The intellectual dishonesty, or such blinkered stupidity that it is indistinguishable from this, of the anti-vaccine crowd is always a spectacle. J.B. Handley is a prime example. He has made himself into an intellectual bully, and internet thug for the Age of Autism.

In a recent piece for this wretched hive of anti-vaccine propaganda, Handley write:

“It’s been asked and answered, vaccines don’t cause autism.”

This lie, it really drives me nuts. More, and I can say this and mean it, anyone who repeats this lie is immediately my enemy. I mean that, I really do, because there are just too many kids in the mix and this is just too important and if you are either intellectually too lazy or too dishonest to understand the science around vaccines and autism, then, well, you are my enemy. Sorry, it’s a hard knock life.

That captures his “Goodfellas” approach quite nicely. If you disagree with him – you are his enemy, the gloves are off, and anything is justified. To add irony to his thuggery, Handley himself is just too intellectually lazy, or (in my opinion) scientifically illiterate to “understand the science around vaccines and autism.” Yet he presumes to lecture those who have dedicated their lives to studying science, and in fact is willing to make them his enemy because they have the audacity to point out that his understanding of science is hopelessly flawed.

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Brian Deer is the investigative journalist who has spent years building a case that Andrew Wakefield’s original Lancet paper alleging a connection between the MMR vaccine and an autism-GI disorder syndrome was not only bad science, it was fraud motivated by greed. In part two of his BMJ series detailing the results of his investigation, Deer follows the money, showing that Wakefield stood to make millions from a monovalent replacement vaccine as well as testing for his proposed new GI disorder. For those interested in the details – read the BMJ article. In short Deer builds a convincing case that Wakefield created a fraudulent study designed to generate fear regarding the MMR vaccine that he would then exploit to make millions. Meanwhile he was also paid over a million dollars by trial lawyers to build a case against the MMR vaccine.

What I want to write about today is a recent blog post by Brian Deer in which he accuses the medical establishment of circling the wagons (at least initially) around Wakefield. Deer specifically cites Ben Goldacre and Paul Offit as examples of physicians who were unwilling to accuse Wakefield of fraud. Deer writes:

But a Philadelphia-based commentator was not impressed by the BMJ’s intervention. “It doesn’t matter that [Wakefield] was fraudulent,” Dr Paul Offit, a vaccine inventor and author in Pennsylvania, was quoted in the Philadelphia Inquirer the next day as saying. “It only matters that he was wrong.”

I wasn’t surprised. From his establishment vantage-point, this was the third time Dr Offit had popped up to opine on the issue. Twice previously he’d been quoted as saying that my findings were “irrelevant” (although he’d been happy enough to use them in his books). Science had spoken, his argument went. There was no link between the vaccine and autism. It was experts like him who should rule on this matter, he seemed to imply, not some oik reporter nailing the guilty men.

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In 1998 Andrew Wakefield and 12 coauthors published a now infamous paper in the Lancet alleging a connection between regressive autism and nonspecific colitis (bowel inflammation). They also reported a “strong temporal association” between this alleged new syndrome and injection with the MMR vaccine. The study was based upon 12 case reports of children with this apparent syndrome. It sparked fears regarding the MMR vaccine specifically, and vaccines in general, that spread initially through the UK but then around the world, including the US. The result was a surge in the anti-vaccine movement, declining vaccine compliance – and in some communities low enough to reduce herd immunity resulting in outbreaks of vaccine-preventable diseases, like measles and whooping cough.

In early 2010 the Lancet finally retracted the paper, citing ethical concerns, and later that year the General Medical Council found that Wakefield had acted unethically. He was eventually struck off and now is self-employed in the US – professionally disgraced but he remains unrepentant and a martyr and hero of the anti-vaccine movement. Like many cranks, Wakefield hides behind a veil of accusations of conspiracies and persecution.

Despite his downfall, the damage had already been done. During this time journalist Brian Deer relentlessly investigated Wakefield and the Lancet paper. The chilling result of this investigation is now detailed in a BMJ paper (the first in a series).

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Occasionally anti-vaccine activists gloat over statistics that show a decrease (any decrease) in vaccine uptake. It is often a childish victory dance, but more importantly is displays their true anti-vaccine motives.

The most recent example of this is Mike Adams at Natural News, who writes:

Vaccination rates among children insured by commercial health insurance plans have dropped four percent between 2008 and 2009, says a new report by the National Committee for Quality Assurance. In its annual State of Health Care Quality report, the organization revealed that vaccine rates are falling sharply among high-education families.

First, before we start to analyze the significance of these numbers (Adams leaps into this analysis with the zeal of a propagandist), let’s see what they actually are. Business Week reports:
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The US Supreme Court is about to hear a case involving an alleged vaccine injury. This one does not involve thimerosal, MMR, or autism – it involves neurological injury allegedly from an older version of the DTP vaccine. However, this case would have implications for the many autism-related claims being made.

The case is not about the facts of the claim – whether or not the DTP actually caused any injury in this case, that of Hannah Bruesewitz, but rather about the vaccine court and the ability of parents to bring suits against vaccine manufacturers.

In 1986 the National Childhood Vaccine Injury Act created a special court, the vaccine court, the purpose of which was to provide an alternate method for determining who deserves compensation for a possible vaccine injury. The vaccine court functioned to protect both citizens and vaccine manufacturers. It provides an expedited route to compensation, with a generously low threshold for evidence. For certain listed injuries, compensation is automatic.

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In the US we punish unethical or incompetent doctors by taking away their license (a matter regulated at the state level). In the UK doctors are punished by being “struck off” the register of physicians. You may recall that the infamous Andrew Wakefield was struck off for ethics violations related to his MMR-autism Lancet study.

Now we have news of another UK physician being struck off – this time for prescribing stem cell treatments for multiple sclerosis (MS) patients. Dr. Robert Trossel was found by the General Medical Council (GMC) to have breached good medical practice by “exploiting vulnerable patients.” He gave stem cell treatments to several patients with MS, at a cost of about £10,000 each.

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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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This is a quick update on the Autism Omnibus hearings – representative cases heard before a special court to decide if there is any credible evidence to conclude that autism may be a vaccine injury. After hearing exhaustive testimony by all sides, the special masters determined that the evidence does not support a link between autism and vaccines.

One of the cases heard was the Cedillo case, which was used as the test case for the theory that the MMR vaccine plus exposure to thimerosal can trigger brain damage that looks clinically like autism. In February of 2009 the court rejected the claim that Michelle Cedillo’s autism was caused by vaccines. No only was the theory of causation without scientific backing, evidence was presented to show that Michelle Cedillo demonstrated early symptoms of autism prior to ever receiving the MMR vaccine.

In fact the Cedillo case is representative of a fact that scientific research is increasingly demonstrating – that subtle signs of autism are present prior to parents noticing that there is a problem and long before formal diagnosis. The consensus of evidence is that signs of autism appear between 6-12 months of age, and maybe earlier in some cases. Meanwhile, the first MMR vaccine is given at 12 months. Since causes must precede effects, this fact alone is fatal to the MMR-autism hypothesis.

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One of my goals in writing for this blog is to educate the general public about how to evaluate a scientific study, specifically medical studies. New studies are being reported in the press all the time, and the analysis provided by your average journalist leaves much to be desired. Generally, they fail to put the study into context, often get the bottom line incorrect, and then some headline writer puts a sensationalistic bow on top.

In addition to mediocre science journalism we also face dedicated ideological groups who go out of their way to spin, distort, and mutilate the scientific literature all in one direction. The anti-vaccine community is a shining example of this – they can dismiss any study whose conclusions they do not like, while promoting any horrible worthless study as long as it casts suspicion on vaccines.

Yesterday on Age of Autism (the propaganda blog for Generation Rescue) Mark Blaxill gave us another example of this, presenting a terrible pilot study as if we could draw any conclusions from it. The study is yet another publication apparently squeezed out of the same data set that Laura Hewitson has been milking for several years now – a study involving macaque infants and vaccinations. In this study Hewitson claims a significant difference in brain maturation between vaccinated and unvaccinated macaque infants, by MRI and PET analysis. Blaxill presents the study without noting any of its crippling limitations, and the commenters predictably gush.

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For those of us trying to increase scientific literacy – understanding of the methods, philosophical underpinnings, common pitfalls, and current findings of science – it can be a frustrating endeavor. Sometimes it seems we are caught in a Catch-22: some people don’t care about science because they don’t understand it, and they don’t want to learn about science because they don’t care. Even worse, at times (most times) we seem to be coming up against emotions and patterns of thought deeply rooted in evolution that nothing short of transcendence will solve.

Three recent studies reinforce our worst fears about human nature and make it clear how much of an uphill battle we face. The first looks at attitudes toward the MMR vaccine and which sources parents trust the most. The researchers found:

Five key themes emerged. Parents felt they didn’t have enough information, especially in relation to the dangers associated with not vaccinating. Government sources were not trusted. By contrast, other parents were trusted: ‘Parents trust advice from other parents,’ one mother said. ‘[You] take it on board. You listen to them.’ Parents also revealed they were biased towards risk-related information. And they misunderstood balance, believing that pro- and anti-MMR arguments should be given equal weight even though the scientific evidence overwhelming favours MMR vaccination.

Part of this seems solvable, but part is inherent. The solvable parts include parents not having enough information regarding the dangers of not vaccinating. Lack of information is always the easiest problem to solve – make the information more readily available, especially to people when and where they are making decisions that will be informed by that information.

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