Dr. Jay Gordon: Will you please stop claiming you’re not an antivaccinationist?

I knew it. I just knew it.

I just knew that when I finally decided to come back from my absence from this blog that something very unpleasant and sad would be waiting for me. True, there had actually been one very nasty thing that I simply had to deal with a few days ago, but that was a particularly vile and despicable human being who, believe it or not, was not John Best. That is not the case here, although the misinformation being pushed is truly disturbing.

Not surprisingly, what awaited me upon my decision to come back was posted earlier this week on that repository of antivaccine propaganda, The Huffington Post. Also, not surprisingly, what awaited me had been penned by everybody’s favorite pediatrician to the stars’ children (especially antivaccine activist Jenny McCarthy’s son Evan), namely Dr. Jay “Whatever You Do, Don’t Call Me Antivaccine” Gordon, the man who’s been known to parrot the worst antivaccine canards, who penned the foreword to Jenny McCarthy’s latest paean to antivaccinationism and autism quackery, and, who, most recently, invaded my alma mater with a kinder, gentler version of his nonsense.

I know, I know, Dr. Jay is “not antivaccine.” How do I know? He tells us so ad nauseam whenever it is pointed out that he is the chief physician apologist for the antivaccine movement, of course! Usually he tells us either with outrage or with a hurt, puppy dog demeanor at the perceived injustice of being called out for spewing his nonsense. I’ve even bent over backwards to try to give Dr. Jay the benefit of the doubt at every opportunity. Indeed, I do believe that Dr. Jay believes he is not antivaccine. Unfortunately, what he believes and reality are related only by coincidence. That includes vaccines, and that also includes his self-delusion that he is not “antivaccine.” If you don’t believe me, get a load of Dr. Gordon’s reaction to the recent decision in the Autism Omnibus, in which the special masters roundly and utterly rejected the arguments of the plaintiffs in the first three test cases (more about that on Monday, unless something more current demands my attention by then). I’m tellin’ ya, the dude is closer to sounding unhinged than I’ve ever seen him, and that anger shatters for me any claim by him that he is not antivaccine. If you think I’m being too harsh, then check out his two posts on HuffPo, “There Is No Proof that Cigarettes Cause Cancer” and The Vaccine Court Was Wrong.

Even I never would have expected something so unscientific and just plain dumb from Dr. Jay. As much as I think Dr. Gordon is probably a nice guy who cares about his patients, being nice does not excuse one from being taken to task for advocating dangerous pseudoscientific nonsense. Unfortunately, he managed to live down to my expectations and then start digging. With a backhoe. Let’s take a look at his first bit of idiocy:

It took fifty years before the courts finally acknowledged that cigarette smoking causes cancer.

There were billions of dollars at stake.

The dozens of court decisions that there “was no proof” were supported by physicians, expert witnesses of all types and hundreds of millions of dollars spent on attorneys.

Experts and doctors alike stated over and over again that we need not continue studying this issue because there was just no proof.

Let me state very simply, vaccines can cause autism.

No real scientist would encourage us to stop studying this possibility.

Note the blatant straw man argument (“No real scientist would encourage us to stop studying this possibility”). Note the specious and false comparison that antivaccine advocates love to use: Comparing tobacco research to vaccine research. No matter how easy it is to demonstrate how wrong they are, they think it’s a slam dunk comparison that bolsters their paranoid, conspiracy mongering world view. After all, decades ago, scientists kept finding scientific and epidemiological evidence that tobacco smoking causes lung cancer and all manner of other health problems. Tobacco companies funded a well-financed denialist campaign of lies, bad science, and outright pseudoscience to try to convince the public that there was no link between smoking and cancer in order to protect their profits and forestall the regulation or banning of cigarettes by the government. So to antivaccinationists, it seems perfectly reasonable to claim that claiming that vaccines cause autism is the same thing, except with the evil big pharma vaccine manufacturers suppressing the “truth” to protect their profits and keep themselves safe from lawsuits.

There’s just one problem. (Well, there are several, actually, but let’s start with one.) If you’re going to compare the claim that vaccines cause autism with the science that shows that smoking tobacco causes cancer and all manner of other health problems, it is the antivaccine advocates who most line up with the tobacco companies denying a link. The reason is that the science at the time showed a strong link between cigarette smoking and cancer, but tobacco companies denied it repeatedly because it would hurt profits. Indeed, tobacco companies maintained a long campaign of misinformation, bad science, and outright lies to stifle any regulation or any attempt to hold them accountable for the health problems cigarettes cause. Unfortunately for Dr. Jay’s analogy, science now does not show a link between vaccines and autism. I know Dr. Jay and other antivaccine apologists and advocates believe that there is a link, but scientific and epidemiological reality do not line up with that belief. The question has been studied and studied multiple times in multiple large, well-controlled epidemiological studies, in multiple countries, all with the same result: There is no detectable link between vaccines and autism or between the thimerosal that used to be used as a preservative in many childhood vaccines and autism. It doesn’t get much more clear than that. Yet in this case, it is the antivaccine advocates–like Dr. Jay–who deny the science and try to convince the public that vaccines cause autism. It is they who use the same sorts of denialist tactics and misinformation that the tobacco companies used all those decades ago: Bad studies, pseudoexperts, and a cadre of attack dogs ready to pounce on any new study, looking for any flaws, real or imagined, that they can exploit to sow doubt. Too bad that in their case it’s more like attack poodles than attack dogs, but the principle is the same, and antivaccinationists use the same techniques amplified by the ability of the Internet to spread misinformation even faster than it spreads information. They don’t need nearly the level of financial clout that tobacco companies did back in the 1950s, because celebrity and the Internet have become the great levelers, allowing them to spread their message far and wide at much less cost.

Note another thing. Note the absolute certainty with which Dr. Jay states unequivocally that “vaccines can cause autism.” He even uses boldface and italics in the font, but that isn’t even enough to convey his level of certainty. He has to underline it too! (Props to the doctor for refraining from using all caps as well.) Note that Dr. Jay’s certainty comes with no scientific evidence presented whatsoever to support it. None. Zero. Zip. Nada. This is very consistent with his past behavior, in which he apparently believes that simply asserting something is the same as proving it. It isn’t; argument by assertion is the lamest form of argument. In any case, apparently, Dr. Jay just knows that vaccines cause autism, science be damned. Indeed, he demonstrates this utter belief–not science, belief–that the “proof” will someday be found:

The proof is not there yet. It will be found. Let’s hope it doesn’t take another fifty years and hundreds of court cases to convince the government and the public. Private industry is once again duping the FDA, doctors and the public. The conflicts of interest are obscene and illegal.

The diseases against which we vaccinate are still dangerous and still present in other countries and in America but simple risk/benefit analysis would show that the risks from the way vaccines are manufactured and administered far outweighs the risks of harm from these relatively rare illnesses.

Yeah, Dr. Jay, and The Truth Is Out There. Fox Mulder and Dana Scully have taught us this, and Dr. Jay wants to believe. Oh, does he ever want to believe! He wants to believe so much that the repeated repudiations of his beliefs by science and now by the courts have driven him to a level of rage that appears to have unhinged his reason beyond what I’ve ever seen before. And, boy, oh, boy, is he pissed off at the special masters:

They were disdainful and unscientific in their approach and did not gather the needed evidence. In the absence of that evidence, they should have insisted on further studies to assist in the decision-making process.

Vaccines as they are now manufactured and administered trigger autism in susceptible children.

This will be acknowledged by the AMA, the AAP, the CDC and the U.S. government at the same glacial pace these august entities followed in supporting the need to discourage smoking because it causes lung cancer, heart disease and other illness.

Actually, the special masters may have been many things, but disdainful they were not, at least not during the proceedings and at least not to the plaintiffs. Indeed, they showed too much respect to quacks–yes, quacks–who did not deserve such respect. In the end, it was obvious–painfully obvious–that the plaintiffs could not produce a coherent or compelling hypothesis for how vaccines might have caused autism in the three test cases, and any disdain that the special masters demonstrated was not directed at the plaintiffs, but rather at those who had duped them (more on that Monday as well). Remember, these three cases were the very best the plaintiffs thought they had to offer. Also remember that the rules of evidence in the Vaccine Court are considerably laxer than in regular court. Daubert rules do not apply; heck, the plaintiffs don’t even have to produce compelling evidence of causation, only a scientifically plausible-sounding mechanism by which vaccines might have caused autism or other neurologic injury for which compensation was being sought. Even by that very low standard, they failed utterly, and the comparison to how tobacco companies suppressed evidence that smoking causes lung cancer is utterly specious.

But get this. Dr. Jay still thinks he is a scientist:

In the meantime, I’d like to answer a few of the comments to my post.

Zortag comments:

“Dr. Jay is not a scientist, he is a technician – that is what most MDs are. They are highly-trained, highly-skilled, and highly-compensated, but they do for people pretty much what a mechanic does for an Audi. I see no peer-reviewed publications in his biography, no additional training in biomedical research, and no specific expertise in vaccine science. He has no more credibility in telling you that vaccines are unsafe than I, a computer programmer, do.”

Actually, I am a scientist. After high school, I continued my education and trained for twelve years in medical science. Subsequent to that, I have observed thousands of children and families and kept records about their health. That, Zortag, is science. Whether or not testing medicines and vaccines on a thousand people and then administering them to 100 million people is science is the real question.

Medical researchers have been caught manipulating results over and over again.

The stupid, it burns my grief away and turns it into disgust that a fellow physician can say something so utterly dumb. Dr. Jay, I’ve tried to be relatively nice in the past, but here the gloves come off. You’ve asked–nay, begged–for a heapin’ helpin’ of not-so-Respectful Insolence, and Orac rarely turns down such a heartfelt request from a “friend” of the blog. So, I have a message for you:

You are not a scientist. You just aren’t. Really. Now, I will concede that the commenter Zortag is an obnoxious, arrogant twit who doesn’t have clue one what he’s talking about when he labels most MDs mere “technicians,” and on the off chance he ever sees this piece, I’d be more than happy to set him straight on that one with an enormous helping of not-so-Respectful Insolence of his very own. However, there is one gem in the latrine that is Zortag’s comment and that is that he is quite correct that most physicians are not scientists. It’s point I’ve made myself time and time again. You, Dr. Jay, in particular are not a scientist. Knowing a collection of scientific facts and how to apply them to illness is not the same thing as being a scientist. Moreover, you have demonstrated time and time again that you do not understand the scientific method. You believe that your “personal clinical experience” trumps large, well-designed epidemiological studies, refusing to acknowledge just how easily humans are fooled by their own anecdotal experience. But apparently you think your clinical awesomeness is simply too awesome to be led astray by the same cognitive shortcomings to which the rest of us are prone by the simple fact of being human.

And that’s the difference between you and me, between you and an actual scientist. We scientists understand how easily we can be fooled into making the wrong conclusions. We know we are prone to confusing correlation with causation. We know that confirmation bias, tending to remember what fits into our belief systems and to forget what does not, is all too likely to trip us up if we are not on constant guard. Regression to the mean can fool clinicians into thinking that an ineffective remedy works, as has happened to so many “brave maverick doctors” who think that the latest woo targeted against “vaccine injury” cures autism. As Dirty Harry Callahan said in Magnum Force, “A man’s got to know his limitations.” Well, I know my limitations, and scientists (usually) know theirs, but you clearly do not know yours. Because scientists know their limitations, they have devised and improved over the centuries the scientific method, in which proper methodology and careful controls minimize the chance that normal biases and our normal cognitive shortcomings will lead us astray.

But not brave, brave Sir Jay! He knows he is right. He knows his observations are correct and not due to any of the cognitive shortcomings and biases with which we mere mortals are plagued. If science doesn’t support Dr. Jay’s unwavering belief based on his clinical experience alone that vaccines cause autism, then he rejects the science as false and concocts all sorts of dark conspiracy theories to explain why study after study after study have failed to confirm his belief. Worse, he can’t even cite his own science, but that doesn’t stop him from making blanket statements like this:

I’m not arguing that we should abandon the shot or the vaccine programs which have saved lives. I’m saying that we should evaluate the possible risk from this and other live virus vaccines much more objectively and scientifically than we have in the past. Yes, h4tch, completely abandoning these vaccines programs could lead to disease outbreaks. I don’t recommend dumping vaccines; I recommend changing the level of safety we demand and a rigorous reevaluation of the schedule which now gives a hepatitis shot to a two-hour-old baby followed by six more shots six weeks later. The way we vaccinate lacks solid scientific support and ignores the possibility of increased vaccine safety.

Note that Dr. Jay cannot cite a single scientific or epidemiological study to support his belief that the current vaccine schedule is unsafe or somehow unsupported by science. Seemingly, he simply finds the idea of giving vaccines to a two hour old baby or a six week old baby repugnant (and therefore wrong) and seems to think that the current recommended vaccine schedule was pulled out of Paul Offit’s nether regions. He then combines that with his anecdotal experience, and–voilà!–instant scientific conspiracy designed to protect the nefarious dark lords of pharma and their minions.

Because Dr. Jay Gordon simply can’t acknowledge the possibility that his clinical experience might–just might–have led him astray.

I will conclude with a plea to Dr. Gordon. Please, please, please, stop your whining about how nasty and vicious I am to label you as “antivaccine.” You convince no one, and your last two HuffPo rants have shattered any pretense you might have still maintained that you are anything other than antivaccine to the core. (Steve Novella was right about you.) Give it up and let your antivaccine freak flag fly high, and embrace your inner antivaccinationist! You know you want to. After all, at various times you have said “I don’t give many vaccines,” and one time you even described an incident where you had to be talked into giving recommended vaccines, “respecting the parents’ wishes to vaccinate.” Meanwhile, you spread misinformation about all sorts of horrible “toxins” in vaccines, give speeches to antivaccine rallies in which you butter up the women who are passionately–and erroneously–convinced that vaccines caused their children’s autism, regularly show up on television as the “vaccine skeptic,” and write forewords to books filled with antivaccine nonsense and autism quackery, all the while confidently asserting that vaccines cause autism despite all the strong scientific evidence that argues otherwise.

If that’s not being antivaccine, I don’t know what is.