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

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

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

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

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

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

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

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

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

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

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

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

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Andrew Wakefield, the UK researcher who sparked unwarranted fears about the risks of the MMR vaccine, has been the subject of a two-and-a-half years ethics investigation by the General Medical Council (GMC). This afternoon the GMC announced their conclusion, ruling that Wakefield acted “dishonestly and irresponsibly” in his research and with “callous disregard” for the children that were the subject of his research.

Wakefield’s Story

In 1998 Wakefield and others published a story in the Lancet where they claimed to find an association between finding the measles virus in the GI tract of children with autism following the MMR vaccine. The study itself was small – only involving 12 children, and the conclusions were modest, not specifically suggesting a link between MMR and autism. But in subsequent press conferences Wakefield raised the alarm, saying, “Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people.”

The result was a significant drop in MMR compliance and a resurgence of measles cases, as this BBC chart demonstrates.

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Politics is partly about setting priorities and agendas, and therefore it is impossible to keep politics out of science. Politicians are also in control of the public’s purse strings, and so funding science also cannot be free from politics.

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

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

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Yes, I know – it’s the Daily Mail. My UK friends tell me this is little more than a rag, not to be taken seriously. But it’s popular enough, and may in fact represent the attitudes of a portion of the public, that sometimes we have to address the claims that are made there. In that way it is like the Huffington Post – a hopeless rag (at least when it comes to science) that sometimes needs a response.

This time the Daily Mail has published an incredible anti-science and anti-intellectual rant by reporter Andrew N Wilson. The article is a discussion of the firing of science adviser, David Nutt, over his recommendations regarding recreational drugs. The Guardian did a decent job of covering the controversy – but also had the moxy to run the headline – “David Nutt Sacked.” Perhaps that does not mean the same thing in the UK as it does in the US – which is hilarious.

There are two issues here – the question of drug policy and how it should be informed by science, and the incredible reaction of Wilson. Interestingly, I find myself siding (just a bit) with Wilson on some points, in that there is a kernel of truth to be had in his screed. Here’s the controversy in a nutt shell. David Nutt produced a report comparing the risks to individuals and society of various substances, including tobacco, alcohol, marijuana, and ecstasy. He concluded that the risk from the legal substances far outweighs the risk from the illegal ones.

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

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

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

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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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The BBC reports today of a National Health Service study that shows that autism rates are consistent at about 1% among all age groups. If true, this has profound implications for the now-discredited notion that autism rates are rising and that this rise is linked to vaccines.

Starting in the late 1990’s fear swept the UK over the MMR vaccine and a possible link to autism – sparked by research by Andrew Wakefield. In the decade since, a succession of studies have shown that Wakefield’s original research was not valid and that there is no detectable link between vaccines and autism. Attention shifted, especially in the US, from the MMR vaccine to a preservative, thimerosal, in some childhood vaccines. This prompted the Centers for Disease control and the FDA, to mitigate public concerns, whether justified or not, to remove thimerosal from the vaccine schedule, which they did by 2002 (except for insignificant trace amounts). This dramatic decrease in thimerosal exposure had no effect on the rate of increase of autism diagnoses – pretty much the nail in the coffin of the thimerosal-autism hypothesis.

Unfortunately – this is a fake controversy, not a genuine scientific one, and dedicated anti-vaccinationists are not swayed by compelling evidence, so their vaccine-autism fear mongering continues, and has even been increasing. They have migrated their claims away from MMR and thimerosal to other “toxins” (mostly imagined), and made-up claims such as vaccines overwhelm children’s immune systems (when in fact they represent an modest addition to the antigens kids are exposed to).

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