I had written previously about the plight of Kathleen Seidel, from the neurodiversity blog, who was the target of an inappropriate subpoena that was little more than blatant harassment. Kathleen filed her own motion to quash the subpoena, and now she reports that her motion was granted – the subpoena is quashed. Congratulations.

Last month I wrote about John McCain’s ignorant parroting of the false claims for an autism epidemic and a possible link to vaccines. I had mentioned at the time that Hillary Clinton had also made some pandering remarks, such as that she is, “Committed to make investments to find the causes of autism, including possible environmental causes like vaccines.”

Orac now gives us an update on the situation. About Hillary he writes:

And when asked if she would support a study of vaccinated vs. unvaccinated children, she said: “Yes. We don’t know what, if any, kind of link there is between vaccines and autism – but we should find out.”

A month ago I praised Obama for having a scientific statement about vaccines on his website. But now he has descended into pseudoscientific pandering, stating:

“We’ve seen just a skyrocketing autism rate. Some people are suspicious that it’s connected to the vaccines. This person included. The science right now is inconclusive, but we have to research it.”

There appears to be no science-friendly candidate left, at least on this issue. The current disconnect between science and politics is very disturbing.

Addendum: This video of Obama making the above comments clearly shows that when he said, “This person included.” he was not referring to himself but someone in the audience. However, his later comment about the science being “inconclusive” is inaccurate.

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Note: On Wednesdays I also post over at Science-Based Medicine.

No. But David Kirby and other anti-vaccinationist ideologues and members of the so-called mercury militia would like you to think so. For background, the Autism Omnibus refers to a set of hearings before the Vaccine Injury Compensation Program regarding claims by about 5000 parents that their childrens’ autism was caused by vaccines. These claims are primarily based upon the various hypotheses that the MMR vaccine, or thimerosal in some vaccines (but not MMR), or the combination of both, is a cause of autism.

So far there have been hearings, but only one final decision. In November the US government settled one case in favor of the petitioner. This is the case those who have supported the failed hypothesis that vaccines cause autism now point to as admission that they were right all along (or at least as a means of stoking the flames of fear about vaccines.) But the US government did not admit vaccines cause autism – they conceded one case that is highly complex and not necessarily representative of any other case and cannot be reasonably used to support the vaccine/autism connection.

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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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I and some other medical science bloggers have spent much time addressing the claims of antivaccinationists and those who attempt to link vaccines and autism. This is because they are engaged in nothing less than an all out campaign to eliminate vaccines. They seem to be driven by ideology and fear, their tools are misinformation, lies, and logical fallacies, and they have been tireless in waging war against vaccines. On their side are dubious and discredited scientists, misguided celebrities, naive or scaremongering politicians, and families who range from sincere but misinformed to ideological true believers. This antivaccination movement overlaps considerably with those who are anti-science or anti-scientific medicine (promoting instead some form of “alternative” medicine). They also enjoy much support from anti-government conspiracy theorists.

Standing against these forces are those few scientists who take the time to confront their claims and set the record straight – mainly through blogs and the occasional article. Government agencies, like the CDC, try but have been fairly ineffective (and sometimes counterproductive) in the PR department. Mainstream scientists and scientific organizations have been doing good research and promoting good science and medicine, but have shied away from confronting the antivaccine cranks directly (sometimes because of direct intimidation).

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The latest issue of the Skeptical Inquirer features a cover article on vaccines and autism by yours truly. I have written quite a bit about this issue over the last year on this blog, and the article is a good compilation of everything I have written, and brings the reader up to date on this issue.

But of course the world of print media grinds much more slowly that the blogosphere. I wrote the article about three months ago and already there have been developments in the vaccines and autism story. As I wrote about in September, a large study conducted by the CDC was published and showed that use of thimerosal does not correlate with any adverse neurological outcome. The study did not look at autism specifically, but at a long list of neurological symptoms. A similar study looking at thimerosal and autism is under way and should be published next year. The mercury militia, true to form, completely misrepresented this negative study, claiming against the evidence that it showed a correlation.

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A new study just published in the New England Journal of Medicine, Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years, does not support a correlation between mercury in vaccines and neurological damage. It adds to the growing evidence that vaccines are safe and they do not cause neurological disorders. This study did not look at autism (a study that will be published next year looks, again, at vaccines and autism), but the mercury-causes-autism crowd are still unhappy with the results.

I have been following this issue closely for several years. Although my awareness of the issue goes back much farther, I started to seriously research the claim that the MMR vaccine, or that thimerosal in other vaccines, causes autism while researching an article on the topic for the New Haven Advocate. As a physician (a neurologist) and a skeptical activist I knew I had to get this issue right. I certainly did not want to falsely stoke the flames of public fear, nor did I want to cast myself in the role of denier.

Early on in my research I really did not know which way I was going to go with the issue. Should my bottom line be that there is real reason for concern here, that there is nothing to the claims, or that we really don’t know and will have to just wait for further research? But after reading through all the claims on both sides, and all the research, it was an easy call – vaccines, and specifically the MMR vaccine and thimerosal, do not cause autism, and the alleged autism “epidemic” is likely just an artifact. Those claiming there is a connection were drowning in conspiracy thinking, logical fallacies, and blatant pseudoscience. Meanwhile every piece of reliable clinical data was pointing in the same direction – no connection.

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Despite a critical lack of supporting epidemiological evidence, there are those who cling to the belief that mercury found in the vaccine preservative thimerosal is an important cause of autism and is responsible for the recent epidemic increase in this diagnosis. Never mind that this epidemic is probably mostly or even entirely an artifact of increased efforts at diagnosis while simultaneously broadening the definition (reflected in the new terminology of “autism spectrum disorder” or ASD).

The argument was based on the assumption of causation from correlation: primarily in the 1990’s the number of routine childhood vaccines was significantly increased. During this same time the number of ASD diagnoses increased dramatically as well (from 1-3 to about 15 cases per 10,000, although the true incidence is probably between 30-60 per 10,000). It would be reasonable to draw from this the hypothesis that maybe there is a causal link between the two – but there are those who drew the conclusion that there must be a link – and that was their folly.
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How much does the public trust in science and scientists? Well, there’s some good news and some bad news. Let’s start with the bad news – a recent Pew survey finds that trust in scientist has been in decline for the last few years. From its recent peak in 2019, those who answered that science has a mostly positive effect on society decreased from 73% to 57%. Those who say it has a mostly negative effect increased from 3 to 8%. Those who trust in scientists a fair amount or a great deal decreased from 86 to 73%. Those who think that scientific investments are worthwhile remain strong at 78%.

The good news is that these numbers are relatively high compared to other institutions and professions. Science and scientists still remain among the most respected professions, behind the military, teachers, and medical doctors, and way above journalists, clergy, business executives, and lawyers. So overall a majority of Americans feel that science and scientists are trustworthy, valuable, and a worthwhile investment.

But we need to pay attention to early warning signs that this respect may be in jeopardy. If we get to the point that a majority of the public do not feel that investment in research is worthwhile, or that the findings of science can be trusted, that is a recipe for disaster. In the modern world, such a society is likely not sustainable, certainly not as a stable democracy and economic leader. It’s worthwhile, therefore, to dig deeper on what might be behind the recent dip in numbers.

It’s worth pointing out some caveats. Surveys are always tricky, and the results depend heavily on how questions are asked. For example, if you ask people if they trust “doctors” in the abstract the number is typically lower than if you ask them if they trust their doctor. People tend to separate their personal experience from what they think is going on generally in society, and are perhaps too willing to dismiss their own evidence as “exceptions”. If they were favoring data over personal anecdote, that would be fine. But they are often favoring rumor, fearmongering, and sensationalism. Surveys like this, therefore, often reflect the public mood, rather than deeply held beliefs.

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There are 33 billion chickens in the world, mostly domestic species raised for egg-laying or meat. They are a high efficiency source of high quality protein. It’s the kind of thing we need to do if we want to feed 8 billion people. Similarly we have planted 4.62 billion acres of cropland. About 75% of the food we consume comes from 12 plant species, and 5 animal species. But there is an unavoidable problem with growing so much biological material – we are not the only things that want to eat them.

This is an – if you build it they will come – scenario. We are creating a food source for other organisms to eat and infect, which creates a lot of evolutionary pressure to do so. We are therefore locked in an evolutionary arms race against anything that would eat our lunch. And there is no easy way out of this. We have already has some epic failures, such as a fungus wiping out the global banana crop – yes, that already happened, a hundred years ago. And now it is happening again with the replacement banana. A virus almost wiped out the Hawaiian papaya industry, and citrus greening is threatening Florida’s citrus industry. The American chestnut essentially disappeared due to a fungus.

And now there is a threat to the world’s chickens. Last year millions were culled or died from the bird flu. As the avian flu virus evolves, it is quite possible that we will have a bird pandemic that could devastate a vital food source. Such viruses are also a potential source of zoonotic crossover to humans. Fighting this evolving threat requires that we use every tool we have. Best practices in terms of hygiene, maintaining biodiversity, and integrated pest management are all necessary. But they only mitigate the problem, not eliminate it. Vaccines are another option, and they will likely play an important role, but vaccines can be expensive and it’s difficult to administer 33 billion doses of chicken vaccines every year.

A recent study is a proof of concept for another approach – using modern gene editing tools to make chickens more resistant to infection. This approach saved the papaya industry, and brought back the American chestnut. It is also the best hope for crop bananas and citrus. Could it also stop the bird flu? H5N1 subtype clade 2.3.4.4b is an avian flu virus that is highly pathogenic, affects domestic and wild birds, and has cause numerous spillovers to mammals, including humans.

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Decades of complex research and persevering through repeated disappointment appears to be finally paying off for the diagnosis and treatment of Alzheimer’s  disease (AD). In 2021 Aduhelm was the first drug approved by the FDA (granted contingent accelerated approval) that is potentially disease-modifying in AD. This year two additional drugs received FDA approval. All three drugs are monoclonal antibodies that target amyloid protein. They each seem to have overall modest clinical effect, but they are the first drugs to actually slow down progression of AD, which represents important confirmation of the amyloid hypothesis. Until now attempts at slowing down the disease by targeting amyloid have failed.

Three drugs in as many years is no coincidence – this is the result of decades of research into a very complex disease, combined with monoclonal antibody technology coming into its own as a therapeutic option. AD is a form of dementia, a chronic degenerative disease of the brain that causes the slow loss of cognitive function and memory over years. There are over 6 million people in the US alone with AD, and it represents a massive health care burden. More than 10% of the population over 65 have AD.

The probable reason we have rapidly crossed over the threshold to detectable clinical effect is attributed by experts to two main factors – treating people earlier in the disease, and giving a more aggressive treatment (essentially pushing dosing to a higher level). The higher dosing comes with a downside of significant side effects, including brain swelling and bleeding. But that it what it took to show even a modest clinical benefit. But the fact that three drugs, which target different aspects of amyloid protein, show promising or demonstrated clinical benefit helps confirm that the amyloid protein and the plaques they form in the brain are, to some extend driving AD. They are not just a marker for brain cell damage, they are at least partly responsible for that damage. Until now, this was not clear.

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