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More biased “journalism” about vaccines

You know, I think I’ve found a bride for Steve Wilson.

You remember Steve Wilson, don’t you? He’s the local “investigative reporter” in my hometown who recently did a truly awful “report” (it actually makes me cringe to call it a “report,” but I couldn’t think of anything else to call it) a couple of weeks ago, in which he regurgitated just about every anti-vaccine talking point about mercury and thimerosal there is out there. I hadn’t seen anything like it, ever (at least not that I can recall). So bad was it that I feared the hyperconcentrated stupid might lower my blog bud PalMD’s IQ by a few points, given how close his home and place of work are to the TV station from which Wilson broadcasts.

Now the stupid’s gone national, with a blatant hit piece by Sharyl Attkisson of CBS News on Friday. In her eagerness to smear Dr. Paul Offit (a.k.a. Satan Incarnate, Darth Vader, or the Dark Lord of Vaccination, if you’re someone who believes that vaccines cause autism) Attkisson took a potentially legitimate point about potential conflicts of interest in science and turned it so stupid that she is worthy of nothing but ridicule.

And Orac’s just the guy to do provide it for her, too, by administering a heaping helping of some not-so-Respectful Insolence™.

Before I tackle what’s wrong with Attkisson’s piece, please join me, if you will, on a trip down memory lane. We’ve met Attkisson before on this blog, oddly enough, about a year ago. At the time, she was busily engaged in seeing how many logical fallacies and uses of the “pharma shill” gambit she could pack into a single story about the manufactroversy of whether vaccines cause autism. At the time, I characterized her story as “beautiful” or “classic crankery.”

Fast forward around 13 months, and it turns out that Attkisson is still at it, undeterred by anything resembling journalistic skill, logic, or ethics. She starts out ominously (I can almost imagine the sort of scary music used in horror movies to ramp up the tension before the monster strikes starting to play here):

They’re some of the most trusted voices in the defense of vaccine safety: the American Academy of Pediatrics, Every Child By Two, and pediatrician Dr. Paul Offit.

But CBS News has found these three have something more in common – strong financial ties to the industry whose products they promote and defend.

She then goes on to list what she considers to be slam-dunk evidence that the entire pediatrics and public health are in the pockets of big pharma. Ironically, enough, she demonstrates her great journalistic skills by finding this information out from publicly available sources, hectoring these organizations, and then insinuating dark conspiracies when they refuse to be interviewed with her. She reserves particular contempt for Dr. Offit:

Then there’s Paul Offit, perhaps the most widely-quoted defender of vaccine safety.

He’s gone so far as to say babies can tolerate “10,000 vaccines at once.”

This is how Offit described himself in a previous interview: “I’m the chief of infectious disease at Children’s Hospital of Philadelphia and a professor of pediatrics at Penn’s medical school,” he said.

Offit was not willing to be interviewed on this subject but like others in this CBS News investigation, he has strong industry ties. In fact, he’s a vaccine industry insider.

Offit holds in a $1.5 million dollar research chair at Children’s Hospital, funded by Merck. He holds the patent on an anti-diarrhea vaccine he developed with Merck, Rotateq, which has prevented thousands of hospitalizations.

And future royalties for the vaccine were just sold for $182 million cash. Dr. Offit’s share of vaccine profits? Unknown.

You know how I know where Attkisson’s coming from and that it’s not anything resembling objectivity? Its her use of the “10,000 vaccines at once” canard. It’s a favorite among the anti-vaccine crowd, because they use it to make it sound as though Dr. Offit is some sort of crazy ideologue who wants nothing more than to inject as many vaccines as possible into babies. Let’s take a look at what Dr. Offit actually said and see if it sounds so ominous:

“Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges – from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.

The bottom line: It’s safe to give your child simultaneous vaccines or vaccine combinations, such as the five-in-one vaccine called Pediarix, which protects against hepatitis B, polio, tetanus, diphtheria, and pertussis (also known as whooping cough. Equally important, vaccines are as effective given in combination as they are given individually.

Nope, nothing ominous there at all. Dr. Offit was simply pointing out that babies’ immune systems can handle far more antigens than are in any vaccines or combination of vaccines presently administered. I rather suspect he probably regrets using that exact turn of phrase, though, because it’s been a favorite whipping boy of anti-vaccinationists ever since he first said it back in 2005. If you don’t believe me, try Googling “Paul Offit 10,000 vaccines” or “Paul Offit 100,000 vaccines” sometime, although this post gives a flavor of the sorts of uses to which Dr. Offit’s quote has been used by anti-vaccine activists.

The obvious question is: Why did Attkisson include that quote? After all, it doesn’t really have anything to do with the story at hand, namely whether or not Dr. Offit has conflicts of interest that make him hopelessly biased. It’s just thrown in there to bias the reader right off the bat, to add to making the reader think that Dr. Offit is, as anti-vaccinationists seem to like to call him these days, a “biostitute.” It’s nothing more than the fallacy of poisoning the well.

Now don’t get me wrong. Potential conflicts of interest do matter. They matter a lot. However, a general principle is that undisclosed potential conflicts of interest (COIs) are of far more concern and potentially far more damaging to the scientific process than disclosed COIs. The reason is obvious. Disclosed COIs are out there and their disclosure makes it possible for any critical observer to decide how much they matter and whether or not they may have compromised the objectivity of the scientist or physician possessing them. In contrast, undisclosed COIs hide information necessary to evaluate a researcher’s objectivity. True, sometimes the disclosure these days can get carried to ridiculous extremes, so much so that at a recent meeting I recall a senior researcher, a veritable giant in our field, basically make fun of the requirement, where the pre-talk disclosures can sometimes seem longer than the talk. Personally, I tend to poke a little fun at the requirements by saying something along these lines before any talk I give, “I have no conflicts of interest to disclose because no company is interested in supporting my research or hiring me as a consultant.” Kidding aside, I believe that disclosure is better than non-disclosure.

Indeed, I’m all for transparency–for everyone! That’s why I’m hoping that Sharyl Attkisson, hot on the heels of this piece of journalistic brilliance, won’t stop just with the AAP, Every Child by Two, and Dr. Offit. That’s why I’m really hoping that I’ll soon see a followup news story by her about the undisclosed conflicts of interest that riddle the “vaccines cause autism” contingent. After all, COIs matter, and it wouldn’t be fair to concentrate only on one side of the “debate,” would it? After all, what happened to the journalistic meme of “tell both sides”?

For example, how much are Mark and David Geier making off of their chelation therapy, Lupron protocol, and their consulting for plaintiffs in vaccine lawsuits or claims against the Vaccine Injury Compensation Program? Or what about their attempt to patent their Lupron protocol? After all, if it’s incredibly suspicious that Dr. Offit patented his rotavirus vaccine, it must be just as bad that those warriors against vaccines, Mark and David Geier, tried to patent their protocol, mustn’t it? Or what about the way that the Geiers set up a dubious Institute and IRB to oversee their “clinical trials” designed to show that their quackery “cured” vaccine-induced autism but didn’t disclose that the IRB had been packed with their cronies?

Surely Attkisson would be interested in that, wouldn’t she? For the sake of the children?

Or how about Andrew Wakefield? Remember him? He not only received hundreds of thousands of pounds from law firms that sue vaccine manufacturers, but received the money while he was doing his “research” that led up to his infamous 1998 Lancet article. Not only that, but he failed to disclose this clear potential COI when he submitted his paper, and the payments weren’t discovered until years after the fact. That was a pretty blatant conflict of interest, so much so that the U.K.’s General Medical Council has in essence put him on trial. Indeed, arguably the resurgence of measles that has occurred in the U.K. can be laid right at Dr. Wakefield’s doorstep, including at least one death. Talk about “litigation-driven research” causing serious mischief and harm! I can’t help but note that no such injury to children can be attributed to any of the publicly disclosed potential COIs mentioned in Attkisson’s story. So why isn’t Attkisson railing against Wakefield’s far more blatant COI than anything Dr. Offit’s ever been accused of? I’m sure it’s just an oversight and that she’ll take care of it in a followup story.

Or how about Laura Hewitson? She’s the primary investigator on a poorly designed and arguably unethical study of the effects of the vaccine schedule on monkeys reported at the International Meeting for Autism Research in May. It turns out that Dr. Hewitson not only has an autistic child, but is a plaintiff in the Autism Omnibus proceeding and that her husband works for Andrew Wakefield. Apparently, at least as far as I can tell, she never disclosed her status as a litigant when she submitted her abstract, even though her abstract appeared at an amazingly convenient time to be featured in Jenny McCarthy’s Green Our Vaccines rally and to be used as “evidence” in the Autism Omnibus, making it one of the best examples of “litigation-driven” research I’ve ever seen. I’m sure that’s an oversight on Attkisson’s part, too.

Or what about the latest unwitting hero of the anti-vaccination movement, Dr. Jon Poling, whose daughter is being used as a poster child for the contention that vaccines cause autism in the presence of mitochondrial disorders, even though her case shows nothing other than how much the claim that vaccines cause autism has shrunk lately? These days, he’s reduced to showing up on blogs and criticizing anyone who critically examines the claim that his daughter represents strong evidence that vaccines are a “trigger” that can cause autism in the background of mitochondrial disease. More relevant to discussions of potential COIs, Dr. Poling was a co-author on a case report in 2006 about a girl with a mitochondrial disorder who underwent developmental regression after being vaccinated, a case report that has been widely cited as “evidence” for the claim that vaccines can cause autism in the presence of mitochondrial disease (which, conveniently enough, we’re told is much, much more common than previously thought). He disclosed neither that he was a plaintiff in the Autism Omnibus nor that the subject of the case report for which he was co-author was in fact his daughter, both serious breaches of reporting potential COIs, as far as I’m concerned. No doubt it’s just another oversight, and Sharyl will leap to correct it.

Finally, let’s not forget the large and growing “biomedical” autism cure industry, which largely depends upon as many parents of autistic children as possible believing that vaccines somehow cause autism. Now there would be a great expose. I wonder if Sharyl’s up for it. Probably not, and more’s the pity. It’s a story that’s begging to be done. It has everything: Parents given false hope, children subjected to dubious treatments, at least one of whom died as a direct result of said dubious treatments, bogus lab tests, quacks galore. In the hands of a competent journalist, it could be awesome–a blockbuster! It could win many awards!

Almost everyone has potential conflicts of interest in science. This is particularly true when researchers work on projects whose end products need to be commercialized in order to become a drug, treatment, vaccine, or what have you. There’s no avoiding working with industry to accomplish this, and that involves commerce and filthy lucre. Indeed, it’s probably not even desirable to eliminate potential COIs even if we could, because doing so would also risk eliminating a major motivating factor for producing better medicines and better treatments. To prevent such COIs from warping scientific objectivity any more than is possible, transparency is the key, and, for the most part, faster and more detailed transparency is a good thing. The only problem is that the pseudoscientists on the “other side” are bound by no such requirement for transparency. They need have no fear that their potential COIs will ever be dragged out from under their rocks and exposed to the light of day. Certainly they have nothing to fear from reporters like Sharyl Attkisson. After all, big pharma is always big and bad; but these are “brave maverick doctors” bucking the system to cure autism, right? They couldn’t possibly be involved in clearly unethical behavior such as failing to disclose blatant potential COIs, could they?

But who knows? Maybe Attkisson will surprise me. Maybe she’s working in part 2 of her expose right now.

I’m not going to hold my breath waiting for it, though.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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