Maybe David Kirby, author of Evidence of Harm and one of the major proponents of the notion that thimerosal in vaccines was largely responsible for the recent increase in autism diagnoses, is sincere when he claims he is not anti-vaccine. I say that because he has backed so far off from his stance that vaccines are the culprit – not completely, and without overtly acknowledging his past errors, but has put some significant distance between him current position and his prior certainty.

In his 2005 book Kirby asks the question:

Did the injection of organic mercury directly into the developing systems of small children cause irreparable harm? It’s a plausible proposition, and a hugely important question. If the answer is affirmative, someone will have to pay to pick up the pieces.

He coyly insists he was just asking questions, but the book makes a strong and, in my opinion, one sided case that there is “evidence of harm” – specifically evidence that thimerosal was a major contributor to autism. It also builds a case for a grand conspiracy to hide this fact from the public. Kirby then made a career out of promoting the notion of a link between vaccines and autism with government and professional malfeasance. He became a hero of the anti-vaccine movement.

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In response to my blog post on Monday, David Kirby wrote a response in the Huffington Post and Dr. Jon Poling (father of Hannah Poling) wrote an open letter to me, placed in the comment section and posted at Age of Autism. It seems only polite that I respond to their kind attention.

The primary focus of my original post (which I further developed yesterday) was that the media is focusing too much attention on what celebrities and politicians are saying about the controversy surrounding the discredited notion that vaccines are a significant cause of autism. Over the past year Jenny McCarthy (now joined by her boyfriend Jim Carrey) has become the major spokesperson for a movement that, at its core, is anti-vaccine and is dedicated to the scientific opinion that vaccines are toxic and cause autism. Recently actress Amanda Peet joined the fray, professing her belief that vaccines are safe, are not associated with autism, and that parents who do not vaccinate their children are “parasites” for depending on other parents who do. (She later apologized for that remark, calling it “divisive”.)

While I appreciate Amanda Peet’s support, I feel strongly that scientific questions should be handled by the scientific community. Celebrities are great when they support causes – but when they second guess the scientific community and decide to advocate for their own scientific conclusions, they are more likely to cause harm than good. Continue Reading »

We predicted it, and it has come to pass. Now that the evidence has laid to rest the dubious claims that thimerosal in vaccines causes autism, the antivaccine crowd is already planning the next phase of their pseudoscientific attack on vaccines. In a recent Huffington Post article, David Kirby writes:

But if thimerosal is vindicated, or shown to be a very minor player, then what about other vaccine ingredients? And what about the rather crowded vaccine schedule we now impose upon families of young children? And what about reports of unvaccinated children in Illinois, California and Oregon who appear to have significantly lower rates of autism? Shouldn’t we throw some research dollars into studying them?

At least now Kirby is admitting defeat on the thimerosal issue. He writes:

Finally, to all those who are going to post comments about the autism rates in California not coming down, following the removal of thimerosal from most vaccines: You are right. The most likely explanation is that thimerosal was not responsible for the autism epidemic. But that does not mean that it never harmed a single child.

Considering how shrill Kirby was in insisting that thimerosal was the cause of autism, including all the cries of conspiracy and malfeasance, this is quite an admission. It also should make a reasonable person wonder why Kirby should be taken seriously at all. But Kirby is not quite ready to give up on thimerosal completely. He is still holding out that future data will show thimerosal played some role, and he claims that we won’t really know the effects of removing thimerosal until 2011 (even though previously he was citing 2007 as the date).

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RFK Jr., who is now running for the Democratic presidential nomination, is anti-vaccine. He will vehemently deny this, but I don’t buy it for a second. He is simply playing the, “I’m not anti-vaccine, I am pro-safe vaccine” gambit, which is disingenuous and always has been. We have been covering this topic for years, and David Gorski did a recent excellent review of this at SBM. You can’t claim not to be anti-vaccine, and then defend a long list of anti-vaccine tropes.

RFK has apparently been avoiding his views on vaccines on the campaign trail, but it always seems to come up. On the Joe Rogan podcast RFK found what he must have thought was a friendly environment, and felt free to repeat is claim that vaccine cause autism. This is a topic I have been covering for two decades – vaccines do not cause autism. But let’s do a quick review of this harmful claim.

This first appeared in the 1990, when the anti-vaccine movement hit upon the increase in autism diagnoses as a new tactic. They start with the assumption that all bad things that happen to children are caused by vaccines, so obviously they must also be causing the rise in autism. When Andrew Wakefield came out with his fraudulent and now retracted study claiming an association between the MMR vaccine and autism, he became an instant celebrity of the anti-vaccine movement. Trouble is – the MMR vaccine does not cause autism. Wakefield, it turns out, had a patent on an alternative vaccine and was trying to torpedo the competition. But the anti-vaccine movement does not let science, evidence, or basic logic get in their way. So they simply moved over to a vaccine ingredient, thimerosal, which is a mercury-based preservative.

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I gave a talk on the vaccine controversy over the weekend. I was not surprised that a couple of audience members had a lot of questions taken directly from anti-vaccine propaganda sites. What was interesting was that they were still pushing the idea that thimerosal, a mercury-based vaccine preservative, is linked to autism.

The reason this is interesting and illuminating is that the thimerosal hypothesis is not just mostly dead, it is most sincerely dead. It is pushing up the proverbial daisies.

A Brief History of Thimerosal

Thimerosal was developed as an organomercurial anti-microbial agent shortly after World War I. It was soon discovered that it has great anti-microbial properties and was well tolerated when injected into rabbits or rats even at high doses. This made it superior to anything else available at the time.

Bacterial contamination was a serious problem for vaccines in the first half of the 20th century. Thimerosal in tiny doses, well below safety limits, proved to be an effective agent for preventing contamination. By the 1940s thimerosal was being added to several vaccines for this purpose.

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One common feature of unscientific belief systems is that they do not change in the face of new evidence. They tend to evolve like cultural beliefs or marketing campaigns, but do not appear to be affected by scientific evidence in any meaningful way.

One great example of this is the idea the autism is linked to vaccines (to be clear up front, it isn’t) This idea had a few important factors in its origin. The first was simply the existing anti-vaccine movement searching for anything to blame on vaccines. The second, and perhaps decisive, factor was the now discredited and withdrawn study by Andrew Wakefield linking autism to the MMR vaccine.

Even as the MMR claim was dying, the anti-vaccine community was moving onto the next target – mercury (specifically the preservative Thimerosal). This was the target of the book Evidence of Harm by David Kirby. This also created common cause between the anti-vaccine movement, and separate “mercury militia” blaming many modern ills on mercury, and some environmentalists (most prominently Robert Kennedy Jr.) who are keen to blame medical problems on any environmental exposure, including mercury and/or vaccines.

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We can add one more study to the pile of evidence showing no association between exposure to thimerosal (a mercury-based vaccine preservative) and autism. The article: Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism, is published in the latest issue of Pediatrics, and shows no association between prenatal and infant exposure to thimerosal and three forms of autism – autism, autism spectrum disorder, and regressive autism.

No one study can ever be definitive, but now we have a large body of evidence from multiple studies showing a lack of association between thimerosal and autism. This won’t stop the dedicated anti-vaccinationists and mercury militia from continuing their anti-vaccine propaganda, but hopefully it will further reassure those who actually care about the science.

Background

This has been a long and complex story, so let me review some of the background. Diagnosis rates of ASD have been climbing for the last 20 years, prompting some to search for an environmental cause. The existing anti-vaccine community, not surprisingly, blamed vaccines. This was given a tremendous boost by the now-discredited study by Andrew Wakefield concerning MMR (which never contained thimerosal) and autism. When the evidence was going against MMR as a cause, attention turned to thimerosal in some vaccines. This notion was popularized by journalist David Kirby in his book, Evidence of Harm.

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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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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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Two recent studies concerning the prevalence of autism in the US have been getting a lot of attention, because they indicate that autism prevalence may be higher than previously estimated. This, of course, fuels the debate over whether or not there are environmental triggers of autism.

One study was conducted by the CDC but has yet to be published. The results were announced ahead of publication by the US Health and Human Services Secretary Kathleen Sebelius to the autism community. She reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000.

The second study was published in the journal Pediatrics and is a phone survey of 78,037 parents. They asked if they had any children who had ever been diagnosed with an ASD. Here are the results:

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