David Kirby’s “logic”: The hepatitis B vaccine may increase the risk of multiple sclerosis, so it’s obvious that vaccines cause autism

It’s really hard to take David Kirby seriously any more.

Well, actually, it’s been hard to take him seriously for at nearly four years now, ever since he wrote his paean to antivaccinationists, Evidence of Harm, in which no conspiracy-mongering related to mercury as an alleged cause of autism was too out there, too ridiculous, for Kirby to parrot. Since then, he’s become antivaccine apologist number one, the go-to guy for the antivaccine movement whenever the twisting of science, logic, and reason was needed to spin an event or a study that refutes the “vaccines cause autism” hypothesis. He’s also cheerleader number one for the antivaccine movement whenever he sees a news event or a result that he can twist as somehow supporting the concept that vaccines cause autism (and all sorts of other horrific things). No one can gloat as gleefully and full of smarm as he can over any bit of news he can twist to argue, no matter how tangentially, that vaccines are the tool of the devll, while all the while disingenuously opining that he is, really, truly not “antivaccine.” In this, he’s like our favorite pediatrician Dr. Jay Gordon on steroids. At least Dr. Gordon seems to have a sense of shame at times. Not our David Kirby. He’s loud and he’s proud, and he wants so very, very much for you to believe that he knows what he’s talking about.

If there’s one thing Kirby can do, it’s to twist any little bit of information and make it seem as though it supports his diehard belief that vaccines cause autism, even when they do not. The most blatant example of this talent on display came when, ghoul-like, Kirby jumped all over the Hannah Poling case and flogs the Autism Omnibus every chance he gets, knowing that verdicts for some of the test cases are due soon. As I’ve said before, science may not matter in these cases because (1) the courts are not a good place to decide science and (2) the National Vaccine Injury Compensation Program is set up by design to give plaintiffs every benefit of the doubt. Consequently, what is decided legally and what is scientifically supportable are two entirely different things, often related only by coincidence. Scientific medicine is decided by experimentation, clinical trials, and data, not adjudicated by the courts, no matter how much David Kirby and his posse of worshiping cranks wish it were otherwise.

None of this stops our master of obfuscation, Kirby the Klueless, who is practically orgasmic at a recent ruling of the special masters of the vaccine court on a different omnibus proceeding. This one happens to be about the question of whether the Hepatitis vaccine causes demyelinating diseases, such as multiple sclerosis (MS). Naturally, he is proclaiming his joy to the world on that home of antivaccination looniness, Age of Autism and stringing together the “what ifs” like no other apologist of pseudoscience can:

All eyes are on Vaccine Court this week, as people await rulings in the autism “test cases” on MMR and thimerosal. But another omnibus proceeding involving Hepatitis B vaccine and autoimmune disorders in adults, including MS, has already been quietly ruling in favor of several petitioners. (HERE)

The most recent case was announced about a week ago. In it, the Court ruled that the victim, an adult female, had contracted a form of demyelinating disease and MS, and eventually died, after receiving the Hepatitis B vaccine series. It was just the most recent case in a rash of rulings in the omnibus proceeding dealing with hepatitis B vaccine and “demyelinating diseases such as transverse myelitis (TM), Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating disease (CIDP), and multiple sclerosis (MS),” according to court papers.

“Petitioner has prevailed on the issue of entitlement. The medical records during decedent’s final hospitalization reflect that she died from demyelinating disease. Not only did decedent have a vaccine injury, but also her death was vaccine-related,” wrote the Special Master in the case.

Kirby, of course, is ecstatic. He thinks he sees in this an omen for the future, as far as the Autism Omnibus goes. Somehow, he thinks this ruling makes a favorable ruling for plaintiffs in the Autism Omnibus more likely. Is he right? Who knows? What I do know is that the ruling Kirby and his antivaccinationist fan club are so full of glee over is based on the thinnest of scientific rationale, as can be seen from the ruling itself. Even the selected bits that Kirby quotes make that obvious. One part that Kirby somehow managed to forget to cite is these passages from the verdict:

To satisfy her burden of proving causation in fact, petitioner must offer “(1) a medical theory causally connecting the vaccination and the injury; (2) a logical sequence of cause and effect showing that the vaccination was the reason for the injury; and (3) a showing of a proximate temporal relationship between vaccination and injury.”

And:

In Capizzano v. Secretary of HHS, 440 F.3d 1274, 1325 (Fed. Cir. 2006), the Federal Circuit said “we conclude that requiring either epidemiologic studies, rechallenge, the presence of pathological markers or genetic disposition, or general acceptance in the scientific or medical 6 communities to establish a logical sequence of cause and effect is contrary to what we said in Althen. . . .”

In other words, using standard scientific methods used to derive and verify likely causation from correlation appears to be actively discouraged in the Vaccine Court. Unless I’m reading this wrong, the plaintiffs don’t have to present any compelling science, epidemiology, or clinical studies demonstrating causation in order to have a chance of prevailing. In fact, if we are to believe the passage above, such evidence almost seems contrary to the spirit of the law. All plaintiffs have to do is to come up with a “medical theory” (hypothesis really, I really hate the misuse of the word “theory” in the context of science like this, although I’m sure the special masters are using it in a legal, not scientific, context); a temporal relationship; and a “logical,” not scientific, sequence of “cause and effect,” which to me sounds as though the special masters and the vaccine court don’t worry too much about confusing correlation with causation and drawing biological inferences in the absence of strong data.

Of course, Kirby does cite one study, a French study published last fall in Neurology. This study, consistent with the general preponderance of evidence that hepatitis B vaccination in general is not associated with an increased risk of MS, as quoted by Kirby, it did find a suggestion that a specific brand of hepatitis B (HB) vaccine might be associated with an increased risk of MS within three years of vaccination. What Kirby did not quote was the review of the literature in the introduction and discussion that pointed out that no increased risk of MS associated with HB vaccine has in general been observed and that the very authors who did the study cited by Kirby found no increased risk themselves in a previous study.

There’s also a problem I have with this study. The relative risk of of MS in this study was determined by subgroup analysis. I’m always concerned when I see subgroup analysis used, because such analyses are fraught with problems. If great care is not taken, they can easily end up turning into data mining exercises that continue until an apparent “positive” correlation is found, and such apparent “positive” correlations become easier and easier to find the more ways the data is cut–unless corrections for multiple comparisons are made and great statistical rigor is applied. Also, in a study of this type, selection bias is a very real possibility. In this study, it might take the form of patients with MS told that a possible link between HB vaccine and MS being more likely to agree to the study in the first place. This is one reason why case control studies are so difficult to do well; it’s very difficult to select truly matched controls to compare one’s test group to. To their credit, the authors of this study did try to control for selection bias by restricting their analysis of patients with MS to only patients who had been otherwise compliant with the vaccination schedule. Whether their strategy was enough, it’s difficult to say. The authors themselves point out that replication is necessary.

Leaving this study aside, it is very important to remember that there is a big difference between the evidentiary standards used in a typical civil tort case and those used for the Autism Omnibus. Civil court cases must adhere to an evidentiary standard known as the Daubert standard. One of the indices of reliability of scientific information in Daubert is the publication of that information in a peer-reviewed scientific journal. Thus, if a plaintiff’s lawyer wants to submit a published article or report as scientific evidence in, for example, a personal injury trial, it’s very important that the article or report be from a peer-reviewed journal. Unfortunately, the more formal Daubert evidentiary requirements, such as peer review of an article or report, do not apply in the Vaccine Court. As pointed out in the very ruling cited by Kirby, all that’s required is anything that the plaintiffs can sell as plausible to the special masters. Consequently, the usual standard of “50% and a feather” that applies to all personal injury cases is even easier to meet in Vaccine Court because the plaintiffs are not restricted to peer-reviewed science. This is in essence a policy decision. Because faith in the vaccine program is considered so important and because vaccination is, in essence, requiring otherwise healthy individuals to take a very small risk, the NVICP and Vaccine Court were designed to be streamlined and to give plaintiffs the benefit of the doubt at every possible angle. That’s why I’ve said from the very beginning that it would not surprise me if one or more of the test cases in the Autism Omnibus were decided in favor of the plaintiffs and why I’ve said before that such a decision would not be any evidence whatsoever (scientifically, at least) that vaccines cause autism.

But never let it be said that Kirby sees the inherent difference between the law deciding a scientific issue and scientists deciding a scientific issue. He goes on to construct one of his elaborate “chain of ‘what-ifs'” that he’s become so well known for:

No wonder that Kirby zeroed in like a laser beam on this passage:

It is biologically plausible for hepatitis B to cause demyelination because vaccines are composed of organic compounds of viral or bacterial origin, whether recombinant or otherwise, whose purpose is to initiate an immune response in the recipient,: the Court noted in the ruling. “But if any of the vaccine antigens shares a homology with the recipient’s antigens, the host’s immune response will attack both the vaccine antigens and the host’s antigens, resulting in an autoimmune response. This concept is also known as molecular mimicry and is well-established in immunology.”

Molecular mimicry is well established in immunology, but unfortunately there is no evidence in the decision that leads me to think that the court accepted anything more than somewhat plausible-sounding speculation on this case, rather than science. But this ruling did open the door wide open for Kirby to speculate, bring together disparate concepts that sound “science-y” and similar or to implicate a mechanism in from one disease that may or may not have anything to do with another condition, as he does for autoimmune demyelination in MS, trying to relate it to vague and controversial evidence for neuroinflammation in autism as though the two were one in the same and as though it were slam dunk evidence that there was a connection. Of course, Kirby’s smart enough to couch his speculation with enough caveats to make him seem not to have gone completely off the reservation while writing confidently enough so that those without a background in biology or medicine find his arguments seemingly plausible, which he does with a vengeance later:

Equally intriguing, along these lines, is a new study published in the Journal of Child Neurology. That paper reported that “anti-myelin-associated glycoprotein positivity” was found in a stunning 62.5% of the autistic children studied. And, a family history of autoimmunity was five times more common in ASD children (50%) than controls (9.4%).

“Anti-myelin-associated glycoprotein serum levels were significantly higher in autistic children than those without such history,” the authors wrote. “Autism could be, in part, one of the pediatric autoimmune neuropsychiatric disorders. Further studies are warranted to shed light on the etiopathogenic role of anti-myelin-associated glycoprotein antibodies and the role of immunotherapy in autism.”

This information is tantalizing, to say the least. And it could provide new avenues of research into the role of vaccines, demyelinating diseases, “autoimmune neuropsychiatric disorders,” and autism.

If the HepB series can destroy myelin in some kids and adults, and cause full-blown MS in adults, then is it really that “fringe” to investigate the plausibility of a biological mechanism whereby some vaccines (including MMR) in a subset of susceptible infants might produce symptoms that are characteristic of autism and/or other neuro-developmental disorders?

The problem here is that the myelin-associated basic proteins (MBPs) found in some autistic children aren’t specific, like the ones found in MS patients, and that MBPs are found in a significant number of normal children. Moreover, there is no evidence that autistic children suffer symptoms or neurologic damage akin to what is found in MS patients. In other words, there is no good scientific reason to suspect that the pathophysiology of MS is related to that of autism, even if there is some sort of “autoimmune” component to autism. Indeed, a recent study found in essence no difference in MBP autoantibody titers between autistic children and controls and concluded that it was “unlikely” that MBP played a role in the pathophysiology of autism. Kirby is basing his speculation not only on the thinnest of gruel as far as whether the HB vaccine induces an autoimmune demyelination that can cause MS, but on even thinner gruel when it comes to relating the pathophysiology of MS to that of autism.

In other words, it’s just David Kirby being David Kirby, as mendacious and full of bullshit as ever.

I take this post by Kirby as evidence that the AoA crowd is worried. They know that the first rulings on test cases for the Autism Omnibus are due soon, and they’re worried that the results, even in that notoriously lax court (as far as scientific standards go) will nonetheless rule against them. Perhaps that’s why Kirby says:

For years, the US Government and the IOM have insisted that Hepatitis B vaccine does not and can not cause MS. But the Federal Vaccine Court has now, essentially, overturned that opinion. Will the Court now do the same for vaccines and autism? I don’t think so – not this week. But it just might keep that door slightly ajar for the future.

It’s idiotic in the extreme to treat the ruling of a court, especially the Vaccine Court, as having any validity whatsoever in answering a scientific question. That’s not what any court is designed to do, although they are often called upon to adjudicate matters of science. Moreover, the Vaccine Court was created for political reasons, in order to provide a streamlined mechanism to compensate people with legitimate vaccine injuries, and it appears to be willing to compensate some claimants even if the science supporting their claims of injury is very, very weak or even nonexistent, as long as a “plausible scientific hypothesis” (I refuse to use the word “theory”) can be constructed.

Yet that’s what David Kirby and his antivaccinationist posse are hanging their hats on. That’s because they are not interested in science; they’ve never been truly interested in following where the science leads. Instead, they just know vaccines cause autism, and that’s the only reason that they are interested in a positive verdict in the Autism Omnibus that they can spin as “validation” of their belief. We, the science-based, are also interested in the Omnibus verdict, but not because we believe that a verdict for the plaintiffs would represent any sort of validation of antivaccinationist conspiracy mongering, but rather because we know what a huge P.R. boost a verdict for any of the test case plaintiffs would represent to the antivaccine movement. It would be a boon to them that they would milk for all it’s worth. David Kirby knows this too, but more importantly he also knows what a huge P.R. blow to his movement a negative verdict would be. That’s why he tries preemptively spin any negative verdict by saying that the court might keep the door to the “vaccine/autism” hypothesis open for a while. In other words, if there is anything in the soon-to-be released verdicts that gives even a hint of succor to the antivaccine movement, he will spin it as “evidence” that the special masters are “leaving the door open” to future claims for “vaccine-induced autism.”

As I said before, it’s just Kirby being Kirby. It’s all he can do. Fortunately for us, some of his commenters are actually honest enough to say what they really believe about vaccines. No going along with the approved mantra of “we’re not ‘antivaccine,’ we’re ‘pro-safe vaccine'” for them! Besides some commenters speculating that there are people out there defending vaccines who actually enjoy “injuring” children, we have Kathy Blanco laying out her true antivaccination credentials for all to see and providing yet more evidence supporting what I’ve said all along, that the “Green Our Vaccine” movement is a sham, a means of hiding the true face of the antivaccine movement, in her comment:

Most of the post are pointing to a variety of agents in these vaccines…which bears my nagging question, green a vaccine? Of viruses? Of each and every ingredient-or leave a couple in? Bottom line, there is no possible scientific way to make vaccines safe. Our entire autism family, as in the whole of our autism society, should not be frustrating our causes more, by doing things that are impossible…the most possible thing is, is, to boycott them, IN TOTAL. This is the only way these people will understand our position.

Don’t worry, Kathy, your position comes through loud and clear. You are antivaccine to the core, and to you and your fellow travelers it isn’t about any ingredients in vaccines. It’s about the vaccines themselves. No amount of “greening” vaccines and, no matter how many “objectionable” ingredients are removed, it will never be enough for Kelly or the rest of the antivaccine movement, because it is the ingredients that make vaccines work, namely the bacterial or viral antigens, that scare them.

And David Kirby is their slick and mendacious mouthpiece.