responses to “Skeptical Battlegrounds: Part IV – Anti-Vaccine Hysteria”

  1. jonny_ehon 22 Dec 2008 at 10:04 am

    Another great article Dr. Novella!

    Don’t forget the “too much too soon” canard being thrown around. It’s really growing in popularity. Dr. Crislip addressed it on SBM quite well not long ago.

  2. Willon 22 Dec 2008 at 10:34 am

    What about the HPV vaccine? I’ve seen a bunch of claims by various Catholic organizations saying that it’s ineffective, or unsafe and so forth. I haven’t seen that many posts by science bloggers, and I’m not sure what to think about it. Is there anything to their claims?

  3. Willon 22 Dec 2008 at 10:37 am

    Here’s an example of an anti-HPV article:

    “Deaths Associated with HPV Vaccine Start Rolling In, Over 3500 Adverse Affects Reported”
    http://www.lifesitenews.com/ldn/2007/sep/07092004.html

    “US Death Toll Associated with HPV Vaccine Jumps to 11 with 3779 Adverse Reactions Reported
    Judicial Watch files lawsuit against FDA for its failure to fully respond to Freedom of Information request”
    http://www.lifesitenews.com/ldn/2007/oct/07100507.html

  4. Oracon 22 Dec 2008 at 11:28 am

    But beyond mainstream media incompetence, there are several outlets that have actively promoted the anti-vaccine movement, and they deserve a large share of the blame for the harm that results. This includes the Huffington Post, which I already mentioned as the blog home of David Kirby. Larry King has also allowed his show to be used to promote anti-vaccine pseudoscience. But the queen of shilling for dangerous quackery is Oprah Winfrey. She has the largest and most adoring audience. She has promoted Jenny McCarthy and Dr. Jay Gordon on her show numerous times. She doesn’t even bother with the token science.

    You forgot aging (and unfunny) shock jock Don Imus and his wife Deirdre. Back in 2005 when I first became interested in the antivaccine movement, Don Imus’ radio show was the reigning king of media outlets promoting the thimerosal scare. David Kirby and Robert F. Kennedy, Jr. were frequent guests. Indeed, when Imus was fired for his racist remarks in 2007, the antivaccine movement was most unhappy. Some even said that big pharma had been looking for an excuse to get him yanked off the air, and his remarks about the Rutger’s women’s basketball team were just the ticket.

    Maybe the reason he’s not as big on the antivaccine front these days is because he was off the air for several months and is probably still trying to rebuild his audience. Also, Jenny McCarthy is prettier and much louder.

    As for the anti-HPV vaccine stuff, here’s an example of the refutation of some of the crap they write about the HPV vaccine:

    http://scienceblogs.com/insolence/2008/08/woo_and_antivaccinationism_in_mainstream.php

    http://scienceblogs.com/insolence/2008/08/why_medscape_why.php

  5. CrookedTimberon 22 Dec 2008 at 12:33 pm

    Wow, openly and brazenly calling out Oprah. Bold move Dr. N.

    I was wondering if it may be helpful to draw parallels between the vaccine hysteria and other public health hysterias. Two that come to mind are power lines and leukemia and breast implants and cancer. Both garnered much publicity in their respective heydays and both had tremendous emotional appeal as sick children and women were paraded out on many of the same media outlets discussed in this post. Both, of course, also didn’t hold up when science was thrown at them.
    There may be more as well that the physicians here are better equipped to discuss. It was helpful for me to see the pattern that develops with such hysterias and the proper way to investigate; perhaps it may sway others as well.

  6. lizditzon 22 Dec 2008 at 3:33 pm

    Thank you, Dr. Novella, for another excellent article.

    I also wanted to mention Diego Pineda (a science writer) and Martin G. Myers, MD, who co-wrote Do Vaccines Cause That?!, which was published by Immunizations for Public Health

    Diego Pineda’s blog:
    http://vaxriskcomm.blogspot.com/

    Do Vaccines Cause That?! webpage
    http://www.dovaccinescausethat.com/

    It is a science-based but breezy book, accessible to parents.

  7. PaulGon 22 Dec 2008 at 5:52 pm

    Excellent article, for a few more based in the UK – with an occasional “Andrew Wakefield” focus, take a look at this site…

    http://nhsblogdoc.blogspot.com/2007/07/andrew-wakefield-mmr-autism-and-gmc.html

    Then run a search for “Wakefield” on the same blog…

    http://nhsblogdoc.blogspot.com/search?q=wakefield

    The guy who keeps this blog is an excellent writer and his science & skepticism are VERY sharp.

  8. theoon 23 Dec 2008 at 8:15 am

    I think this point you made is poignant: “Anti-vaccine hysteria, however, hampers effective vaccine safety by diverting attention and resources to false claims.”

    Not just with vaccines but also dealing with autism. A great example is McCarthy’s claim that she “cured” her son. Most likely she had no effect and his “improvement” was simply natural cognitive development (autism isn’t static after all) and she fell for the regression fallacy. Of course, there’s always the chance she actually hampered his development with whatever pseudoscientific treatment she opted for, and he would be completely cured if she’d done nothing! Or maybe it did help. There’s no way of knowing, either way.

    Even if you knew nothing about vaccines or autism specifically. Just watching McCarthy et al. on Larry King live would be enough to know their side is off base. I can’t recall seeing so many fallacies in such a short period of time. False Cause/Correlation Error, Regression Fallacy, Burden of Proof, Stacking the Deck, False Dichotomy, Argument from Ignorance, Wishful Thinking, Impugning Motives, Browbeating, the list goes on… You could get almost 20 “Name that Fallacies” just from this one interview. (I’ve made a start: http://www.skepticsfieldguide.net/search/label/Jenny%20McCarthy but I’ve run out of steam!)

    They don’t understand what a hypothesis is. They think “hypothesis” is a synonym for “conclusion”… They also don’t understand that the plural of anecdote is not data. McCarthy literally says this on Larry King: “Thousands and thousands of mothers saying so is scientific evidence!” she yells.

    Also, we skeptics keep “defending” vaccines and letting the vaccine cause autism brigade set the agenda. A suggestion might be to simply dismiss this claim and then say, “I don’t want to talk about this because it’s not an interesting area of research in autism. It hasn’t yielded any fruitful results. What has however is… (and then head to the wikipedia entry on autism: http://en.wikipedia.org/wiki/Autism#Causes). I.e. we allow them to Stack the Deck and spend 99% of the time discussing the now discredited vaccine hypothesis, and just mention the genetic and other potential environmental factors off hand. If the discussion was weighted with a 1:1 ratio with the leading areas of potentially rewarding research, we’d mention the vaccine hypothesis off hand only.

  9. theoon 23 Dec 2008 at 8:36 am

    @Will.
    I’m no expert on the HPV vaccine, but similar anecdotal reports came out here (Australia) when Year 9 students (14 years) were given it. MAny symptoms smacked of the nocebo effect: en.wikipedia.org/wiki/Nocebo. That’s not to say there couldn’t be a problem, but if getting a jab in the arm didn’t cause some people some problems, that’d be really weird.
    Also (and I don’t like to impugn motives, but) I some underlying reasons for objection are due to the bizarre logic that girls will now have more unprotected / premarital sex if they are vaccinated…

  10. Oracon 23 Dec 2008 at 10:20 am

    Of course, aiding and abetting the antivaccine movement are doctors like Dr. Jay Gordon and television shows like The Doctors.

    It’s the old “balance” fallacy. In politics “balance” is usually a good thing. In science, there are right and wrong answers. However, science television and journalists can’t resist presenting “both sides” of an issue, even when one side is strongly supported by science and the other side is a fallacy-laden load of pseudoscientific drivel.

  11. rlindgrenon 23 Dec 2008 at 8:35 pm

    I think most of the people talking about this topic (including you Dr. Novella) have missed the critical point that has given the Jenny McCarthy’s their weight on this issue. As a parent of a child with Autism I see pragmatically that McCarthy is the worst thing that can happen as she draws attention and money away from those that are in the position to actually help. But that is precisely was families effected with Autism crave but have received little help from the medical community as a whole. There is plenty of research going on….I get that. But as a parent I need solutions TODAY for my daughter with Autism and answer on what to do TOMORROW on how to prevent Autism in our newborn son. Credible science based answers to these questions are simply lacking from the medical community right now. I have heard too many times “there is no evidence…” and “keep doing what you are doing …”. None of these answers come with the understanding of Autism’s causes and effective treatments. Until those issues can be addressed the McCarthy’s will always be winning the argument. She can be debunked day in and day out but answering her with “you are wrong as shown is study ABC” but providing no viable alternative is, as any debater knows, a loosing argument.

    Autism is an extremely frustrating problem to deal with. Insurance companies steadfastly refuse to cover any treatments or therapies, the medical community offers very few solutions (and frankly can barely agree on how to diagnose, don’t know if it is genetically based, a biological problem, or caused by some environmental influence), and it is emotionally and financially draining. Our daughter is in ABA and speech therapy six days a week. While these are the generally accepted treatments, there is limited evidence that these will be effective in the long term.

    My point here is that while McCarthy is detestable for her anti-virus stand, parents are desperate to help their kids and the medical community needs to step up with better solutions. That is the only was truly help.

  12. Scott D.on 23 Dec 2008 at 11:41 pm

    This American Life had a piece on the effects unvaccinated children have on communities.

    it starts at 14 minutes:
    http://www.thislife.org/Radio_Episode.aspx?episode=370

  13. Steven Novellaon 24 Dec 2008 at 1:04 pm

    rlindren,

    I appreciate your position as a parent of an autistic child. But I disagree with your logic. Of course the medical community needs to continue to improve our understanding of autism and how to treat it. But there is very active research going on, including research into practical management.

    You seem to be committing the argument from final consequences – we need a solution, therefore give us one. If you don’t give us one, it is because you don’t care or are not trying hard enough. And further, we will listen to anyone offering a solution, whether or not it is valid.

    But the medical community is already offering the best that is out there, while working on better solutions. It’s not as if they are holding back. And unfortunately you cannot simply wish a scientific solution into existence because you need one.

    If you want better solutions, the support legitimate scientific research, and oppose the activity of cranks like McCarthy who are diverting time and attention away from real solutions.

  14. [...] NeuroLogica Blog » Skeptical Battlegrounds: Part IV – Anti-Vaccine … [...]

  15. HCNon 24 Dec 2008 at 8:55 pm

    rlindren, the focus on vaccines distracts from the real research. It wastes resources and makes children vulnerable to the real infections which can cause other more serious disabilities.

    Here is a link to the Autism Research Network:
    http://www.autismresearchnetwork.org/AN/

    I live near one of the universities listed. It includes an Experimental Education Unit which conducts real research in educating autistic students (it used to focus on Down Syndrome twenty years ago). It is also contains a real functioning preschool/kindergarten providing classroom experience (sometimes with “normal” children as models), OT/PT and speech therapy. There is no cost to attend the preschool (at least the last time I looked).

    We did not use it, but one son did get very low cost speech therapy from the speech and hearing clinic. The therapy was provided by students, under the direct supervision of the professors. I know very well the limitations of insurance coverage for therapies (we were not able to buy a van until oldest son “graduated” from private therapy when he was about 13 years old).

    Good luck, it is lots of work. Also, it takes a long time. My 20 year old son attended community college with disability services.

  16. jonathan xon 03 Jan 2009 at 11:32 pm

    Dr Novella,
    having read your articles about the “anti-vaccination” movement I am somewhat perplexed over some of your conclusions/statements.

    As I understand it you have an animated discussion in the US about:
    1) do certain vaccines per se cause neurological disease (specifically autism spectrum disorders)?
    2) does mercury (contained in vaccines) cause neurological disease (specifically autism spectrum disorders)?

    In your rebuttal of these claims (1,2) you make several claims of your own that cannot but raise my ‘skeptical hackles’.

    Let me first digress a moment and state my stance: I am pro vaccination and my children are vaccinated and not autistic (although one of my colleagues is), but I am severely skeptic against claims of mercury not causing adverse reactions at “low levels”.

    Which statements of yours do I then have reservations against?

    A) Ad hominem attacks certainly do not make converts nor lend weigth to your arguments. E.g. “anti-vaccine cranks”, “Only the most rabid (or scientifically illiterate) anti-vaccine fanatics still cling to the thimerosal claim”, “just as scientifically clueless”, “relentless in spreading her scientific illiteracy and fear mongering” etc. etc.

    B) Sweeping claims that thimerosal (“…thimerosal in particular, do not cause autism”) or any other substance used in vaccines are safe. In most cases research is inconclusive/inconsistent (18) and you seem to argue in part from personal incredulity rather than scientific evidence. And this little gem: “Anti-thimerosal hysteria therefore also threatens the health of children in poor countries.” Is it ‘argument from final consequences’ or ‘confusing association with causation’ or maybe a ‘false continuum’ or hmmmm…

    C) Inconsistency. You state that “Mercury is still on the list, but they have added aluminum, which is added to vaccines to make them more effective.” (BTW one of the claims made for thimerosal) but present no evidence that aluminum or mercury improve the “effectiveness” of the immune reaction in any helpful way. *To do this double blind studies of vaccinated and not vaccinated children need of course to be done*, and I frankly doubt they ever will. Studies do actually suggest that the opposite may happen: that e.g. an auto-immune reaction may be precipitated. If this is because of the child receiving the thimerosal (or mercury in any form) or the mother or both is not clear (3-4) and (5) suggesting other patways. So despite Hviid et al (6) and Madsen et al (7) the question of thimerosal etc combined with a vaccine is still unsettled.

    A fascinating review, that, albeit indirectly, suggest possible mechanisms for maternal (or even grand-maternal for that matter) causes is given by Mehler (8).

    D) Animal models of mercurotoxicity are completely ignored in your discussion, despite being of great interest as they suggest various possible paths for mercury induced neuropathologies related to mothers and babies. E.g. Vas and Monestier’s (9) overview may be of interest. To quote them and sum up: “In genetically susceptible mice or rats, subtoxic doses of mercury induce the production of highly specific autoantibodies as well as a generalized activation of the immune system.” The key here is genetically suscpetible. (An interesting overview of “studies of genetic variation in susceptibility to cytokine-related brain damage” is btw given by Dammann and O’Shea (10).)

    That certain individuals are at risk from vaccination is certainly not news (11-13). Despite that, mercury, aluminum etc “adjuvants” are used, regardless of the absence of proof of their safety (absence of proof is not proof of absence…).

    E) I especially liked your comment that “Meanwhile, evidence is accumulating that autism is largely a genetic disorder (Szatmari 2007). This by itself does not rule out an environmental factor…” and then you proceed to ridicule those you despise(?) for putting forth environmental causes: “Those who argue for the link have put forth increasingly desperate notions. Kirby has argued that mercury from cremations was increasing environmental mercury toxicity.”
    Actually a coming paper by Abedi-Valugerdi (14) “suggest that long-term exposure to certain environmental factors can activate the immune system to produce autoimmunity per se, without requiring specific susceptible genes” and a paper by Palmer et al (15) has “found that for every 1000 pounds of
    industrial [mercury] release, there was a corresponding 2.6% increase in autism rates (p

  17. jonathan xon 03 Jan 2009 at 11:37 pm

    cont. from previous post

    industrial [mercury] release, there was a corresponding 2.6% increase in autism rates (p

  18. jonathan xon 03 Jan 2009 at 11:39 pm

    cont.

    industrial [mercury] release, there was a corresponding 2.6% increase in autism rates (p less than .05) and a 3.7% increase associated with power plant emissions(P less than .05)…”

    Hmm, let’s see a genetic disorder mainly triggered by pollution… maybe more like normal humans affected by an abnormal environment!

    F) You also state that “the autism “epidemic” probably does not represent a true increase in the disorder, but rather an artifact of expanding the diagnosis (now referred to as autism spectrum disorder, ASD) and increased surveillance (Taylor 2006)” and fail to mention that e.g. Rutter (16) and Newschaffer (17) assert that it is not possible to definitively ascertain this.

    Contradictory evidence? You bet, put not quite as you mean.

    Yes I am aware that this rambling rant contain a certain level of, uhm, sarcasm, but I expect better arguments and certainly a sound skepticism against the sources you cite and not just some cherry-picking to bolster your position.

    You may have noticed that I do not attack you conclusions about vaccination, just certain aspects of your argumentation.

    Regards,
    Jonathan X

    (1) Novella, Skeptical Battlegrounds: Part IV – Anti-Vaccine Hysteria, retrieved jan 3rd 2009 2255 GMT
    (2) Novella, Vaccines & autism: Myths and Misconceptions, Skeptical Inquirer magazine, Nov/Dec 2007
    (3) Cohly HH, Panja A. Immunological findings in autism, Int Rev Neurobiol. 2005;71:317-41.
    (4) Mutter J et al, Mercury and autism: accelerating evidence?, Neuro Endocrinol Lett. 2005 26(5):439-46.
    (5) Theoharides TC et al. Novel therapeutic targets for autism. Trends Pharmacol Sci. 2008 Aug;29(8):375-82.
    (6) Hviid A et al. Association between thimerosal-containing vaccine and autism. JAMA. 2003 1;290(13):1763-6.
    (7) Madsen KM et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 112(3 Pt 1):604-6
    (8) Mehler MF. Epigenetic principles and mechanisms underlying nervous system functions in health and disease. Prog Neurobiol. 2008 86(4):305-341.
    (9) Vas J, Monestier M. Immunology of mercury. Ann N Y Acad Sci. 2008 1143:240-67.
    (10) Dammann O, O’Shea TM. Cytokines and perinatal brain damage. Clin Perinatol. 2008 35(4):643-63
    (11) Kingsley JD et al. Immunizations for patients with metabolic disorders. Pediatrics. 2006 Aug;118(2):e460-70.
    (12) Brady MT. Immunization recommendations for children with metabolic disorders: more data would help. Pediatrics. 2006 118(2):810-3. (Definitively more sensible than shrill Offitt.)
    (13) Weissman JR et al. Mitochondrial disease in autism spectrum disorder patients: a cohort analysis. PLoS ONE. 2008;3(11):e3815
    (14) Abedi-Valugerdi M. Mercury and silver induce B cell activation and anti-nucleolar…in connection with autoimmunity? Clin Exp Immunol. 2009 155(1):117-24.
    (15) Palmer RF, Blanchard S, Wood R. Proximity to point sources of environmental mercury release as a predictor of autism prevalence. Health Place. 2009 15(1):18-24.
    (16) Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr. 2005 94(1):2-15
    (17) Newschaffer CJ, Investigating Diagnostic Substitution and Autism Prevalence Trends, Pediatrics 2006; 117(4):1436-7.
    (18) Hughes JR. A review of recent reports on autism: 1000 studies published in 2007. Epilepsy Behav. 2008 13(3):425-37.

  19. jonathan xon 03 Jan 2009 at 11:43 pm

    Note: FYI the less than sign (originall shown between ‘p’ and value) causes truncation.

    /JX

    PS below follows a test of a common escape sign (slash and backslahs) to see if the ‘less than’ sign is accepted

    /

  20. jonathan xon 06 Jan 2009 at 2:15 pm

    Gripe part 2 :-) about:
    “…permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim.”

    Are you surprised they do? You want to convince with reason but end up ramming vituperative authority down their throats! Yes, scientifically uneducated, whom can both have no schooling or impressive degrees, can be hard to convince, especially about having to wait for clearcut evidence (which can take decades), but just calling them stupid won’t help.

    So, what’s wrong and correct with your statements above

    1) Not effective
    Quite a semantic question. What do you and they mean by effective?
    a) Less childhood infections in said diseases? aka your 2
    b) Less complications from vaccinations than full-blown infection? aka your 3
    c) Something else?

    In a) we can safely conclude that, yes, evidence is overwhelmig.

    In b) on the other hand we cannot as evidence goes both ways (GBS, rabies DEV, YEL-AVD, YEL-AND etc vs. IOM reports). Indirect human experiments have been done (mass vaccination campaigns), but since, to my knowledge, no analysis of pre- and post-vaccination occurence of neurological disorders has been done of “vaccination naive” populations, no data is available in this case too. We can only conclude that overt more or less immediate effects are not known, but not that long term effects can be excluded. Be those neurological or sub-par immunological “activation” or disruption of the human microbiome or something else.

    2) Reduced or eliminated infectious disease
    See 1a) above.

    3) Not safe
    See 1b) above.

    4) Pointless to discuss. When lots of money or prestige or careers are at risk to be lost debates tend to be uni-dimensional monologues concocted by preconcieved notions and prejudice, while proof go out the window with the garbage.

    About moving on to new claims.
    As the debate begun by pointing at thimerosal (thiomersal) is not solved due to other known neurotoxic substances being added to vaccines (eg. aluminum compounds and phenol(1)) we cannot say. While a vociferous group claims it is unsafe and an equally vociferous group claims poison is good for you (sorry I meant an adjuvant is good for you) nothing will be settled until serious science without prejudice is done.

    Whining about “anti-vaccine cranks” moving on to next claim is pointless as long as you do not realise that exchanging one possible toxin with another and then telling the “cranks” to shut up it is safe, hardly will be conducive to serious debate nor serious skepticism.

    Genetic autism
    Somewhere along reading your blog posts I noticed that you believe a strong genetic component has been proven in autism. You just miss one point: just because you do not have the genetical ability to grow back your leg it is not a
    genetic disease to not be able to regrow a leg. Although incidence rates of chopped off legs are so low that it should be considered a genetic disease… (hmm I can probably exchange leg with diabetes and CVD, see e.g. the Kitava study (2) for a comparison of some conditions with “the west”)

    What I wish to stress is that if the environment is causing abnormal number of disorders, the environment that should also be “cured” if we ever wish to remove the source of disease. And that regardless if said environment is contained in a syringe or comes in the form of a polluting industry.

    (1) Grandjean P, Landrigan PJ. Developmental neurotoxicity of industrial chemicals. Lancet, 2006 368(9553):2167-78. Review including list of over 200 known neurotoxic ubstances.
    (2) http://www.staffanlindeberg.com/TheKitavaStudy.html (this is great skeptic work btw)

    Addendum
    In a very very strict sense everything is genetic, so trying to medicate away all the health effects our modern environment and lifestyle is not always reasonable. Sure you can call it evolution at work and do nothing. Who knows, maybe humanity will then end up as resistant as rats and cockroaches and still intelligent. But that would be a pretty cynical way to go.

    Addendum 2
    “Children should not be ingesting food containing neurotoxic pesticides. Many pesticides are made specifically to destroy insects’ nervous systems.

    Unfortunately, humans have a biochemistry very similar to insects.

    This makes human brain development sensitive to the pesticides, and the consequences are serious in this age of technology, where we – and future generations – must rely on optimal brain functions. When something goes wrong in the child’s brain development, it is damaged forever, you do not
    get a second chance to build a brain”
    Professor P Grandjean, adjunct professor of Environmental Health at Harvard University and expert on children’s environmental health at the WECF lunch at the European Parliament 7th of October 2008.

    Addendum 3
    I recommend parents check this site http://www.cosmeticsdatabase.com/special/parentsguide/ingredients.php?nothanks=1.

  21. [...] Another slice of awesomeness is Steve Novella (from Skeptics’ Guide to the Universe), a practicing MD and blogger of some repute. He is more, well, medicinal when he writes about vaccination, but his writing is no less damning of antivax nonsense. [...]

  22. Astrology | 2012xFactoron 11 Jan 2009 at 12:03 pm

    [...] Another slice of awesomeness is Steve Novella (from Skeptics’ Guide to the Universe), a practicing MD and blogger of some repute. He is more, well, medicinal when he writes about vaccination, but his writing is no less damning of antivax nonsense. [...]

  23. [...] NeuroLogica Blog » Skeptical Battlegrounds: Part IV – Anti-Vaccine Hysteria There is a dedicated fringe anti-vaccine movement. They are dedicated to some permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim. [...]

  24. DEon 16 Jan 2009 at 11:31 am

    Parents of autistic kids are particularly vulnerable to snake oil salesmen. Its driven by despair, and they need help. A fairly natural response to the sort of devastation brought by autism is to try to blame something. So far, its been vaccines, thimerasol, and on and on…

    The Government needs to take more of an active role. Causes of autism are unknown. Few good techniques to help autistic kids are known. And autism deeply affects 1 in 150 or so kids. When the sense of urgency and funding match the crisis, and when results start to flow from the work, fewer nutcases will grow out of the despair.

    I have two questions for you.

    - Where is the documented harm? Ms. McCarthy and others are wrong, but I don’t see spikes in Polio, Mumps, Rubella or other diseases. This attitude can only go so far, but you match their hyperbole and that isn’t helpful either.

    - They aren’t interpreting the science correctly, but maybe you could cut the parents some slack wouldn’t hurt?

  25. HCNon 16 Jan 2009 at 12:46 pm

    DE said ” Where is the documented harm? Ms. McCarthy and others are wrong, but I don’t see spikes in Polio, Mumps, Rubella or other diseases. This attitude can only go so far, but you match their hyperbole and that isn’t helpful either.”

    Then you have not been paying attention. There have been spikes in mumps (a couple of years ago it went through the American Midwest causing at least four people to become deaf, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5520a4.htm), then there was the infamous spike of measles last year (including the one where the idiot unvaccinated family went to Switzerland, brought back a kid with measles and then infected a bunch of infants in a doctor’s waiting room), plus the deaths of infants from pertussis has been increasing over the past few years due to the erosion of herd immunity by folks like Jenny McCarthy and friends.

  26. quiacton 23 Feb 2009 at 10:05 am

    Thoughts Regarding Autism Spectrum Neurodevelopmental Disorders

    Of these rare neurological dysfunctions, Autism is the most common of these passive developmental disorders. Autism is a disability that is suspected to be caused possibly by a brain development disorder of unknown cause, yet some suspect the cause is some sort of neurological dysfunction- possibly with a genetic predisposition. Autism is about 3 times more common in males than females as well.
    Usually, symptoms of the disease present themselves before the toddler reaches the age of three. Before Autism was more understood, others inaccurately labeled autistic people as childhood schizophrenia or as having a psychosis or mental retardation.
    Symptoms of the autistic patient included limited or dysfunctional social and personal or intimate relationships with others, their intelligence is affected, and the autistic person typically is adverse to change. Also, the autistic person tends to be compulsive and prefers to be alone. They lack eye contact as much as physical contact with other people.
    Out of over two dozen diagnostic criteria utilized for these disorders, eight must be present to be considered autistic, according to the DSM. As with all passive developmental disorders, the person expresses language, social, and behavioral difficulties.
    Treatment includes what are called psychotropic medications that delay the progression of the disorder, as well as relieve some of the symptoms of one who is autistic. Behavioral therapy is common as a treatment regimen as well. Boys get Autism much more than girls.
    Then there is the controversy between many who claim that thimerosal- a preservative containing mercury, which is a neurotoxin that was used in vaccines until 2001, was the catalyst for autism in children.
    Over 5000 lawsuits have been filed because of this belief, and some have been successful for the plaintiff. Yet most agree the correlation between thimersal and autism is void of scientific merit. Furthermore, the cases of autism have not decreased since the preservative was discontinued in 2001.
    Aside from Autism, the other four passive developmental disorders are known as autism spectrum disorders.
    Asperger’s Syndrome is more common than autism, and the symptoms are milder, as there is minimal delay in language abilities, if at all. What is expressed with Asperger’s syndrome is mild autistic symptoms. In time, the patient may express atypical personality disorders, though.
    While intelligence is within normal limits with the Asperger’s patient, social interactions and abilities preset difficulty for such a patient. As with Autism, medications and behavioral therapy are treatment regimens with one with this syndrome
    Rett’s Syndrome or disorder presents with not only atypical behavior, but also suffers from restricted physical growth and movement. There is cognitive and social impairment as well. The disorder affects mostly girls, and the cause is due to a gene mutation.
    Childhood Disintegrative disorder is rare, and is 10 times less common than autism. The disorder has a late onset with mild autistic symptoms. The disorder affects mostly boys, and regression is sudden and possible with this disorder. Skills lost with this disorder may be language, social, self-care, as well as play or motor skills. Decreased function or impairment with this disorder may include social skills and behavioral flaws. Central Nervous System pathology is a suspected cause of this disorder.
    Finally, there are passive development disorders that are not otherwise specified. This may include atypical autism, for example. Yet as with the rest of types of these disorders, the symptoms vary in their frequency and intensity, as well as the range of abilities of these developmental disorders vary widely as well.
    Medicinal treatment is believed to be not necessary for the management of the autistic person. However, cognitive and behavioral therapy prove to be most beneficial for all the different types of Passive Development Disorders that unfortunately exist for unknown reasons, yet further research should be done to discover both the etiologies as well as more effective treatment for the Autism Spectrum.
    http://www.autism-society.org
    http://www.medicalnewstoday.com/articles/139183.php
    Dan Abshear

  27. [...] is Vaccines, which clear germs up quick, But some folks don’t like them, they fight little [...]

  28. [...] and spoken about it at length in very large venues like Oprah’s and Larry King’s shows, but her claims are wrong. Worse, they’re dangerous: by claiming vaccines are dangerous, she is scaring parents into [...]

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