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“A Dose of Controversy”: More like a dose of equivocation

Last Thursday, I expressed dismay about an upcoming NBC news special, A Dose of Controversy, which is about a man who arguably caused more damage to public health than just about anyone in the last decade, namely Andrew Wakefield. Anyone who’s a regular reader of this blog knows just what I think of Andrew Wakefield. I’ve made no secret of it; I have little but contempt for the man, whom I view as incompetent, dishonest, and a quack. Andrew Wakefield, as you may recall, is the British gastroenterologist who in 1998 published a study in The Lancet that claimed to find a link between the MMR vaccine and “autistic enterocolitis.” This study, aided and abetted by truly irresponsible journalism, launched a panic in the U.K. that is only now starting to abate. In the interim, measles, once thought conquered, has become endemic again in the British Isles. In any case, it matters not to the anti-vaccine movement that (1) his study was poorly designed and utterly refuted by later studies; (2) it was revealed that Wakefield received £435,643 in fees, plus £3,910 expenses from lawyers trying to show that the MMR was unsafe; (3) the PCR laboratory that Wakefield used was so poorly run that it apparently had no knowledge of the concept of a negative control; and (4) strong evidence has been revealed that Wakefield falsified data.

If there’s one thing that causes my teeth to grind almost as much as the thought of Andrew Wakefield on national TV, free to spew his pseudoscience, self-aggrandizement, and comparisons of his plight to that of Galileo, it’s the convention of “balance” in news stories. I’ve written extensively about this bogus false equivalence between pseudoscience and science, particularly regarding the vaccine/autism manufactroversy. One extreme example was a particularly execrable episode of an execrable TV show, The Doctors, in which the “tell both sides” mantra led to an infuriatingly inaccurate picture, in which the beliefs of anti-vaccine apologists like Dr. jay Gordon were treated as equivalent to those of scientists.

As I expected, the NBC special is cut from exactly the same cloth; it’s just that the seams don’t show as badly.

I don’t know what possessed me, but I considered it more or less my duty to subject myself to this nonsense. So I did just that yesterday evening, as NBC aired A Dose of Controversy. It was torture, but I do it all for you (and because it’s a quick blog post). I did it even though the site, much less the voice, of Andrew Wakefield, as Pink Floyd sang in The Wall, fills me with the urge to defecate.

Of course, I knew right away from the title of the broadcast that this broadcast was going to be a “tell both sides” crapfest right from the start. The reason, of course, is that politics is not medicine. In politics and many other controversies, there often are two sides with cases of similar validity. In such cases, it is critical to report both sides fairly and accurately. However, in science and medicine, the “tell both sides” mantra often grossly exaggerates the validity of pseudoscience when it’s a conflict between pseudoscience and science. That’s exactly what’s going on with the vaccines/autism “controversy,” because there is no medical controversy over whether the MMR vaccine causes autism or whether vaccines in general cause autism. Rather, it’s what we call a “manufactroversy,” or a manufactured controversy. It’s pseudoscience versus versus science, but Lauer et al starts out painting the story as that of the proverbial “brave maverick doctor” (Andrew Wakefield), who thinks he’s found a horrible result that the medical establishment does not want to acknowledge, which is why it tries to shut him down. Meanwhile, it has a horrible graphic between each segment that shows a vaccine being drawn up, with newspaper headlines and pictures of Wakefield flashing behind it.

The First half of the show is constructed as mainly “dueling interviews,” one with Andrew Wakefield and the other with Brian Deer, interspersed with brief clips that provide background and serve as exposition, right from the start setting up the false equivalence. It also sets up the “brave maverick doctor” against the dogged journalist. Who couldn’t love a story like that? In this case, I can’t. The broadcast did hit all the low points of Andrew Wakefield’s career, such as his conflict of interest, in which he was paid large sums of money for two years before his 1998 Lancet paper by lawyers preparing a class action suit against vaccine manufacturers; his being investigated by the General Medical Council; the infamous incident in which Wakefield got blood samples from healthy children at a birthday party and then later joked about two children fainting and one passing out; and the fact that several of the children in his study were plaintiffs in the class action lawsuit. However, it assiduously avoided the F-word (scientific fraud), and, worse, it set up the allegations in a he said/she said structure, in which Wakefield makes claims, which are then refuted; or Brian Deer describes the findings of his investigation, each of which Wakefield always has a glib explanation for.

Actually, if you want to get a feel for how this whole episode was done, there was the infuriating manner in which Lauer interviewed Deer. For example, he asked Deer, “In your opinion how much was Wakefield paid?” as though the number Deer came up with was, as Asimov so famously said about a “theory,” something Deer had “dreamt up after being out drunk all night.” Come to think of it, the word “theory” is bandied about referring to the hypothesis that vaccines cause autism; it always irritates the crap out of me how that word is misused because in science it is a term with a lot of certainty behind it whereas in colloquial usage it does often mean a “hunch” or an “idea.” Then Lauer repeats the offense by saying to Deer, “It’s your opinion that Wakefield was involved in the development of another vaccine,” again, as though Deer’s conclusions about Wakefield’s conflicts of interest were nothing more than mere opinion, no more or less likely to be valid than Wakefield’s assertions. It is a fact that Wakefield received £435,643 in fees, plus £3,910 expenses from lawyers trying to show that the MMR was unsafe, a matter of public record. Deer’s “opinion” has nothing to do with it. It is a fact that Wakefield had a patent application for a single dose measles vaccine filed before he published his Lancet paper. These are not matters of “opinion.”

Despite this, Brian Deer did get in some good zingers, for example:

  • “This thing stank from the day it appeared.”
  • “Wakefield was greedy, and that’s how I caught him.”

Best of all, after Lauer asked Deer, “Do you ever worry that Andrew Wakefield is right?” his response was an unquivocal “no.” Nor should he. Again, as Pink Floyd sang, the evidence is “incontrovertible.” At another point, when Lauer says:

LAUER: This back and forth between you and Andrew Wakefield has been going on a long time. It seems that Dr. Wakefield has an answer for everything you allege.

DEER: And the dog ate his homework. He’s always got a story…This guy sued me. I could have lost my home; I could have lost everything apart from what I’m wearing.

And about Wakefield’s suit having gone nowhere, Deer quipped, “I’ve got the check” (for Deer’s legal fees).

Paul Offit was also interviewed. He got in some good licks, too, describing how he had been threatened, how an anonymous caller had mentioned his children’s names, a clear threat that he knew who they were and where they went to school. He even admitted that there was one time when he considered giving it all up, and that was it. Still, when he wondered why parents listen to celebrities like Jenny McCarthy instead of scientists and physicians, he encapsulated every frustration those of us on the side of science have felt. That was the power and the problem. At times Dr. Offit came across as testy and angry. Now, far be it from me to criticize a man like Dr. Offit for being angry at what anti-vaccinationists have done to public health in this country, and I very much liked how uncompromising he was when he pointed out that the anti-vaccine movement has caused considerable harm. Unfortunately, the comparison with the unctuously calm demeanor of Andrew Wakefield does not work to Dr. Offit’s advantage. He was right about each and every canard of the anti-vaccine movement he shot down, but his passion came across a bit too angry.

Then, of course, there was Bernadine Healy. I’ve written about her having aligned herself with the anti-vaccine movement before. Here she does it again, big time, providing quotes that only J.B. Handley or Andrew Wakefield himself could love: “Scientists have to be listened to. I don’t think it’s terribly humble to say stop, we have all the answers, shut down the research”:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Straw men that big are usually seen in the Burning Man every year, and Healy could be just the guy who sets it ablaze. No one has ever said that we “have all the answers.” What science says is that the evidence against the contention that vaccines cause autism is such that by any reasonable stretch of the imagination the hypothesis has been refuted.

Perhaps the most disturbing part of the show occurs near the end, when NBC went into Thoughtful House and followed parents of an autistic child through an endoscopy by Dr. Arthur Krigsman. Tim Kasemodel is interviewed about his son Thomas, who is shown being sedated so Krigsman can do both an upper and lower endoscopy on him. The cost is reported to be $4,500 out of pocket, not to mention the pain, fear, and distress to which Tom Kasemodel is subjected being subjected to a medical procedure that is almost certainly unnecessary. It’s very striking how all the trappings of scientific medicine are there, but none of the methodology. Indeed, Lauer inadvertently stumbled on just the issue:

LAUER: Based on your experience, have you made children better? Anecdotally do you have evidence?” Do they get better?

Wakefield, of course, responds in the affirmative. What Lauer should have asked Wakefield is whether he has randomized controlled clinical trials to support his belief that autistic children “get better” at Thoughtful House. He doesn’t, but pretty much every child they scope (85%, according to Dr. Krigsman) has “autistic enterocolitis,” even though, as in the case of Tom Kasemodal, Dr. Krigsman was hard-pressed to find abnormalities. (“Mild or softer findings,” he said about Tom.) Of course, on pathology, Thoughtful House pathologists apparently found “mild inflammation.” What did Krigsman prescribe? Lots of supplements, daily laxatives, and periodic colon cleansing. Can you imagine subjecting an autistic child to laxatives and colon cleanses? As far as I’m concerned, that’s child abuse, particularly given that there’s no scientific justification for it.

Sadly, A Dose of Controversy falls into the same trap that so many media examinations of pseudoscience fall into. It applied the journalistic convention designed for stories about politics, legal matters, and other human conflict to something it’s not well-suited for, the battle between pseudoscience and science. In doing so, it gives the impression that there is actually far more to the pseudoscience than there in fact is. Even worse, it dollops onto that convention another cliche, namely the iconoclast, the rebel, the “brave maverick doctor bucking the system against who the system stands united. Pile it all together, and it was a huge missed opportunity. Two statements illustrate this well, both occuring near the end of the report. First Lauer describes Wakefield as a man who will listen to these parents, respond to them, and stand up for them, while Wakefield says, “I don’t know if vaccines cause autism. I know it’s a question that needs to be asked and I’m not going to walk away from it.”

I predict that the phones at Thoughtful House will be ringing off the hook this week. I guess I should be grateful that, for whatever reason, Jenny McCarthy wasn’t interviewed for this report.

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]

260 replies on ““A Dose of Controversy”: More like a dose of equivocation”

“It’s pseudoscience versus versus science, but Lauer et al starts out painting the story as that of the proverbial “brave maverick doctor” (Andrew Wakefield), who thinks he’s found a horrible result that the medical establishment does not want to acknowledge, which is why it tries to shit him down.”

I see the defecation snuck in there.

The minute I saw Healy spouting that crap on the teaser (we were watching NBC News) I knew the special was going to be awful. Thanks for summarizing it and confirming that my suspicions of the tone were 100% on.

WEEKLY COLON CLEANSING???? Is this guy NUTS??? I can see laxatives for a constipated child, because of the vicious cycle of constipation->pain->refusal to defecate->more constipation etc. I can see enemas if the child is constipated until they are regulated. I can see increased roughage in a diet if a child will eat it. I can see dietary supplements if a child is such a picky eater (and I had 2 of them like that) that they need them. But I cannot imagine subjecting a child to weekly colon cleansings. Good grief!

Go on, judge! Shit on ‘im!

Speaking as someone who has had to have endoscopy and strong laxatives for real medical reasons, no one should have to go through that without a medical reason for doing so.

Y’know. A week or two ago, someone mentioned Bernadine Healy in a thread on vaccines, and I had gone searching to see if she had changed her stance, at all, given how much research has been done since she first came out saying that “we shouldn’t shut down scientific inquiry into vaccines, blah blah blah”. I found a quote from only a couple weeks before that restated that stance, so I’m not surprised that she, once again, stepped in it.

Just goes to show that even fools can achieve high office.

As to the rest of the show, I feel relieved that I missed it. It’s a great shame when advertising masquerades as journalism.

This isn’t my area of expertise, but I was under the impression that overuse of laxatives, colon cleansing, etc. damaged the colon. (I always heard this during high school health class discussions about eating disorders, so they may have exaggerated the effects.)

I wasn’t as disappointed as you. Then again, I have no faith in our “news” media to report facts, only the “news” (the story consistent with the agenda). I was actually surprised that Lauer didn’t give Jenny much more play, since the first 2 rules of the MSM are “If it bleeds, it leads.” and “Sex sells.” Accordingly, since I expected essentially nothing, that there was anything of substances was a pleasant surprise.

Still, I think that some of your comments are not accurate.

“For example, he asked Deer, ‘In your opinion how much was Wakefield paid?'”

You’re not subject to British libel laws. If Beer was wrong as to a “fact”, Wakefield could sue him (again). By stating “an opinion”, Beer won’t get sued and have to pay Wakefield’s attorneys. Still, it would have been nice if Lauer had explained British libels laws and “loser pays” rule on attorneys fees, and let Beer elaborate more on the what and why Wakefield had had to pay Beer’s attorneys.

“At times Dr. Offit came across as testy and angry.”

If someone threatened my children, I’d be testy and angry, too. Too bad Lauer didn’t further show the dark side of the anti-vax movement, or explain how and why that position threatens the health of children who are vaccinated. Unvaccinated children are walking incubators for mutations of diseases that vaccines would protect against. If they just wanted to let their own kids suffer, I might not object. It’s the putting everyone else at risk that burns my butt.

I don’t know if you caught Mrs. Kasemodal’s comment about why they brought their son to the place. “We think he has a hidden intestinal problem.”

The beauty is that, now, after nothing was found, they can still claiim it is a HIDDEN problem. Oh, he has an intestinal problem, and we’ll find it, darn it! A win for Wakefield!

I didn’t see the first half but caught the Krigsman crap. Man, what a load of bullshit reporting that was. “Courts found that Krigsman was a charleton, and a whackjob fraud. However, when we interviewed him, Krigsman defended his actions.” – cut to interview with Krigsman declaring he will be vindicated.

Really? The guy that the court laughed off as being an idiot disagrees with the court’s opinion? Who’d of thought it?

I did like the statement from the president of the Gastrointestinal society: “Autistic entercolitis is not a real disease”

Of course, Krigsman begs to differ…

I did not have as much a problem with what was said, rather it was how. The piece felt like the lead up to a boxing match. I do think that overall this was a win for the scientists.

I wasn’t as disappointed as you

I can understand this, actually. In fact, I’m guessing that NBC is going to defend it on the grounds that they provided authoritative information, and, in fact, denied their was an autism connection. Recall the statement, “It’s been 15 years since Wakefield’s publication, and even though since then science has shown there is not a link between vaccines and autism, the controversy continues”

But it is also the case that while the truth was there, the show was far too sympathetic to the views of the anti-vaxxers to be consistent with mainstream medicine

Good God, that awful?

WEEKLY COLON CLEANSES? What the heck?

Wakefield should be in jail for allowing child abuse to occur, not to mention endangering lives with his rhetoric.

Gonna retweet this. People need to read it.

Actually, I have to go back and listen to the show again. I don’t remember if it was weekly or monthly now. Either way, it’s bad; it’s just that monthly would be a little less bad.

Actually, the problem I had with the show was that Wakefield is complete red-herring. Assume for the sake of argument that Wakefield was an honest, ethical researcher, and that his original publication was preliminarily suggestive, but too small of a scale to be conclusive. It did, however, warrant follow-up.

Given all that, so what? The follow-up has been done, in far more detail than the original work and NOTHING HAS BEEN FOUND. So even if we assume Wakefield’s original study was on the up-and-up (and it was treated that way), it was still a dead end. So who cares about Wakefield’s stuff anymore? Obviously, just the anti-vaxxers, because it’s the only thing they have. They have to cling to thouroughly discredited work (both scientifically discredited, and professionally).

But the most important point is that, even the best assessment of Wakefield is “innocently mistaken”. It could be even worse. However, under no circumstances can he be viewed as “right.” So what’s the hubbub?

I have to disagree. In my opinion, no way was the program balanced. I thought it was a big win for science. My husband, who knows little about the controversy, watched it without commentary from me and thought it made the ant-vaccine movement look pretty bad.

At almost every turn, Lauer was questioning and critical as were others interviewed. The strong commentary that not vaccinating was dangerous was clear.

Every parent has had a kid with a belly ache. To link it to autism? I’m sure the vast majority watching this would think this was just plain weird. And, to have to pay out of pocket?

Viewers saw a guy, drummed out of his homeland, no backup, weird theory, taking money from the desperate, looking weary and unsure.

And, the commentary at the end that England is looking into possibly taking action is devastating. Viewers will also remember the last thing said: vaccinations are important.

I say well done. Very well done.

In the “good ole days” guys like Wakefield and Krigsman would be horse-whipped and ridden out of town on a rail.
I have no empathy for them at all, reserving what I do have for the poor boy who will now be subjected to torture by laxative and enema. For health reasons I wont’ go into, I’ve had both a sigmoidoscopy and a barium enema series, and prep for those was a unique kind of hell I’d go a long way to avoid repeating. I had them 2 weeks apart at different facilities and had to do the prep at home, myself. That said, I’d like to ask — what is it with alt-med scammers and their fascination with poo ?
Did mummy make them sit sideways on the toilet ?
Are we just a bit obsessive with fecal matter ?
Do they put on latex gloves and a mask before sitting on the toilet ?
I just don’t get it.

I keep wondering when the news channels with a) stop employing obnoxious, loudmouthed airheads like Beck and Olbermann and b) grow a spine and expose charlatans and frauds rather than selling cheap, pathetic melodramas that make no distinction between fact and opinion.

So far I’m 0 for 2.

“Actually, the problem I had with the show was that Wakefield is complete red-herring.”

Well, Wakefield is from a country where the following warning signs are taken seriously:

http://www.telegraph.co.uk/travel/picturegalleries/6055997/Sign-language-week-62.html

http://www.telegraph.co.uk/travel/picturegalleries/5939712/Sign-language-week-59.html

http://www.telegraph.co.uk/travel/picturegalleries/5842424/Sign-language-week-57.html

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=2

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=3

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=4

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=5

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=6

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=9

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=12

http://www.telegraph.co.uk/travel/picturegalleries/5788182/Sign-language-week-56.html?image=18

[OK, not all of them are from the UK, and (I hope) not all of them are serious. Still, D.C. seems to have hit the nail on the head. Before last night, few in the U.S. had heard of Wakefield. Dateline gave him $ Millions in free publicity. As Huey Long recognized “I don’t care what the write about me. I only care that they spell my name right. In six months no one will remember what they said about me, but they will remember my name.”].

My nephew has autism and every day is a huge challenge for him, my sister, brother-in-law and his younger, typical brother. While there may be science around vaccines not causing autism, where is the science that shows what to do about it or what IS causing autism????? My family is desperate to help my nephew and they get reports from other families of autistic children that the Thoughtful House can help kids recover. So, they are trying it. What else is are parents to do, but try what they can!?!? And it’s not true that every kid gets the same treatment. For instance, laxatives would be the worst for my nephew as he hasn’t hardly had a formed stool in his entire life and they haven’t prescribed that. As a pregnant woman expecting a boy with a better than 1 in 100 change of being autistic, I am frightened, too. What do I do to prevent this? Anything? Nobody can tell me. These families really need help and NOW!

Also, I am as frustrated as the rest of you on the horrible quality of reporting in this country. We have to get back to getting the $$$ out of the newsroom…

I’d have to say that at least it is having a positive effect. The anti-vaxers I know are in a tizzy over it. They saw all kinds of things that they didn’t like, and were complaining on the forums almost as soon as it went off.

They complained about Lauer’s “tone” when talking to Wakefield, and his “adoring tone” with Dr. Offitt.

I laughed almost the whole way through! Matt Lauer was *SO* completely biased it was just laughable! Not that I expected anything else, but he was just so freakin’ *obvious*! He spoke in snotty tones to Dr Wakefield but he had this adoring tone with prOffit. And why didn’t he bring up Brian Deer’s checkered past?! He also asked prOffit for “advice for parents.” Why didn’t he ask Wakefield for advice for parents?

They complained that since it didn’t support them, then what was the point. Darn it, why can’t all interviews tell us what we want to hear!

not happy! and the end when he asks so for those parents wondering what to do the Pediatric association recommends not to delay vaccinations and that it does not cause autism. clearly stating that parents should vaccinate! whats the point of the show?

And others had to “preview” it before their husbands got to see it. Needless to say, the husbands don’t have to worry about spending an hour watching it.

I think I will have to DVR it and ‘preview’ it before I let DH watch. I always get my hopes up and then get let down by these specials not talking about the things I really want them to talk about…

I would stop short of saying I like it simply because the anti-vaxers hated it. That’s akin to the way they embrace any quck that doesn’t like vaccines, no matter how “out there” or fraudulent they are. Just because they don’t like it isn’t a good enough reason to applaud it.

Overall, I think it is about as good as you can hope for from a mainstream news organization. They feed off of controversy, and when dealing with straight facts Wakefield is a feeble opponent. At least it didn’t support the anti-vax argument and did quite a bit to destroy Wakefield’s credibility with the masses. It’s not even the type of thing they would splice up into moderated clips to forward around. They want it to disappear.

KW said: While there may be science around vaccines not causing autism, where is the science that shows what to do about it or what IS causing autism?????

An excellent question, KW. And that is exactly what most scientists would like to answer. The problem is there is a ridiculous amount of money thrown after the “vaccine-link” red herring that has proven over and over to be a dead end. Let’s throw away this nonsense of attacking vaccines and spend that money on trying to figure out the real cause.

Everytime AoA “demands” more research into vaccines they are taking money away from something that might be helping your nephew or potentially your own child.

BTW – it was monthly colon cleanses not weekly. Still bad if you ask me.

The big problem I had with the reporting was that the scientific fraud was pretty much glossed over — they just showed the headlines in the UK papers and mentioned that 10 of the 12 authors had removed their names from the paper. They should have explained in more detail why The Lancet editor would have not published the paper knowing what he knows now.

@KW

where is the science that shows what to do about it or what IS causing autism?

Scientists are working on it. So far, there is preliminary work that suggests a major genetic component. The exact cause or causes of autism are not yet known, though some causes have been ruled out (e.g., vaccines). With that in mind, at present, as awful as it may seem, there is nothing that can stop or prevent it.

There are ways, however, to deal with some of the difficulties. Behavioral therapy is one. If a child does happen to have any other physical ailments (e.g., constipation, acid reflux, etc.) that cause physical discomfort, treating those issues are likely to result in improvement in acting out/aggression as well.

The drivel continues with people such as Wakefield. I didn’t see a mention of Jim Carey’s wife on Oprah spouting the same kind of anti vaccination nonsense. Why anyone would a nanosecond of credence to anything she has to say beggars belief.
if vaccines cause autism then why aren’t the number of cases in the hundreds of thousands based on the number of vaccinations that have so far been given.

if vaccines cause autism then why aren’t the number of cases in the hundreds of thousands based on the number of vaccinations that have so far been given.

This isn’t a fair comment. It’s not as simple as If X then Y. The human body is complex, and how it responds to stimuli depends on lots of different things, most of which are not known or knowable.

That being said, it’s not a question of “where aren’t there more cases” (btw, the claim last night was that there WERE hundreds of thousands – 300 000, in fact), it’s why don’t autism rates appear to be correlated with vaccination?

Everyone should listen when scientists poke fun at the kids he jabbed at a birthday party, and later paid them for their blood? The thing is, Wakefield never said the MMR caused autism, and suggested the 3 in 1 jab be separated. It’s really the parents of kids with autism that went haywire and put words into that debunked study and it’s still parents keeping that debunked theory going. Wakefield is only feeding into them and making money off listening to them. Wakefield also never defined why separate jabs would make a difference. If the measles end of the jab was the culprit, wouldn’t one then consider not having it at all? And lets not forget, he couldn’t double talk his way out of that 1997 application for paten on a vaccine to replace the MMR. The man did and still does wreak of conflict of interest.

The story about the family who traveled for those GI scopes, as if Wakefield is the oooooooonly doctor in the whole world who can locate this hidden gut problem, and of course since it was out of state, those parents had to pay out of pocket. Let’s not forget also, Wakefield is not licensed in the States to practice. Some one is going to need to check Thoughtful House’s tax statements. You bet they should be getting a lot of calls this week!

Good post, Orac. I didn’t see it, so I can’t chime in on which side got more of a benefit or who got hurt, but the fact that there is a question about “which side won?” shows that too much credence was given to the anti-vac crowd.

As for your points on the “in your opinion…” questioning of Deer, could you ever imagine if anyone asked Lauer that when he was doing a report? “Matt, in your opinion did Governor Spitzer engage a high-priced call girl?” He’d think that a completely ridiculous way to phrase the question, and from your descriptions it seems really ridiculous here. If he wanted to be respectful, he should have asked what Deer’s findings were, rather than essentially calling into question the fairness of his reporting. If I were Deer, that sort of thing would have gotten a pretty quick and pointed rebuke.

I too was struck by Lauer’s asking “In your opinion . . . ?”

I don’t think that wfjag’s argument will wash. Wakefield already sued Deer over the same facts and then withdrew the suit, agreeing to pay all costs. The facts are matters of public record. If anything, Deer’s case would be stronger now. In addition, he makes the same claims on his UK-hosted website, not cloaking it in the guise of “opinion.” If Wakefield was going to sue again he would have done it by now, in my opinion.

“Where is the science that shows what to do about it or what IS causing autism?”

This research is ongoing but is currently being distracted. Funds that could be directed at potential causes are being used to study, re-study and study again this false notion about vaccines. Each time, no relationship has been found. The opportunity costs are significant.

http://biology.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pbio.0020267&ct=1

Sorry to go OT but this is on meta-topic for this blog, and I really can’t believe what I’m hearing.
There’s a lady on the radio protesting about the phasing out incandescent bulbs, in favour of lower energy ones. She said it twice now! “blue light is worse. It’s 200nm beyond ultra-violet on the spectrum”!
What! The! Fuck!
They had another guy on who described the classic symptoms of radiation poisoning, as experienced by those close to nuclear explosions, and ascribed them to low energy bulbs.
I know. It’s so-obviously an astroturf campaign, but that woman has kids and they convinced her she needs to “spend two days in a darkened room” whenever she sees a low energy bulb, even if it’s off!
What! The! Fuck!

GregF #16

Olbermann has ridiculed the anti-vaccers. Several times. And loudly.

Did they listen? Of course not; they equate KO with Beck.

All MSM are liars; whatever they report is false. Believe the opposite is the mantra.

Next week on Dateline – Bernie Madoff: Swindler or Casualty of the Recession?

As a pathologist, I would REALLY like to see those biopsies that supposedly show “mild inflammation”. Since the GI tract from stomach on is essentially lined with mixed inflammatory cells, a diagnosis of mild inflammation sounds like BS to me. Maybe if neutrophils were present, such a diagnosis could be made, however, they can be present after “vigourous” bowel preps. Also, intestinal biopsies in children routinely contain a very active looking and dense chronic inflammatory cell population, that could certainly look like a chronic inflammatory reaction to someone not used to pediatric specimens. Also, Thoughtful House would be able to choose the pathology group they refer to – which might have some bearing on the results they receive…

The Blind Watchmaker – Thanks for the link. That was interesting info. Also interesting, my nephew doeas have a larger than average cranium. Maybe it’s part of it…

I’d be interested in the thoughts of those on this post re: the link between antibiotic use and autism. My sister was on triple antibiotics for the first 6 days of my nephews life (uterine infection) and he breast fed the whole time. Also, he had repeated ear infections early on for which he took antibiotics. Any science behind this link????

My nephew has autism and every day is a huge challenge for him, my sister, brother-in-law and his younger, typical brother. While there may be science around vaccines not causing autism, where is the science that shows what to do about it or what IS causing autism?????

It’s being worked on but people like Wakefield and Thoughtful House are damaging that research by causing people to have to waste a huge amount of resources battling their nonsense. You should be angry and them for how they are hindering actual good empirically based science and medicine from finding a cause / treatment.

My family is desperate to help my nephew and they get reports from other families of autistic children that the Thoughtful House can help kids recover. So, they are trying it. What else is are parents to do, but try what they can!?!?

And risk unknown damage from an unproven and unsupported psuedo-scientific treatment? They might as well go to a witchdoctor.

And it’s not true that every kid gets the same treatment. For instance, laxatives would be the worst for my nephew as he hasn’t hardly had a formed stool in his entire life and they haven’t prescribed that.

Why don’t they have studies like the ones Orac mentions above to support anything they are doing?

As a pregnant woman expecting a boy with a better than 1 in 100 change of being autistic, I am frightened, too.

As are many people. You have to decide who to trust. Those with the massive weight of the empirically derived medicine saying that Vaccines are not involved in autism or some quacks who refuse to back their claims?

What do I do to prevent this? Anything? Nobody can tell me. These families really need help and NOW!

No one knows for sure. That includes Wakefield.

But science based medicine is the only group that is actually making progress from the work they are doing. Wakefield et al are working off of blame and fear.

Bruce McN:

You’ve got it on the nose. Brian Deer has the pathology reports. I’m sure he’d be glad to hear from you.

Even though complaints from chronic pain patients are easier to diagnose and document we now have created a situation where doctors are under-prescribing out of fear, especially if their patient are in their last stages of life because the docs can be charged with murder if autopsies shows high traces of pain medication. I pray this madness comes to an end and I sincerely hope none of you will ever be dying in extreme pain in a hospital, nursing home or maybe at your own house while the doctor is afraid to give you that prescription or injection during your last moments. Yes, definitely keep this medication away from kids but do make it available to those who can benefit from it!

@KW

As a pregnant woman expecting a boy with a better than 1 in 100 change of being autistic, I am frightened, too. What do I do to prevent this? Anything? Nobody can tell me. These families really need help and NOW

If there’s as much of a genetic component that there seems to be, there ma be nothing you can do about it. The problem with places like thoughtful house is that they are giving the desparate parents hope that their child’s autsim can be cured. Most likely it can’t. So the quacks tell them to give the kids this supplement and that, subject them to endoscopes and enemas and the parents swallow it all, instead of accepting their child for who they are and helping them to cope with their illness instead of trying junk science to cure it.

Excellent post, and further evidence illustrating the decrepitude of ‘crumbling old media.’

To quote another lyric, Paul Brady from his “Nothing But the Same Old Story”

http://www.youtube.com/watch?v=lWjFVWKqOg8 :

“[…] the sound of the crumbling foundations
any fool can see the writing on the wall
but they just don’t believe that its happening.”

-r.c.

And others had to “preview” it before their husbands got to see it. Needless to say, the husbands don’t have to worry about spending an hour watching it.

Can I just say, women like this piss me off. I am a new parent, and have encountered a few who are this way, the ones who insist that in terms of parenting, it is their way only, and dad’s only job is to do whatever they say. And if dad has the gaul to question their decision, well, she’s the mother and she is always right.

I volunteer at Dad’s Boot Camp during baby classes, and one thing I always emphasize is that “team parenting” means that you work together, and that if you are a caring dad, then your “instincts” are just as legit as hers, and don’t let her tell you that your opinion doesn’t count.

This is just another example of this – mom has made up her mind that vaccines are evil, and dad can’t be allowed to question it. She won’t even allow him to learn about it from a source that she thinks could cause him to doubt her legitimacy.

I’m sure, however, that she will let him read Jenny McCarthy’s and Bob Sears’s books.

Research question for you. Assuming that the increase in autism numbers is due to 1) broader definition, and 2) better screening, has anyone tried to run numbers for “If we were still using [old definition] and were only detecting [old percentage] of cases, what would the numbers look like today?” I’m sure it’s not quite as simple as that, but it seems like it ought to be possible to control for those variables in a historical study.

Maybe it turns out they do account for ~100% of the increase; or maybe they turn out to only account for 75% and there is some other (as yet unidentified) environmental factor at work. I know that still wouldn’t convince the die-hards, but it might give a sharper tool for deflating their arguments.

OT, but Pablo, good for you! For about five years, every other month I led a two-hour “Fatherhood 101” workshop for new and expectant fathers at the local hospital. I always told them that there’s nothing a father can’t do other than breastfeed. That pre-screening comment really caught my attention, too. Fathers and mothers are parents. Any division of childrearing responsbilities should be made based on mutually agreed-upon and practical/logistical issues. (I also bristle at marketing showing how only mom can choose the right breakfast cereal, e.g, Kix, or the correct peanut butter, e.g., Jif.)

I’m stepping off my soapbox now…

Pablo,
The entire anti-vax movement is based in hypocrisy. The moms that post this stuff prattle on about being “educated”, but filter information from their husbands so they don’t get the whole story. I guess they don’t trust them enough to be “educated”.

They go on about how NBC must have been paid by pharma companies to have done that report and complain about Deer about his “questionable history”, but never even pose the most basic amount of skepticism towards Wakefield or his organization that are profiting from his “research”. And that is despite having it laid out in front of them.

It couldn’t be further from “education”. Legitimate education and research does not have to filter competing viewpoints. If what they believe is accurate then it should be able to withstand critical thinking. It’s telling that they would hide it from their spouses – it tells me that they hold their beliefs more sacred than their desire to share parenting with their husband.

It’s mind boggling to read posts talking about how well they have researched things and how educated they are and then they have quotes from Kevin Trudeau in their signatures …

So instead of following the “two sides of every story” format, why can’t they use the “true crime” format instead? Seems much more appropriate.

Oh boo hoo hoo.

NBC actually did a fair and balanced report on a complex medical issue and guess what, the side promoting more vaccines for children and stopping all research into the risks of these vaccines came off looking REALLY bad.

You know it is true.

Quick quiz. Anyone who saw the piece ask yourself which doctor came off as angry, entitled, prickly and feeling that he was being persecuted. That would be Dr. Paul Offit.

Who was called a baby killer, was said to have blood on his hands, admitted that he received millions from selling a vaccine and called for the end of research into the safety of vaccines.

Again, that would be Dr. Paul Offit.

Who came off as reasonable, not easily rattled and more interested in helping children than battling it out with his critics.

That would be Dr. Andrew Wakefield.

And who was admired by parents and said he did not know if vaccines caused autism, but said there should be more research.

That would be Dr. Andrew Wakefield.

Basically, Wakefield was JFK to Offit’s Nixon. As they said about Nixon, would you buy a used car from this man.

And I’m glad a reporter actually included that Offit has made millions from the sale of vaccines and that he has objectivity issues. You never see that fact in any AP, Reuters, USA Today or New York Times stories with Offit in them. They simply quote Offit trashing anyone who dares to question vaccines and they never mention his pretty serious conflict of interest.

A lot of people were hoping that this NBC story would be a big knock-out blow and send the anti-vaxers into a tizzy. Actually, it looks like the other way around.

One last thing to the fans of this blog. Please keep bashing celebrities like Jenny McCarthy and making fun of autistic parents and their children. And Doctors like T. Bruce keep telling anyone you disagrees with you to fuck off.

But, once and for all, please STOP the straw man argument that there are limited funds for research and that autism-vaccines studies are taking up too much time and valuable resources.

Last spring, the CDC actually did a study on…wait for it…the fact that pets actually trip their owners.

Below is the Wall Street Journal link. That says a lot about the priorities of the CDC.

http://blogs.wsj.com/health/2009/03/27/cdc-to-americans-dont-trip-over-your-dog/

Orac –
Didn’t Wakefield have a patent in the works for a single-shot measles vaccine as well?

“Didn’t Wakefield have a patent in the works for a single-shot measles vaccine as well? ”

Yes. The current spin is that this was a vaccine to treat people with persistent infections, not a vaccine to prevent disease. That’s what Dr. Wakefield claimed.

All well and good, except that this patent specifically calls for the vaccine to be used to prevent measles.

http://briandeer.com/wakefield/wakefield-patents.htm

I was diagnosed with autism long before there was ever an MMR vaccine.I have many other childhood medical onset medical condiations,that directly contribute to the severity of my autism.One of these is inflammatory bowel disease.My new DAN! doctor believes I may have an autoimmune complex,that mainstream doctors would not,or could not diagnose.I had autism,my doctors always said,so I either had to accept my symptoms as an unexplained part of it,or I had a “mental illness” (autism) and was making up factitious illnesses,because that’s what people with “mental illnesses” do.

Prior to the vaccine business in the late 90s, NOBODY believed anybody with autism had any immune or medical problems that went along with it.I think the better DAN! doctors,like mine, are probably a good ten or twenty years ahead of mainstream medicine as far as autism as treating autism as a medical disease is concerned.They all believe autism has many different causes and triggers,but they all believe there are serious medical conditions that go along with the autism,and contribute directly to its severity.Unlike most mainstream doctors who see it as a psychiatric disease.

I have had two major autistic regressions as an adult.Both were preceded by acute infection.My autism was probably triggered by acute meningitis as a baby.Many of the parents who say their children developed autism from vaccines,did not go directly from vaccination to autism.Many developed an acute febrile illness,after the vaccine,and then developed autism as a result of the post vaccine illness.

As a child,I had to have an enema at least once a week.Otherwise I was so backed up,I could not go on my own.I usually had a good five pounds or more,of fecal matter impacted in there at any given time time.It was not until I was in my twenties,that I started on very high doses of enzymes and probiotics,that I was able to have regular bowel movements. So I can easily understand an autistic child having to undergo a regular colon cleanse.

Sullivan said:
“All well and good, except that this patent specifically calls for the vaccine to be used to prevent measles.”

From your source, it says nothing of the sort. The vaccine that he calls for a patent for is for the Varicella virus. In case you didn’t know, that isn’t measles. The other patent for the Measles treatment says (directly from your link and highlighted)
“Pharmaceutical composition for *treatment of MMR virus mediated disease*” (*emphasis mine*).

It is very clear that you and Deer are misrepresenting the facts.

After further reading, I see where it mentions the vaccine. Please excuse my previous post.

However, the second patent application says for the treatment of MMR mediated disease. His idea that was posted on 2-2-98 is for a Varicella vaccine. It appears as if he revised his research and findings prior to releasing the Lancet article. Deer’s claims are merely speculation.

“NBC actually did a fair and balanced report on a complex medical issue . . . “

It is not a complex issue. The “vaccines cause autism” hypothesis is deader than Julius Caesar. To anyone who bothers to read the science on it, the issue is settled, with the vast majority of the most credible evidence being in favor of “no, there is no causative link between vaccines and autism”

“But, once and for all, please STOP the straw man argument that there are limited funds for research and that autism-vaccines studies are taking up too much time and valuable resources.

Last spring, the CDC actually did a study on…wait for it…the fact that pets actually trip their owners.”

A study was done on something you don’t consider important, ergo there is plenty of money for unnecessary studies to find a non-existent link between vaccines and autism ?

As for the “Ooh look, Wakefield happy-shiney, Offit Evil-Meanie” bit of nonsense, Science does not work by popularity contest. Newton was, by many accounts, quite the egotist, irascible and disdainful of his competitors.
This does not make sir Isaac wrong. (to be pedantic, Newton was incorrect in some respects once you throw in quantum mechanics, but his laws of physics still work as originally written in the Principia some 322 years ago.
For all that, health-scammer and con man Kevin Trudeau is considered to be quite the handsome and charming fellow.
So what ? His books are still scams and his criminal behavior is still criminal behavior.

@David M.: you said “Quick quiz. Anyone who saw the piece ask yourself which doctor came off as angry, entitled, prickly and feeling that he was being persecuted. That would be Dr. Paul Offit.
Who was called a baby killer, was said to have blood on his hands, admitted that he received millions from selling a vaccine and called for the end of research into the safety of vaccines.
Again, that would be Dr. Paul Offit.
Who came off as reasonable, not easily rattled and more interested in helping children than battling it out with his critics.
That would be Dr. Andrew Wakefield.
And who was admired by parents and said he did not know if vaccines caused autism, but said there should be more research.
That would be Dr. Andrew Wakefield.”

Well, gee, maybe Dr Wakefield has never had death threats through the mail, creditable enough that he had a bodyguard and the FBI involved, had his children’s lives threatened.

If that was me, I, like Dr. Offit, would come across as prickly (or possibly MORE than prickly), persecuted, etc. Dr Wakefield, even though he is NOT licensed in the US, is head of Thoughtful House.

He never declared his conflicts of interest until Brian Deer brought them out, and he tried (and LOST) to shut Mr. Deer up by suing him. Dr. Offit has always declared his conflict of interest AND recused himself when a vote on which rotovirus vaccine should be used so that he was not voting for or against a competing vaccine. Give me a honest, prickly man over a dishonest, “reasonable” man anyday.

@WScott, #40

Not exactly what you are looking for, but this paper, and the proceeding one by Chakrabarti and Fombonne looked at the preschoolers in the same geographic area. In the first study they looked at kids born between 1992-1995, and in the second one between 1996-1998. These are the dates over which the “epidemic” was supposed to be really taking off. They found a stable incidence when using the same diagnostic instruments. The full text is available through pubmed.

Am J Psychiatry. 2005 Jun;162(6):1133-41.
Pervasive developmental disorders in preschool children: confirmation of high prevalence.
Chakrabarti S, Fombonne E.

Child Development Centre, Central Clinic, Stafford, UK.

OBJECTIVE: The rate of reported pervasive developmental disorders has increased, and the authors found a rate of 62.6 per 10,000 in a previous study of preschoolers in Stafford, U.K. They conducted another survey in 2002 to estimate the prevalence in children in a later birth cohort and to compare it to previous findings from the same area. METHOD: Screening for developmental problems included 10,903 children ages 4.0 to 6.0 years who were living in a Midlands town on the survey date. Children with symptoms suggestive of pervasive developmental disorders were intensively assessed by a multidisciplinary team using standardized diagnostic interviews, psychometric tests, and medical workups. RESULTS: Sixty-four children (85.9% boys) were diagnosed with pervasive developmental disorders. The prevalence was 58.7 per 10,000, with a 95% confidence interval (CI) of 45.2-74.9, for all pervasive developmental disorders, 22.0 per 10,000 (95% CI=14.1-32.7) for autistic disorder, and 36.7 per 10,000 (95% CI=26.2-49.9) for other variants. These rates were not significantly different from the previous rates. The mean age at diagnosis was 37.8 months, and 53.1% of the children were originally referred by health visitors. Of the 64 children with pervasive developmental disorders, 29.8% had mental retardation, but this rate varied by disorder subtype. Few children had associated medical conditions. CONCLUSIONS: The rate of pervasive developmental disorders is higher than reported 15 years ago. The rate in this study is comparable to that in previous birth cohorts from the same area and surveyed with the same methods, suggesting a stable incidence.

pD: You agree with most of Roger Kulp’s statements?! Hmm. A bit strange since most of them are personal anecdotes from his childhood. Exactly how are you supposed to agree with his testimony of five pounds of fecal matter 😉

Actually, who came off as angry, entitled, prickly and feeling that he was being persecuted, wouldn’t you when there’s been death threats and threats against your children all over this vaccine debate? What the public seen was a natural reaction that anyone would have had under those same circumstances and I would bet the public is thinking “who in their right mind would threaten the well-being of a mans children over this??” The one who appears unstable is those who made those threats, and a man still trying to conduct his life and profession through it all and not give in to mean cruel people. Also, at the mention of McCarthy, very few can maintain cool calm composure! Don’t think she isn’t making a pretty profit either off of all of this.
Has anyone’s child ever had rotovirus?? Mine has. So some see dollar signs, I see I wish that vaccine was available to prevent the damage it did to my child who has autism. Rotovirus can kill babies, I see nothing Wakefield is doing to save lives. And of those parents who admire Wakefield? It’s a blank statement without validation of what exactly he’s even done for their children and they make it out as if he’s the only doctor in the whole wide world that listens. Remember, Wakefield is no autism expert nor was he ever involved with autism until that phone call which resulted in his debunked study.
What the public seen was finally the face and voice behind the only thing the man is famous for, a debunked study of who hasn’t done much at all for the autism community in the past 15 years other than to be paid to ‘listen’ to parents. He’s not even suppose to have direct medical consults so one wonders if they should be investigating just what’s going on in Texas.

@Jennifer #55 – thanks. Looks interesting – tho I don’t have access to pubmed. (Not my field.)

Just a mom,

You nailed this on the head. I’ve been active in on-line autism discussion groups for years, and I can tell you that I’ve never seen anything but blind admiration for “Dr. McDreamy” the beautiful Dr. Wakefield. Part of his particular strength is that he IS so handsome and charismatic. Certainly no death threats! So handsome, so kind, listens so well to parents, tells them what they want to hear, a brave maverick doctor, unfairly persecuted. And all this despite the fact that the best cases they could find for the autism omnibus hearings did not demonstrate that he has actually helped children. Quite the reverse, actually.

On the other hand, Dr. Offit has demonstrably saved many children’s lives through his vaccine inventions. But the vitriol, threats (veiled and otherwise) as well as our-right hatred expressed on every major biomed discussion group towards him is frightening.

The factual content of the show was OK, but the show typically turned it into a “these guys vs. those guys” dispute: Wakefield and Healy on one side, Deer and Offit on the other, and I think that this is the message that most viewers will be left with. The fact that the overwhelming scientific consensus is that Wakefield is at best incompetent, and perhaps even a fraud, was passed over quickly with brief shots of the many publications refuting Wakefield’s claims, although I thought that it was good that they flashed on the screen the number of subjects in the larger studies that showed Wakefield to be wrong. Still, the underlying story was Wakefield vs. his critics, rather than Wakefield vs. pretty much everybody who has ever studied the subject.

A presentation that more fairly represented the science would have been to show Wakefield, and then a dozen or so autism researchers and public health experts talking about how very wrong and damaging Wakefield’s claims are. It would have been good to have another gastroenterologist, like Michael Gershon, addressing the fundamental implausibility of Wakefield’s claims.

Ok, let’s nail the Wakefield measles vaccine once and for all, and show him for the liar that he is.

Here, at Brian Deer’s website, is the issued patent document for Dr Wakefield’s vaccine.

http://briandeer.com/mmr/1998-vaccine-patent.pdf

You may notice that the patent BEGINS:

“The present invention relates to a new vaccine/immunisation for the prevention and/or prophylaxis against measles virus infection…”

What part of the words “vaccine”, “immunisation”, “prevention” and “prophylaxis” is it possible not to get?

And just to show that Dr Wakefield had this scheme going BEFORE he published his paper to start the vaccine scare, how about this one, the unpublished version submitted to the patent office:

http://briandeer.com/wakefield/vaccine-patent.htm

There are lies, damned lies, and “autistic enterocolitis”

Look. I have no doubt that parents of autistic kids suffer. But that’s it. It’s the parents who suffer. From my knowledge the quacky cures are going to cause the child more pain than the disorder does, not to mention the trauma of having a parent who is convinced that there’s something wrong with you! And I’m kind of tired of feeling sad for desperate parents of autistic kids.. Part of the problem is the attitude of the parents towards their child. Your kid is somehow imperfect because he’s mentally ill. You need a cure! NAO! Autism has gobs of money thrown after it. Celebrities bring it to general attention, even if the awareness is tainted with misinformation. People give a crap about autism!
Where’s the outcry for the lack of cure for bipolar of obsessive compulsive children? Where are the parents of teens with psychosis complaining about how they’ve been driven to dangerous quackry to cure their kid because they’re just so desperate? Where are the parents with kids who have congenital birth defects? They don’t have the limelight of public sympathy so they have to do what you desperate parents ought to be doing which is trying to raise a kid with a sense of right and wrong and the ability to cope and utilize the way their mind and body work.

“Who came off as reasonable, not easily rattled and more interested in helping children than battling it out with his critics.
That would be Dr. Andrew Wakefield.”

..in common with most successful conmen

“And Doctors like T. Bruce keep telling anyone you disagrees with you to fuck off.”

David M, I don’t recall telling you to fuck off. If I did, then my work is done.

You’re not subject to British libel laws. If Beer (sic) was wrong as to a “fact”, Wakefield could sue him (again). By stating “an opinion”, Beer won’t get sued and have to pay Wakefield’s attorneys.

Actually, Orac is subject to the English and Welsh libel laws (but possibly not Scottish). It’s enough that his blog can be read over there.

Also, IANAL but I’m not sure the “in your opinion” trick would work. The advice I’ve seen from lawyers is that the courts would happily see through such tricks.

What a shame that Dr. Wakefield’s study is such an easy target and that he, himself, appears to have economic conflicts of interest. I don’t know him personally, but I continue to give him the benefit of the doubt.

I have spoken with and exchanged email with Dr. Offit and I also give him the benefit of the doubt. I have foolishly made intemperate remarks about him and his very real economic conflicts of interest but I think that he is consistently motivated by his desire to save lives with vaccines. I disagree with his methods and many of his ideas but I will never again impugn his personal motives. He started in this field long before it became wildly lucrative for him and I believe that his vaccine profits–while not an insignificant reward–were not his primary aim.

I watched the TV show and was disappointed. I think that there was no in depth evaluation of Dr. Wakefield’s research, shortcomings or anything else.

Obviously, I’m biased and saw the show through a different lens than many of you and it felt like an unbalanced presentation against Dr. Wakefield. But . . . in further disagreement, how can one argue with Dr. Healy’s request for more scientific investigation of autism’s causes rather than less investigation?

Dave, I did see Pink Floyd perform The Wall, in 1979 I believe. It was incredible!! I would have traveled miles to spend an hour watching David Gilmour and the guys playing rather than watching Wakefield, Deer, Lauer and Offit!!! A point of easy agreement, right?

Best,

Jay

Best,

Jay

@Jay Gordon

how can one argue with Dr. Healy’s request for more scientific investigation of autism’s causes rather than less investigation?

Ah, but no one is saying to do less investigation into the causes of autism. What we’re saying is that vaccines as a cause is a dead end for further research. We’ve looked. We found no causal link. Time to move on to other potential causes.

Healy’s wrong about this, too. Her comment that implies the anti-anti-vaxers are saying “stop, we have all the answers, shut down the research” is, well, just wrong.

Overall, I’d give your and Healy’s attempts to spin the issue a D.

But . . . in further disagreement, how can one argue with Dr. Healy’s request for more scientific investigation of autism’s causes rather than less investigation?

But Jay, who is doing this? No one that I’ve seen. Admittedly, I have seen a call to move on from vaccines, but “quit wasting time looking for a vaccine/autism link” is a far cry from calling for an end to scientific investigation.

But . . . in further disagreement, how can one argue with Dr. Healy’s request for more scientific investigation of autism’s causes rather than less investigation?

Yes indeed, how can you and Healy possibly justify not researching the causes of autism in favor of pouring the money down the drain studying things where there’s already strong evidence that they are not involved?

YOU’RE the one trying to block effective research into the causes of autism. Those of us who are rational would rather move on from the discredited speculations and get on with the real, productive, research that might actually provide real answers.

I personally don’t think Wakefield is handsome at all and when I seen his wife, I still wonder how he landed her, she is gorgeous. I think the man has a striking resemblance to Jeffrey Dahmer. The thing is, is Wakefield these days other than his speaking engagements, isn’t suppose to have medical consults with patients and he confirmed this as well. Anything he is doing today, my son’s own GI doc has done. I don’t worship my kids doctor, either or any of my son’s therapists. They are there to do a job, and in the end it’s my kid who is doing all the hard work.

Yes indeed, how can you and Healy possibly justify not researching the causes of autism in favor of pouring the money down the drain studying things where there’s already strong evidence that they are not involved?

What we’re saying is that vaccines as a cause is a dead end for further research. We’ve looked. We found no causal link.

What evidence? Where have you looked. There may be no association but those who state the issue has been studied are living in a dreamworld

Since the MMR does not represent all vaccines the vaccine/autism link has never been studied. There are actually more autism studies on linoleum, TV and weather than there are on vaccines in general. Yet vaccine enthusiasts argue vaccines have been proven safe in regards to autism and therefore should not be studied in order to save money for more promising research.

Of course there’s really no reason to study the issue. After all the many reports of normal children regressing after vaccination(a highly unnatural intervention into a developing child) must all just be coincidental.

Common sense dictates that, if environmental factors were involved, vaccination would have to be a logical area of exploration. That’s apparently why there is, on this blog, such a strong bias to conclude the disorder is entirely genetic

Argue why you believe the association implausible but don’t pretend there has been any actual research done

Of course there’s really no reason to study the issue. After all the many reports of normal children regressing after vaccination(a highly unnatural intervention into a developing child) must all just be coincidental.

And how about the reports of unvaccinated children developing autistic symptoms around the time they would have received their vaccinations?. Are they coincidental? How about the Generation Rescue phone survey that found that autism was significantly more common in unvaccinated girls than vaccinated girls? Coincidence?

Given that it is clear that symptoms of autism become apparent is around the age when most children get their vaccines–even in children who don’t get vaccinated, the proximity in time does not constitute evidence of anything. One might as well blame Junior High School for puberty (Have you ever noticed that many children start exhibiting symptoms of puberty shortly after entering Junior High? Coincidence? I think not! I challenge you to show me the study that proves that Junior High School does not cause puberty!)

So if there is an environmental factor in autism (something that we have no actual evidence for), we need to look at everything. How about BPA? Or birth control medications in the water supply? Where do we start? There are thousands of substances in the water and air that weren’t there a few decades ago.

@Sid Offit

Let’s take a look at the evolution of the vaccine-autism kerfuffle.

First argument: “It must be thimerosal.” Okay. We studied it and found there was no link.

Second argument: “Oh. Hmm…then I guess it must be the MMR!” Hmm. An idea based on a flawed and most likely fraudulent study, but we looked at it anyway. Nope. No link.

Third argument: “You scientists are really getting annoying. Well, if it isn’t thimerosal or MMR, then it must be both together!” 🙄 Okay, we’ll look. Nope. Nothing there, either.

Fourth argument: “But the thimerosal! It’s mercury!” Look, we already examined that. Besides, it isn’t there anymore!

Fifth argument: “Aha! Aluminum! They switched out thimerosal and put it aluminum!” Good grief…thimerosal’s a preservative, aluminum salts are adjuvants. There wasn’t any substitution. Besides which, there is no evidence to suggest that aluminum causes autism. There’s more in breast milk and formula than in any vaccine, anyway!

Sixth argument: “Grrr…uh…formaldehyde! Fetal tissue! Squaleeeeeene! It’s gotta be something!” Look mate, before we go chasing rainbows, here, is there really an epidemic? Because, accounting for a number of things (criteria, awareness, etc.) the incidence seems pretty steady.

Seventh argument: “Aha! You didn’t study any of those things! Nor did you study vaccines in toto vs. completely unvaccinated!” You understand the problems with such a study, right? Ethics, money, logistics. Besides which, you haven’t even established that there is anything other than a coincidence going on between vaccines and autism.

Eighth argument: “But the mercury! MMR! Formalde–” Just stop. We’ve already gone over this. Why don’t we try something else. Show us the study that establishes a causal relationship between vaccines and autism.

“But the vaccines! It must be the vaccines!”

Sid, I know you’re a troll here, but could you at least try not to be a boneheadded troll? MMR is an unnatural interruption of a child’s development? Are you implying that the “natural” alternative is possibly interrupting that development permantly with measles mumps or rubella? I suppose you object to the use of formula for women who can’t lactate or the use of baby-gates and electrical plug covers too. Falling down the stairs and getting electrocuted are natural parts of a child’s development. I feel bad for your kid if he ever gets into poison ivy. “no, Timmy you can’t have any calamine lotion! it’s not natural! It has teh toxins!

“I personally don’t think Wakefield is handsome at all and when I seen his wife, I still wonder how he landed her, she is gorgeous.”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/4246536/Sign-language-week-32.html

“Yes indeed, how can you and Healy possibly justify not researching the causes of autism in favor of pouring the money down the drain studying things where there’s already strong evidence that they are not involved?”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/3917183/The-best-of-Sign-Language.html

“There may be no association but those who state the issue has been studied are living in a dreamworld”

http://www.telegraph.co.uk/travel/3150841/Sign-language-week-19.html

“Since the MMR does not represent all vaccines the vaccine/autism link has never been studied.”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/5163976/Sign-language-week-44.html

“There are actually more autism studies on linoleum, TV and weather than there are on vaccines in general.”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/4603140/Sign-language-week-36.html

“Of course there’s really no reason to study the issue.”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/4527079/Sign-language-week-35.html

“After all the many reports of normal children regressing after vaccination . . ”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/4943266/Sign-Language-week-39.html

“. . . must all just be coincidental.”

http://www.telegraph.co.uk/travel/picturegalleries/4029850/Sign-language-week-30.html

“That’s apparently why there is, on this blog, such a strong bias to conclude the disorder is entirely genetic”

http://www.telegraph.co.uk/travel/picturegalleries/signlanguage/5093791/Sign-language-week-43.html

“Argue why you believe the association implausible but don’t pretend there has been any actual research done”

http://www.telegraph.co.uk/travel/picturegalleries/3518392/Sign-language-week-26.html

@trrll

Obviously you’re not using phone surveys and personal anecdotes as scientific evidence. And I’m not aware of the department of Health and Human Services conceding that Junior High caused “puberty-like symptoms”. And you’ve avoided the real issue which is where are all these studies exonerating vaccines? As I stated, argue why you believe the association implausible but don’t pretend there has been any actual research done

@Todd W
Seventh argument: “Aha! You didn’t study any of those things! Nor did you study vaccines in toto vs. completely unvaccinated!” You understand the problems with such a study, right? Ethics, money, logistics. Besides which, you haven’t even established that there is anything other than a coincidence going on between vaccines and autism

So you’re confirming my only assertion which is it’s never been studied. And you used mercury 4 times in 8 “arguments”. And I don’t know of anyone implicating aluminium or squalene nor do I know of any studies involving them.

@Todd

When I start vouching for the safety of vaccines and forcing them upon America’s children then I’ll be responsible for producing vaccine/autism studies

Actually, sid is double-talking. First he claims that MMR is not the only vaccine that could cause the problem so the investigations of MMR are not the end of the story. Then he claims that autism symptoms show up after vaccination, so it makes sense to investigate vaccines.

The problem, however, is that, in fact, the autism signs he is referring to really only show up about the same time as the MMR vaccines, and not the other ones

So if we should investigate vaccines because autism signs show up after getting them, then why do we have to investigate other vaccines that are given long before or long after autism is indicated?

@Sid Offit

My summary of the arguments come from personal experience dealing with anti-vaxers. They keep bringing up thimerosal/mercury despite the studies that show there’s no connection. Quite a few antivaxers have brought up aluminum, among other ingredients, and with the H1N1 vaccine, people are starting to talk about squalene, another adjuvant that has been approved and in use in Europe for quite some time, but which has not yet been approved in the U.S.

Part of the reason that we aren’t putting any more effort into more vaccine studies is because of a couple basic points:

1) The “autism epidemic” appears to be a figment, as I, and others, have already pointed out.

2) The anti-vax arguments keep shifting. Every time they claim something, they claim it absolutely must be that thing (e.g., thimerosal). When the studies are done and their pet guess comes out hollow, they remain convinced that something about the vaccines must be the case. So, they latch onto a new “it must be”. Then that one turns up empty. And all this time, they aren’t suggesting any plausible mechanism.

3) A definitive study would, indeed, be to look at vaccinated vs. unvaccinated. But, as has also been stated, the expense and logistics (testing each vaccine individually? altogether? combination A? combination B? etc.) would be enormous hurdles to overcome, never mind the ethical problems with such a study.

And even if we did all the studies possible regarding vaccines, and they all came up negative, there is still the teensiest remotest possibility that vaccines still do something, and so vaccines will still be blamed.

Now that I’ve gotten that out of the way, where’s that study that shows vaccines cause autism?

Obviously you’re not using phone surveys and personal anecdotes as scientific evidence.

I’m perfectly happy to dismiss all anecdotal reports as any kind of evidence. But if we’re going to do this we have to be even-handed–we have to acknowledge that anecdotal reports of children developing autism after getting their vaccines are just as much not evidence as anecdotal reports of children developing autism after not getting their vaccines. But in that case, we have no evidence implicating vaccines at all. The closest thing to a vaccinated vs. unvaccinated study we have–small, to be sure, and carried out by people with a known bias in favor of blaming vaccines–failed to find a correlation. And larger, much better conducted studies of specific vaccines–of the MMR, of vaccines containing thimerosal–showed that for those vaccines, there is no appreciable correlation. Of course, the “antivax” crowd clearly has the financial resources to carry out a much larger vaccinated vs. unvaccinated study, but curiously, they have exhibited no interest in doing so. I wonder why?

So if we dismiss anecdotes, we have no particular reason to suspect vaccines.

And I’m not aware of the department of Health and Human Services conceding that Junior High caused “puberty-like symptoms”.

Oh, so now the game is “appeal to authority,” is it? OK, let’s play that game. What sort of authority is Dr. Healy? Is she an expert on vaccines? On immunology? On autism? On public health? Please list her peer-reviewed publications demonstrating her research experience in any of these fields. There are certainly plenty of authorities around with expertise in the actual field of vaccines. Your namesake, for example.

And you’ve avoided the real issue which is where are all these studies exonerating vaccines?

No, you are avoiding my question: Where are the studies exonerating Junior High School as a causative factor in the onset of puberty? After all, the evidence for this is much, much stronger than the evidence for vaccines and autism, because there are far more parents who can attest that their children entered puberty shortly after entering Junior High School. I’ve heard many sad stories of how a beautiful, loving child turned into a sarcastic stranger shortly after entering Junior High School. You may “argue why you believe the association implausible but don’t pretend there has been any actual research done.”

@Pablo

Good point.

@Sid Offit

When I start vouching for the safety of vaccines and forcing them upon America’s children then I’ll be responsible for producing vaccine/autism studies

Ah, but you are making a claim that vaccines are dangerous and that they cause autism. The onus is on you to back up your claim.

Thimerosal and MMR have been studied to the extent that the dead horse is now just a faint red smear on the ground. Other aspects mostly have not been specifically studied, though the pre-approval and ongoing safety monitoring required of all vaccines would be expected to pick up any large effect.

There is no credible cause to look more deeply, as there is no evidence even hinting at the possibility of any hypothetical mechanism. This means that any such study would be completely at random and without foundation, and therefore can only be concluded to be a waste of money.

I don’t blame Dr. Offit at all for being angry. He puts up with way more crap than anyone should, much less a man who has saved actual children’s lives.

I was once on the receiving end of the vitriol of the anti-vax movement–and I don’t even have a child with autism. I called a mother who had offered to share the name of her child’s PT. Our child had (and still has) low tone and gross motor delays. During a very civil conversation, she mentioned that she thought her son’s autism was caused by vaccines. I said I did not think our problems had anything do with shots and that our kids were up to date. She launched into this tirade about the pharma industry. I was frankly shocked at how wound up she was and I tried to get off the phone.

The call ended as follows:
–You still get your kids vaccines?
–Yes.
–(screaming) Well, I hope your child has something very serious. Like autism even. You deserve it and I hope you suffer every day like I do.

I spent the next three years worrying about her showing up in my driveway.

Nice people you hang out with, Dr. Jay.

@Sid B

I suppose you object to the use of formula for women who can’t lactate

Obviously you understand that natural breast milk is much better for a child than it’s man-made alternative. You do know that, right?

I feel bad for your kid if he ever gets into poison ivy. “no, Timmy you can’t have any calamine lotion! it’s not natural! It has teh toxins!

My child’s name isn’t Timmy

When I start vouching for the safety of vaccines and forcing them upon America’s children then I’ll be responsible for producing vaccine/autism studies

Why stop there? Don’t you also need

1) vaccine/alzheimer’s studies?
2) vaccine/skin cancer studies?
3) vaccine/hernia studies?
4) vaccine/ed studies?
5) vaccine/baldness studies?
6) vaccine/nearsightedness studies?
7) vaccine/hemmerhoid studies?
8) vaccine/stuttering studies?
etc

See, by throwing out these barriers, it is sid’s way of preventing any vaccines from being acceptable.

To him it’s not sufficient that there is no reason to think that vaccination has any effect on ED.*** Nope, it has to have been studied to rule it out. Unless that is done, vaccination should be stopped because it might cause ED later in life.

***I was going to say “his ED” but I thought I’d keep it civil 🙂

@Todd

you are making a claim that vaccines are dangerous and that they cause autism. The onus is on you to back up your claim

I make no such claim. I say there is reason to study a possible association and I dispute those who say it has been studied

@Pablo

When parents report their children going bald right after their 18 month shots and HHS starts handing out money for “baldness-like symptoms” I’ll call for an investigation

@Sid Offit

I say there is reason to study a possible association

What association do you think there is between vaccines and autism? Other than the coincidence of symptoms developing about the same time as the MMR (which, as we’ve seen, has been shown to have no causal link to autism), what evidence have you seen to support such an association?

When parents report their children going bald right after their 18 month shots

Right. So now we are back to this.

As I said above, the only vaccine that this applies to is MMR. Yet, you have not been satisfied with the MMR results, and insist that ALL vaccines are studied. Despite the fact that parents have not reported their children becoming autistic after the other vaccines.

As I said, you are double-talking.

There is no more indication that non-MMR vaccines cause autism than there is that they cause ED, or baldness.

And any hints that MMR cause autism have been investigated.

I say there is reason to study a possible association and I dispute those who say it has been studied

I say there is reason to study the possible association between the celestial teapot and autism, and I dispute those who say it has been studied.

I’ve got just as much backing for that as you do, so if you want to continue studying vaccines and autism you must also support my research into the celestial teapot. Are you going to step up and admit it, or reveal yourself as a hypocrite?

@Pablo
Despite the fact that parents have not reported their children becoming autistic after the other vaccines.

You’re wrong

Hannah was 19 months old and developing normally until 2000, when she received five shots against nine infectious diseases. She became sick and later was given a diagnosis of autism.

Followed by this post:

For example, I watched as my son, Matthew, received 4 different immuniztions in one day. Within 24 hours, he began to run a high fever. We were told that his fever was a “normal” reaction to the shots, and we should stop being so worried to a “typical” known side effect. Within one week, my son who was talking, singing, laughing, and maintaining eye contact with us — was gone.

He was gone? Where’s the missing person’s report?

I admit “vanishing” is not known to me to be a vaccine complication.

Sid Offit you’re wrong, The Poling child ‘missed’ most of her scheduled vaccines due to being sick all the time (she wasn’t healthy to begin with) and the doctor seen fit to overload her with a ton of catch-up vaccines in one sitting and her parents allowed this. Had that been me, I’d have taken my child right out the door. This is where parents need information, start questioning bad doctors trying to over inject your child. The vaccines are not to blame for the Poling child, the doctor is. The vaccines Poling had that day were unlike any other parent who claimed autism- vaccines, since most kids do not get that many catch-up vaccines in one office visit plus she also had a genetic (from her mother) disorder which played a large role and those vaccines made THAT disorder worsen. Unless every other vaccine autism case has that same genetic disorder, missed a ton of scheduled vaccines and then was injected with a ton on one day, that is the Poling case and can not be compared to any other vaccine injury case. The only thing the public can learn from that case is to RUN when a doc comes at your kid with that many jabs.
What’s also confusing to the public is just how many jabs/ diseases a child got in one day. Depending on how it’s worded to the comprehension of the reader, it means 2 different things.

You can get a high fever from the MMR and any other vaccines as well as from the common cold. The trigger would had been the fever, and just so happened then from a vaccine. A high fever could have come with an ear infection, strep throat, or any viral or bacterial infection kids get during childhood. The thing to ask is, of those many who also had high fevers, why for them did autism result and not for the others?

“The thing to ask is, of those many who also had high fevers, why for them did autism result and not for the others?”

Good question.

Sid,
You do realize that while there are benefits to breastmilk, there are also drawbacks and limitations (ie, the transmission of disease, inability of a mother to lactate, etc), and that several generations have grown up being fed with formula and somehow survived don’t you?
You do realize that a good many women can’t lactate or don’t produce enough milk to nourish their babies or simply feel that nursing does not fit with their lifestyles, don’t you?

@trrll
You seem to be confusing an anecdote as scientific evidence with an anecdote as a reason to investigate a hypothesis

Oh, so now the game is “appeal to authority,” is it? OK, let’s play that game. What sort of authority is Dr. Healy? Is she an expert on vaccines?

I don’t see the connection between Healy and the HHS concession

@Just a mom

she also had a genetic (from her mother) disorder which played a large role and those vaccines made THAT disorder worsen.

But, Dr. Poling, a neurologist, says:
“No one knows if Hannah’s mitochondrial dysfunction existed before receiving vaccines.”

And anyone here will tell you there is no such thing as a ton of vaccines since according to Dr. Offit we could get 100,000 all on one day

The AAP has no problem with it so I don’t think it’s all that unusual

The U.S. Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics both recommend giving a child all of the routine childhood vaccines he or she needs at the same doctor visit.

Finally

You can get a high fever from the MMR and any other vaccines as well as from the common cold. The trigger would had been the fever

But if she was so sick as you stated why wasn’t the autism triggered earlier?

I’m not using any of this to say vaccines cause autism but I was asked why I think a possible association should be investigated

I spent the next three years worrying about her showing up in my driveway.

Nice people you hang out with, Dr. Jay.

Posted by: grenouille | September 1, 2009 4:05 PM

I don’t know this person, Froggie, but, if I did, I’d tell her that she was rude, insensitive and wrong. I’d tell her that this type of insulting unintelligent statement damages the credibility of anyone trying to have a civil conversation about autism.

Best,

Jay

Pablo states:

“There is no more indication that non-MMR vaccines cause autism than there is that they cause ED, or baldness.”

Well, since the prevalence of baldness in men hasn’t changed much since before the advent of vaccines (i.e. prior to 1796), we can safely put that one aside (unless “Sid Offit” feels it still warrants investigation).

However, I have noticed a marked rise (pun intended) in advertisements for “erectile dysfunction” cures in the past five years or so.

This is significant, since the MMR vaccine was introduced in 1971 and children (ages 1 to 15 years at the time) who received the vaccine then would now be between 39 and 53 years old – a group that includes the prime “ED” ages.

Thus, we have “evidence” – fully equal to that linking vaccines and autism – showing that the introduction of the MMR vaccine back in 1971 led – irrefutably – to the current epidemic (tsunami?) of erectile dysfunction.

Or, it could just be a coincidence. You decide.

Prometheus

@Prometheus

It would be more like getting the shingles vaccine then having an equipment failure soon thereafter

Sid Offit~ Polings dad being neurologist makes you wonder why he allowed so many jabs.
‘The U.S. Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics both recommend giving a child all of the routine childhood vaccines he or she needs at the same doctor visit.’ You’re confusing that to what actually happened in the Poling case. She missed her ‘recommended’ vaccines due to being ill at the time they were recommended. She wasn’t in that office getting any thing but catch-up vaccines and her dad not knowing if mitochondrial dysfunction existed or not means nothing. He did know she had been ill as an infant but had nothing to contribute that too until they found out she did inherit mitochondrial dysfunction. Did your child ever have those same vaccines in the same day as Poling?? That is the question and I can say my child did not, nor did the schedule at that time recommend such a dose.

Funny thing about those high fevers. One study suggested autism symptoms became better while a child had a high fever. So here you have those high fevers causing autism, and also reducing autism.

Waaay too much troll-feeding going on here, folks. There is no response to the opinion: “You need to keep an open mind … until you decide that vaccines cause autism, at which point you need to close your mind.” You can’t use logic and evidence to argue against an illogical, faith-based position.

The troll really put on the goalpost move. It’s a pretty lame one as well, since his claim to study what supposedly hasn’t been studied is based upon an anecdotal correlation that is associated with MMR vaccinations.

We should all get back to poking fun of Matt Lauer. He just seems like the most gullible person on television. Yes, the first five seconds of an interview he’ll grill, but then he can’t help but be as helpful as possible to whomever he’s interviewing.

J.Gordon:

Didn’t post 100 negate post 106?

If not, does that mean Einstein’s hair made him look like a homeless high school dropout, decreasing his credibility 75 – 80, maybe 81%?

Or, am I being too dickish…doctor?

Matt Lauer’s striped gangster suit decreased his credibility 75-80%.

I rarely agree with you, Dr. Gordon, but I am with you on that point.

@Dedicate Lurker

Instant Karma is a bitch. You have a lot of stones making snide remarks about autistic children and their parents. Hope you are taking your vitamins and looking both ways before you cross the street.

@Just a Mom

Nice. Blame the parents. Like we frickin invented vaccines, mandated they be given to children and then stuck Mercury in them. Good one jumping on the Polling family. Kick them when they are down. Shows the class of the readers of this blog.

@Prometheus

Okay. I FINALLY UNDERSTAND. You can’t get it up. That explains a lot. Sorry dude. I’m afraid it is just genetics. Everything is just genetics.

Obviously you’re not using phone surveys and personal anecdotes as scientific evidence.

You are the one who offered anecdotal accounts of children developing autism after vaccination as evidence implicating vaccines in autism, not I. But you don’t get to have it both ways: if you choose to accept anecdotes as evidence, then you don’t get to pick and choose; you must also consider the case of children who were not vaccinated, but who developed autistic symptoms around vaccination age anyway.

If you choose to abandon anecdotes as evidence, that leaves you with nothing. There is no non-anecdotal evidence even suggesting a role for vaccines in autism. Indeed, the MMR, which is the vaccine that is normally given around the time autism symptoms typically emerge–indeed, the very one associated with most of these anecdotal accounts that you seem to set such great store in–has been specifically excluded as a cause of autism by multiple large studies. And while a phone survey is rather weak evidence, it agrees with the other studies of specific vaccines in finding no evidence for a vaccine link to autism. Surely if vaccination greatly increased the risk of autism, then even a phone survey ought to be able to pick up such a large effect don’t you think? Especially one commissioned by an organization that is biased toward blaming vaccines?

I don’t see the connection between Healy and the HHS concession

You are the one who invoked Healy as an authority to support your insistence that there is reason to be more suspicious of vaccines than of the thousands of other chemicals, diseases, and antigens that children are routinely exposed to. Frankly, the fact that you would resort to a tactic as lame as appeal to authority is tantamount to admitting that you have no real arguments of your own. But if you are going to appeal to authority, then you have to provide evidence that the individual whose unsupported opinion you are quoting actually is an authority in a relevant field. So I ask you again, what are Dr. Healy’s qualifications as an expert in any of the relevant fields: immunology, autism, immunology, or public health?

But, Dr. Poling, a neurologist, says:
“No one knows if Hannah’s mitochondrial dysfunction existed before receiving vaccines.”

I love the way people can take a statement of ignorance as evidence of something:
“No one knows if space aliens are sneaking into our children’s rooms at night and dropping autism-inducing worms into their ears.”

However, we do know that some things are so improbable as to verge on the ridiculous. Like autism-inducing space aliens. Or a vaccine somehow producing the very same DNA damage in trillions of mitochondria located in different cells scattered throughout the body.

@Trrll

you’re confusing my use, on post #70, of Scott #68’s words expressing his belief that actual studies on vaccine and autism have been done. He referred to Healy not I (How do you conjure those little lines appearing in front of the words of another anyway?)

You are the one who offered anecdotal accounts of children developing autism after vaccination as evidence implicating vaccines in autism

And I’ll repeat:
You seem to be confusing an anecdote as scientific evidence with an anecdote as a reason to investigate a hypothesis

@trrll

However, we do know that some things are so improbable as to verge on the ridiculous. Like … a vaccine somehow producing the very same DNA damage in trillions of mitochondria located in different cells scattered throughout the body

http://www.time.com/time/health/article/0,8599,1721109,00.html

Dr. John Shoffner, the Atlanta-based neurologist who identified Hannah Poling’s mitochondrial disorder, is “genuinely puzzled” by the court’s judgment. Shoffner, who has been studying and treating these disorders for 20 years, says it’s impossible to say whether Hannah’s mitochondrial disorder was, in fact, a pre-existing condition that set the stage for her autism (as the government contends) or if it developed along with her autism.

@trrll

However, we do know that some things are so improbable as to verge on the ridiculous. Like … a vaccine somehow producing the very same DNA damage in trillions of mitochondria located in different cells scattered throughout the body

CDC:
More research is needed to determine if there are rare cases where underlying mitochondrial disorders are triggered by anything related to vaccines

The CDC left out the “ridiculous” part. You need to call them. Tell them about those aliens too. The ones that live in that celestial teapot.

http://www.cdc.gov/ncbddd/autism/mitochondrial-faq.html#vaccines

J.Gordon:

Didn’t post 100 negate post 106?

If not, does that mean Einstein’s hair made him look like a homeless high school dropout, decreasing his credibility 75 – 80, maybe 81%?

Or, am I being too dickish…doctor?
Posted by: marcia | September 1, 2009 10:54 PM

Good one, Marcia.
Jay

Sid,
Since when does “triggered” mean “created with no previously existing condition”? My asthma is triggered by dust mites but that doesn’t mean dust mites caused my asthma without any preexisting conditions. I have never heard or read an even vaguely plausible explanation of how any exposure to vaccines could cause a change in DNA throughout the mitochondria of millions of cells. If that were the case, researchers would be all over it.

@SidOffit
“http://www.time.com/time/health/article/0,8599,1721109,00.html

Dr. John Shoffner, the Atlanta-based neurologist who identified Hannah Poling’s mitochondrial disorder, is “genuinely puzzled” by the court’s judgment. Shoffner, who has been studying and treating these disorders for 20 years, says it’s impossible to say whether Hannah’s mitochondrial disorder was, in fact, a pre-existing condition that set the stage for her autism (as the government contends) or if it developed along with her autism.”

Your inability to understand this quote and put it in context says it all.

@Sid Offit

You didn’t quite answer my question, so I’ll ask again:

What association do you think there is between vaccines and autism? Other than the coincidence of symptoms developing about the same time as the MMR (which, as we’ve seen, has been shown to have no causal link to autism), what evidence have you seen to support such an association?

Hannah Poling was a) a unique case, b) a situation with an underlying medical condition and c) as others have said, likely received shots off-label (i.e., not following the schedule guidelines in the labeling). And don’t quote the 10,000 shots bit at me. It’s not relevant.

I want to know, with vaccines in general, what associations do you see between vaccines and autism and what evidence do you have to support those?

And (d) would most likely have suffered the same result from an actual measles infection or other high fever, therefore even if not vaccinated herself would have been 100% reliant on everyone ELSE being vaccinated to try and avoid said high fever from an infection.

@Sid Offit

You seem to be confusing an anecdote as scientific evidence with an anecdote as a reason to investigate a hypothesis

Ah yes, the famous “I’m just saying” defense. To be rational, a reason must be based on some kind of evidence. If anecdotes of autism developing around the time of vaccination are a reason to investigate, then anecdotes of autism developing around the same time without vaccination are a reason to think that there is not a connection worth investigating. And of course, we can add to it the actual evidence: extensive investigation of specific vaccines, including the one that is given around the time when autism typically develops, that show no correlations, as well as weaker evidence, such as the Generation Rescue survey that found numerous unvaccinated children with autism, and failed to document any association with vaccination.

Dr. John Shoffner, the Atlanta-based neurologist who identified Hannah Poling’s mitochondrial disorder, is “genuinely puzzled” by the court’s judgment. Shoffner, who has been studying and treating these disorders for 20 years, says it’s impossible to say whether Hannah’s mitochondrial disorder was, in fact, a pre-existing condition that set the stage for her autism (as the government contends) or if it developed along with her autism.

A mitochondrial disorder is due to a genetic mutation in trillions of mitochondria, each with its own independent genome, located in cells throughout the body. So for a mitochondrial disorder to “develop” along with autism, some force (space aliens?) would have had to separately create all of those identical mutations. I think that it is fair to term this notion ridiculous.

Hannah Poling experienced a severe fever after vaccination. This is something that is known to occur, and also known to be very rare, although Hannah had a prior history of fevers (which is why she had not been vaccinated on a normal schedule), so it is not entirely certain that vaccination was the cause. She was subsequently found to have a mitochondrial disorder of a sort that can be triggered by a fever. Such mitochondrial disorders are also thought to be rare. So at worst, this falls into a category of known rare risks that has been accounted for in assessing the risks and benefits of vaccination, and has no relevance to the most cases of autism, which are not associated with severe fevers and encephalopathy.

If anecdotes of autism developing around the time of vaccination are a reason to investigate, then anecdotes of autism developing around the same time without vaccination are a reason to think that there is not a connection worth investigating.

If there were only one cause to every condition on the autism spectrum that would make sense.

You seems to be constructing a barrier to restrict avenues of inquiry. I don’t know how many great discoveries would have been made employing that mind set. Anyway it seems it would be difficult to arrive at a cause of autism if you resist any inquiry into environmental factors while waiting for a determination that the disease is entirely genetic

What’s being resisted is pouring money down a rathole without any foundation for believing it’s relevant, and when there’s specific cause to believe that it’s NOT.

By the standards you claim should apply, we should be studying the celestial teapot as a cause of autism. So I ask again. Are you going to step up and support celestial teapot research, or reveal yourself to be a hypocrite? I suspect the latter.

Aaaah, Reminiscent of the good old days when this topic would go on for 300 comments or more putting ORAC and RI over the many million mark.

Allow me to summarize: The studies indicating “no connection” between vaccines and autism and other large side effects are inadequate and honest scientists will readily admit that.

The studies connecting vaccines to autism causation are also inadequate and honest people will also admit that.

Carry on.

Best,

Jay

[This post sat on my desktop for the over 24 hours. Ooops!]
As has been stated so eloquently and often here and elsewhere, serious ethical issues mitigate against prospective, blinded, randomized studies of vaccinated and unvaccinated children. The discussion of whether or not existing studies are sufficient is so polarized that anger rises faster than reasoned discourse.

I so sincerely believe that it is impossible to prove the “negative” that “vaccines have no connection to autism” that I keep putting my opinion in here for the majority to attack and disdain. Then, when I affect my “puppy dog” sadness (as Dave calls it) at the nasty responses, I get ridiculed. I can handle that.

Again, Carry On!

Best,

Jay

@trrll

A mitochondrial disorder is due to a genetic mutation in trillions of mitochondria, each with its own independent genome, located in cells throughout the body

Yes, but not really

http://www.umdf.org/site/c.dnJEKLNqFoG/b.3042179/k.5799/Inheritance__Genetics.htm
However, not all mitochondrial disease is primarily genetic. For example, anti-retroviral medications used to treat HIV/AIDS can damage mitochondria and cause symptoms due to resultant energy failure. Removal of these drugs reverses the process and the symptoms resolve. There are other environmental causes of mitochondrial disease, and likely many that we do not know about.

http://www.healthline.com/galecontent/mitochondrial-disorders/2
In many cases, a mitochondrial disorder is passed genetically from parent to child (inheritance… in some cases, no other family members are affected by the disease and there appears to be no genetic link. These cases are called random or sporadic occurrences and may be caused by a number of environmental factors including certain drugs

And what was the magic vaccine fever that triggered her alleged pre-existing mitochondrial disorder when she had such a long history of prior fevers?

@Todd

What association do you think there is between vaccines and autism? Other than the coincidence of symptoms developing about the same time as the MMR (which, as we’ve seen, has been shown to have no causal link to autism), what evidence have you seen to support such an association?

You seem to cling to the idea that the majority of anecdotal reports came after just the MMR. I see no evidence for that. And you seem to be employing a bit of circuitious logic here as in where is the scientific evidence connecting vaccines to autism because were going to need it before we study a possible connection between vaccines and autism

I want to know, with vaccines in general, what associations do you see between vaccines and autism and what evidence do you have to support those?

Not associations but reasons to study.

The Banks case featuring vaccination leading to ADEM leading to developmental delay resembling autism

Vaccines have a history of causing side effects including high fever, encephalitis and seizures

A large increase in vaccines temporally associated with a rise in autism

Anecdotes

Temporal associations between vaccine adminstration and autisms emergenge

If there were another environmental factor with similar characteristics I’d say study it. Do you have one? If not all you have is genetics and genetics are not thought to act alone

I don’t argue vaccines cause autism. I’m simply giving some reasons to study a possible connection

Finally, on a humorous note, you say:

Hannah Poling .. likely received shots off-label (i.e., not following the schedule guidelines in the labeling). And don’t quote the 10,000 shots bit at me. It’s not relevant.

I’m not familiar wit “off-label” uses of vaccine. Could you explain? And why is the 10,000 shots at one time argument invalid. It’s used all the time to defend vaccine safety

Allow me to summarize: The studies indicating “no connection” between vaccines and autism and other large side effects are inadequate and honest scientists will readily admit that.
Because…it is impossible to prove the “negative” that “vaccines have no connection to autism”

The studies connecting vaccines to autism causation are also inadequate and honest people will also admit that.
Because… they do not exist.

Fixed that for you.

The studies connecting vaccines to autism causation are also inadequate and honest people will also admit that.

No, honest people will admit that they don’t exist. This perspective is straight-up wrong and completely indefensible. On one side, there is a good bit of evidence. It’s not conclusive, but conclusive is impossible. On the other side, there is zero evidence. Therefore you conclude that it must be assumed that said other side is correct.

And no, you don’t suggest that “it might have some validity” or anything like that. Your actions prove beyond the faintest shadow of a doubt that you are completely convinced that everyone should act as if we’re certain vaccines cause autism.

@Sid:

So it’s to be the hypocrisy then, I see.

I don’t know this person, Froggie,

I dunno, Dr. Jay. Maybe you met her at the Green Our Vaccines rally.

she was rude, insensitive and wrong.

Don’t you frequently appear in public with an actress who fits that description?

@ T.Bruce McNeely

Because…it is impossible to prove the “negative” that “vaccines have no connection to autism.”

Then how can you rule something out so completely that cannot be proven, anyway?

If the studies done were only on thimerosal and on MMR vaccine, and lets say for sake of argument they really did prove no connection to autism and everyone on BOTH sides agreed with that, why is it unreasonable to question other vaccines? Aren’t there 36? 48? whatever it is by now that kids are getting these days? With so many parents reporting adverse events,regression into autism, etc. in the 100’s? 1,000’s? Why would you not take that seriously? I don’t believe they’re making it up or lying, do you? I’m not saying I know what causes autism, of course, but for those so scientifically minded, doesn’t that have to be shown inequivocally that NO vaccines cause autism before you can honstly say that? Studying one or two, only, it just cannot be truthfully said. I expected more from scientists.

@Sid Offit

You seem to cling to the idea that the majority of anecdotal reports came after just the MMR.

I made no such claim that “the majority of anecdotal reports came after just the MMR”. My comment “Other than the coincidence of symptoms developing about the same time as the MMR” means that you should not use those anecdotes to support your opinion that there is some possible association between vaccines and autism that should be explored.

you seem to be employing a bit of circuitious logic here as in where is the scientific evidence connecting vaccines to autism because were going to need it before we study a possible connection between vaccines and autism

Nothing circuitous in my question at all. You make a claim that there is some reason to investigate vaccines for a possible connection to autism. The onus, therefore, is on you to establish why there is sufficient reason to undergo such investigations beyond what has already been done.

Not associations but reasons to study.

You said earlier that “there is reason to study a possible association”. So, I am asking what possible associations you think there are, and what evidence do you have to support such beliefs.

The Banks case featuring vaccination leading to ADEM leading to developmental delay resembling autism

Vaccines have a history of causing side effects including high fever, encephalitis and seizures

Fever, encephalitis, seizures are all known, but rare, adverse reactions to vaccines. And, guess what? None of them are autism!

A large increase in vaccines temporally associated with a rise in autism

The rise in autism was also temporally associated with a change in diagnostic criteria, increased screening activity, increased awareness, and so on. Studies examining this suggest that the incidence rate of autism has not actually increased. This would suggest, then, that vaccines are not implicated, as there is another, much more plausible explanation.

Anecdotes

Anecdotes are not data and often miss key elements (e.g., that autism symptoms start to show around the age that kids are getting more vaccines).

Temporal associations between vaccine adminstration and autisms emergenge

See point above. Also, is there a specific pattern? Is there one, or a small combination, which appears to have a greater prevalence? The only vaccine I’ve heard of thus far that has this temporal association is the MMR, which, as we’ve seen upon proper study, does not actually appear to have any causal link.

I’m not familiar wit “off-label” uses of vaccine. Could you explain?

Off-label means that the drug/medical product was used in some way contrary to what is in the labeling for the product. For example, most vaccines state that there should be a minimum time between shots. If the physician ignores those guidelines and gives multiple shots on the same day, that would be off-label use. In other words, the doc wasn’t following the instructions for use.

And why is the 10,000 shots at one time argument invalid. It’s used all the time to defend vaccine safety

Because I haven’t used it, and I won’t use it unless I see the science to support it. Dr. Offit may be right or wrong when he makes that statement. I don’t know, though. I go by what’s in the label of the vaccine.

At any rate, in the end, it appears that you have no compelling reason to study a potential vaccine-autism link any further. Everything you’ve mentioned has been addressed in some form. If you say that the amount of vaccines received is responsible (and not any particular ingredient), then you need to show some evidence to suggest that the number is responsible. Vague worryings don’t cut it.

@givemethetruth:
You obviously haven’t been following the issue. Hell, you don’t appear to have read the second paragraph of my “correction” – you know, the one where I state that there is no demonstrated connection between vaccines and autism. See also Scott’s comment at #129.
No, you can’t rule the connection out 100.00000%. You can, however, look at the evidence, and conclude that it would be absurd to blame autism on vaccines. I won’t go into the rest of your arguments, because this has been done over and over again. Anyone for Whack-A-Mole?

@ T.Bruce McNeely

I read your WHOLE post, thank you.

I am “just a parent” and I’m sincerely trying to learn and understand this whole issue. Even the “experts” disagree. Verbal attacks only reduce your credibility IMO.

Because…it is impossible to prove the “negative” that “vaccines have no connection to autism.”

Then how can you rule something out so completely that cannot be proven, anyway?

Sounds like someone really, really wants to believe in unicorns just because we can’t disprove them with 100% certainty.

However, not all mitochondrial disease is primarily genetic. For example, anti-retroviral medications used to treat HIV/AIDS can damage mitochondria and cause symptoms due to resultant energy failure. Removal of these drugs reverses the process and the symptoms resolve. There are other environmental causes of mitochondrial disease, and likely many that we do not know about.

Certainly a toxic agent that damages mitochondria can produce symptoms that resemble a genetic mitochondrial disorder. Hannah was not receiving any drug known to be toxic to mitochondria. In the decision of the DVIC, Hannah was reported to have a mitochondrial mutation. The decision to award compensation was based on the conclusion that she had a pre-existing genetic mitochondrial disorder that predisposed her to encephalopathy.

In many cases, a mitochondrial disorder is passed genetically from parent to child (inheritance… in some cases, no other family members are affected by the disease and there appears to be no genetic link. These cases are called random or sporadic occurrences and may be caused by a number of environmental factors including certain drugs

A mutation such as Hannah’s could originate from a parental somatic mutation that was present in the mitochondria of the ovum and was passed on to the child, or it could be a somatic mutation that occurred early in the child’s embryonic development and that was inherited by all of the cells that derived from that embryonic cell. What it couldn’t be is caused by vaccination.

Verbal attacks only reduce your credibility IMO.

I apologize for my sarcasm.
I do not apologize for my exasperation.
It really looked to me like you did not read (or understand) my entire comment.
Your concerns have been addressed over and over again in this blog, and you will find many other references in the archives. Please read them.
There is a reason why the anti-vax movement is also called the disease-promotion movement. Hence my exasperation.

@ givemethetruth #134

Even the “experts” disagree.

If, in this phrase, you mean that a small number of individuals, generally lacking quality, scientifically-relevant evidence for their claims disagree with the overwhelming majority of physicians, researchers and medical organizations, then I agree with you completely.

It’s truly not unlike the “experts” that think HIV doesn’t cause AIDS, that humans have no effect on climate, or that the Earth is 6000 years old. One side has the science to back up their positions; the other side talks as loud as possible, utilizing an unending array of logical fallacies, to try to make up the difference…

Sez Jay Gordon: “I so sincerely believe that it is impossible to prove the “negative” that “vaccines have no connection to autism”[.]”

You dolt. Such a thing cannot be proven, so anyone who’s put an ounce of thought into this matter will agree that we cannot PROVE that vaccines have NO connection to autism.

That you still do not understand something like this boggles my mind. Please educate yourself about science. Your mind must be shockingly closed, since I would think you’d have picked up enough of the stuff to understand this issue from your time trolling orac’s blog.

I have no doubt that you can handle ridicule. With opinions as devoid of thought as yours, you must get it all the time. You would be a laughingstock if you weren’t so dangerous. As it is, you deserve little beyond scorn and disdain.

As a parent I come to this site to try to read and learn. Yes, I also read the “other” side’s sites as well. I wish I could spend more time on this, but being a busy SAHM I have little time for this-especially, uninterrupted. So, no, I don’t always get to read all posts, nor do I have time to search archives. So forgive me if you feel my concerns were already addressed. I thought I was welcomed or even encouraged to be here since I’m the kind of person this site is trying to win over. You must realize that “your” experts, scientists, etc. are just names with letters after them, to “people like me”. As are the experts, scientists, etc. from the other side. I read things I don’t believe from both sides and things I also find credible from both sides. I also see lies being told from both, as well as name calling and verbal abuse which I always find saddening. If you want to call me ignorant, whack job, or whatever, that’s your choice. I’m just letting you know where I’m coming from. Maybe I’m representative of the “average” parent-I don’t know.

I don’t know this person, Froggie,

I dunno, Dr. Jay. Maybe you met her at the Green Our Vaccines rally.

she was rude, insensitive and wrong.

Don’t you frequently appear in public with an actress who fits that description?

Posted by: grenouille | September 2, 2009 3:52 PM

No, I have never appeared with an actress meeting your description.

Bob, thanks for your measured response above. In my experience, when someone calls another person a “dolt” they’re trying to end a conversation not start one. They also have nothing better to say. You do though, don’t you?

Best,

Jay

Givemethtetruth–

Excellent comments. I have long asked for some consistency in civil responses on this site and have been repeatedly disdained for that request. I hope you have better luck than I.

Best,

Jay

What a shame that Dr. Wakefield’s study is such an easy target and that he, himself, appears to have economic conflicts of interest. I don’t know him personally, but I continue to give him the benefit of the doubt.

He’s violated the most basic ethical principles of medicine (and laughed about it), he’s faked results, he’s carried out risky, invasive procedures on children for no good reason, and he’s up to his eyeballs in financial conflicts of interest. What would he have to do for you to stop giving him the benefit of the doubt? Disembowel a puppy live on TV?

What a shame that Dr. Wakefield’s study is such an easy target and that he, himself, appears to have economic conflicts of interest. I don’t know him personally, but I continue to give him the benefit of the doubt.

One can’t help but note that you are not inclined to give Dr. Offit the benefit of the doubt in any way. I wonder why that is? Hypocrisy, perhaps?

I have long asked for some consistency in civil responses on this site and have been repeatedly disdained for that request.

Perhaps because people attempting mass murder don’t deserve civility?

This is what I wrote as the beginning of POST 65 above:

“What a shame that Dr. Wakefield’s study is such an easy target and that he, himself, appears to have economic conflicts of interest. I don’t know him personally, but I continue to give him the benefit of the doubt.

I have spoken with and exchanged email with Dr. Offit and I also give him the benefit of the doubt. I have foolishly made intemperate remarks about him and his very real economic conflicts of interest but I think that he is consistently motivated by his desire to save lives with vaccines. I disagree with his methods and many of his ideas but I will never again impugn his personal motives. He started in this field long before it became wildly lucrative for him and I believe that his vaccine profits–while not an insignificant reward–were not his primary aim.”

Why on earth would you say would you just said, Orac?

Jay

“Why on earth would you say would you just said, Orac?”

Because he, himself, is a hypocrite, Dr. Jay. He says he gives people the benefit of the doubt, but from his exchanges with you, that is obviously a lie. He says that nothing will convince him that there is a connection between vaccines and autism, but evidence can change his mind. He says he doesn’t bash or belittle parents looking for answers, but that is an enormous lie because that was the first thing he did when I originally came to this site under a different name and asking questions.

I find these people hilarious, personally, because they are consistently shooting themselves in the foot. The truth of the matter is that Dr. David here is a nobody. He is nothing. He is a little nerd who has been given rock-star status by other little nerds who think it’s cool to bash other people for their beliefs. Likely, this is because they received one too many swirlies in their youth and this is the only way they can sooth their bruised egos.

Sue, put down the Mad Dog 20/20 and sobered up then come on back. You and your hero (the rest of the world’s zero) Jay Gordon are here for a reason: you want to learn, you’re bothered by a complex problem, but you have neither the intellectual capacity nor the patience to actually read and understand what sincere and learned people have to say about the subject. You rant here and then scurry back to your AoA quack safehaven. It’s old.

Why on earth would you say would you just said, Orac?

Because your actions belie your words, Jay. You claim to give Offit the “benefit of the doubt” but in practice, you don’t do any of the sort. You don’t accept anything he says, and promote the opposite.

Meanwhile, you actively encourage Wakefield’s perspective.

So no one can be blamed for dismissing your comment.

You must realize that “your” experts, scientists, etc. are just names with letters after them, to “people like me”. As are the experts, scientists, etc. from the other side

Sigh.

OK, let’s start at the beginning. Who do you think are the “experts” on this topic. Can you please list the experts for each side, and, if you could, please describe why you consider them to be experts?

I am a parent of a child with autism. Here are my quick thoughts. I truly believe that vaccines are a cash cow for pharm companies and if they can sell millions with only negatively affecting a few, they will do it. I just had my NT daughter into the doc the other day because she complained of sore throat and ear hurting. Ended she had an ear ache. I asked to have her tested for H1N1 and docs says “we can do it, but she does not have it”. Test came back 10 minutes later as positive for swine flu. My point? Doctors still don’t understand a large part of the human body, and definitely not autism. While we raise millions for research, it seems like we make only incremental gains. I spend every day wishing my child could go to school with your typical child. I want him to get married. I want him to have a friend. While the medical community dicks around for the next 20 years with double blind studies funded by Merck and other pharma companies, I am not going to let a study funded by these folks let me forget that thousands of parents see their kids spiral into another world called autism after shots. If shots are safe, why is their a vaccine injury fund? This offit guy may have saved many lives from vaccinations, but it comes with cost of injuring others. I guess if you have more wins than losses, keep producing more vaccines and shooting our children up. If we lose a few more to autism..great. As long as we were able to prevent something else so be it. How can doctors be so sure there is no link when they can’t seem to figure so many other things out (cancer, autism, etc) They do not know it all. Sometimes, believe it or not, the parents know more. If parents of children with autism were not trying to pull my son out of autism every hour of every day, they would actually file vaccine injury claims and you would probably see a major issue. We just don’t have time.

Miguelito:
I know that I’m wasting time, but here goes – there is NO evidence that autism is caused by vaccines. And, no, anecdotes, rumors and propaganda are not evidence.

@Miguelito

If shots are safe, why is their a vaccine injury fund?

Here is info on the National Vaccine Injury Compensation Program, including why it was created. It was not only to protect vaccine manufacturers. http://www.hhs.gov/nvpo/factsheets/fs_tableIV_doc1.htm

Also, bear in mind that “safe” is a relative term when it comes to any medical product. Basically, it means that the benefits of the product outweigh the risks of the product and the risks of not using the product. In the case of vaccines, using the immunity granted is worth much more than the rare serious adverse events and the risks of complications from infection if they were not used.

Pablo, don’t you dare call me a liar.

I have spoken with Dr. Offit, exchanged email and have easily come to realize that he is sincere in his desire to improve children’s health. I disagree vehemently with his point of view about vaccines and especially vaccines and autism.

My thinking he’s wrong does not stop me from understanding his life’s work.

I am so sick of this anonymous rudeness and name calling. And, ORAC, you are pretty damn wrong too for quoting have my post and twisting it.

Jay

Oh Jay, you are such a swell guy. You are so kind to not consider Paul Offit a pharma shill (although you have had no problems accusing others of such). You just think he is stupid and deluded. How could I have not appreciated your sentiment?

Dave, a favor, please. The last two posts have typos: 146 has “would” repeated when I meant “what” the second time and 155 has “have” instead of “half.” Could you please correct those? Is there a way one can edit one’s own posts after posting? Thanks.

And Pablo, yes, I am a swell guy. But, I do think that, technically speaking, Paul Offit is a pharma-shill but he discloses all his conflicts. That might not make it right in my book but he’s honest about the money he makes promoting the benefits of vaccination.

Jay

Dr. Jay, just a simple clarification.

You think Dr. Offit is a “pharma-shill” but he is also “sincere in his desire to improve children’s health”.

I believe the disconnect is in that when “pharma-shill” is typically used it is insinuated that someone’s motives are driven by profit from pharma companies, at the expense of health.

So when you say he “is a pharma-shill”, you don’t mean it in the way most anti-vaxers do? It just means that he derives income from his research and speaking on behalf of vaccines but his motives are still sound? In other words you don’t think he recommends vaccines because it makes him more money?

@trrll

The decision to award compensation was based on the conclusion that she had a pre-existing genetic mitochondrial disorder that predisposed her to encephalopathy.

Your assertion that Hannah’s condition is of genetic origin is far from certain. According to Dr. Poling:

Dr. Shoffner performed genetic testing on both Hannah’s muscle and her mother’s leukocytes subsequent to our case report. Hannah (muscle mtDNA) and her mother (leukocyte mtDNA) were both found to be HOMOPLASMIC for the mtDNA T2387C transition mutation. Our analysis of this genetic finding in the mtDNA was significantly different than those of other physicians that I’ve seen in scientific blogs or commentary. I suspect it would have been fatal to both Hannah and her mother if this homoplasmic mutation was pathogenic since (as I am sure you are aware) the mutation is on the 16S ribosomal subunit which is highly conserved. Thus, this mutation probably represents a benign polymorphism rather than pathogenic mutation. It is unlikely, but possible, that the mutation is significant to Hannah

So that makes you a disease mongering alt therapy shill then Dr Jay?.
Presumably you charge top dollar for your “services”? Or do you do it all for free?. I’m guessing you’re not working downtown at a free clinic for the disadvantaged?.
How much cash do you make hawking your antivax ,disease mongering propaganda around?
On what grounds do you base you statement that Dr Offit is wrong?, your years of research in the field of immunology?. What are you qualifications again?.

And Pablo, yes, I am a swell guy. But, I do think that, technically speaking, Paul Offit is a pharma-shill but he discloses all his conflicts. That might not make it right in my book but he’s honest about the money he makes promoting the benefits of vaccination.

Although if you were being fair, you would want to acknowledge that Dr. Offit’s financial interest is only in a single vaccine, RotaTeq. As the developer of a vaccine that has saved millions of lives worldwide, Dr. Offit certainly deserves whatever profits he has made. Nevertheless, Rotateq is a recent addition to the vaccine schedule, and is given well before the age at which children typically develop autistic symptoms. Thus, it could not reasonably be suspected as contributing to autism. He is not a drug company employee, and thus has no financial stake in the vaccines that are at issue in vaccination/autism debate. It is hard to justify the implication that he any motivation for promoting the benefits of other vaccines besides than protecting children.

@Sid Offit

So, you’ve gone from suggesting that vaccines might cause autism (“we just don’t know zomg!!!”) to apparently suggesting that vaccines might cause mitochondrial disorders? I presume that you have more than a single case to support such a hypothesis?

@Todd

Yes Todd vaccines might cause autism. Sorry. Anyway you really need to follow these threads more carefully. Trrll challenged my assertion that Jon Poling believed Hannah’s MD may not have been present at the time of her vaccinations.

But, Dr. Poling, a neurologist, says: “No one knows if Hannah’s mitochondrial dysfunction existed before receiving vaccines.”

Anything I’ve posted subsequently has been in regards to that assertion. I never expressed a belief that vaccines or mercury cause MD.

Trrll challenged my assertion that Jon Poling believed Hannah’s MD may not have been present at the time of her vaccinations.

No, I didn’t challenge any assertion about what a distraught father may or may not have believed. I simply pointed out that the notion that her mitochondrial dysfunction was caused by vaccination is entirely implausible–particularly considering that she was found to have a mutation in a critical mitochondrial gene.

But, Dr. Poling, a neurologist, says: “No one knows if Hannah’s mitochondrial dysfunction existed before receiving vaccines.”

Anything I’ve posted subsequently has been in regards to that assertion. I never expressed a belief that vaccines or mercury cause MD.

And it is equally true no one knows if Hannah’s mitochondrial dysfunction was caused by space aliens (which is rather more plausible than the notion that vaccines can cause mitochondrial dysfunction).

Imagine you are one of the parents in this audience. Would a study showing you no link between vaccines and autism mean much to you? would you believe pharma sponsored studies or parents with no financial agenda?

Why on earth would you say would you just said, Orac?

Because that was your M.O.: to slime Paul Offit for “conflicts of interest” and as a “pharma shill.” Not to give him the “benefit of the doubt” because you don’t agree with him while you bend over backwards to ignore Wakefield’s undisclosed conflicts of interest.

You say you don’t do that any more and that you accept Offit’s word. Fine. We’ll see if that’s true as the conversation moves on. I’ll start a fresh slate and call you out if you start doing what you used to do.

If shots are safe, why is their a vaccine injury fund? This offit guy may have saved many lives from vaccinations, but it comes with cost of injuring others. I guess if you have more wins than losses, keep producing more vaccines and shooting our children up. If we lose a few more to autism..great. As long as we were able to prevent something else so be it. How can doctors be so sure there is no link when they can’t seem to figure so many other things out (cancer, autism, etc) They do not know it all.

While it may be different for a parent to accept, it is a fact of life that nothing is safe. Cars aren’t safe. Bicycles aren’t safe. When you put your child in the car to go to school, or the doctor, there is a chance that as a result, he will be killed. You do it because you have made a judgment that the benefit outweighs the risk, even though the benefit may be as small as a trip to the movies, and the risk is death or dismemberment. Vaccines are much, much safer than cars, but they are not absolutely safe. So there is a vaccine injury fund to help parents in the rare cases in which children are injured by vaccines. And also to help all of the other children who are protected by vaccines, by preventing the potential liability from rare vaccine injuries from making vaccine production so uneconomical that all of those other children would be denied protection from death or disability caused by vaccine-preventable diseases.

We don’t know it all. In fact, we don’t know much of anything with absolute certainty. We don’t know everything about gravity, so I can’t promise you with absolute certainty that when you let your child go out into the yard to play, that he will not float up into the sky to suffocate in outer space. The best that I can tell you is that while we don’t know everything about gravity, but everything we do know tells us that such a thing won’t happen. Similarly, we don’t know everything about vaccines, or autism. But everything we do know tells us that vaccination and autism are unrelated.

I disagree with Dr. Offit but also disagree with anyone who says that his life work has solely been a process to make himself rich.

He accepts large sums of money from pharmaceutical manufacturers for research, speaking and more and that might not meet your definition of pharma-shill. So be it. I have been wrong in the past in inflaming the antipathy between Dr. Offit and the online autism community. Again, based on my experience and interpretation of existing research and data, I think that Paul Offit’s vaccine recommendations are not as safe as they could be and that the way we vaccinate “triggers” autism in some children.

No, Flim Flam (nice name) I don’t charge “top dollar.” I charge fair fees for the hour I spend with each child and family, do a reasonable amount of pro bono medical care and I’m quite proud of my pediatric practice. A small percentage of the day is spent caring for families with kids on the autism spectrum and most of my hours are devoted to neurotypical newborns, babies, children and teens. I happen to love my work. I don’t agree with everything that goes into the effort to convince parents that they need to look hard at the vaccine schedule before acquiescing to all the shots, but I strongly support that effort.

Best,

Jay

@Jay Gordon

I think…that the way we vaccinate “triggers” autism in some children.

I’ll ask the same thing of you that I asked Sid Offit. What evidence do you have that brings you to the belief that vaccines “trigger” autism? Further, at what rate do you believe this happens?

You know, I think that the antivaxers may be onto something when they mention aluminum as a possible “trigger” of autism. No, wait. Hear me out. See, every child that has autism was either breast fed or received formula, both of which have significantly more aluminum in them than, say, a vaccine. In fact, the correlation is so strong, that, contrary to antivaxers’ erroneous conclusion that it is the aluminum in vaccines that triggers autism, it is clearly aluminum in breast milk and formula that causes autism.

I hereby call for an end to all breast feeding and formula until we have 100% safe breast milk and formula! It may take the starvation deaths of kids for everyone to finally realize that we aren’t going to stand for aluminum in our breast milk and formula any more! Who’s with me?

Again, based on my experience and interpretation of existing research and data, I think that Paul Offit’s vaccine recommendations are not as safe as they could be and that the way we vaccinate “triggers” autism in some children.

How about based on science?

As I’ve pointed out to you time and time again, your “experience” can be profoundly misleading, particularly since you became known as the “vaccine skeptic” pediatrician (which leads antivaccine parents to seek you out), and your interpretation of existing research, to put it ridiculously kindly, leaves much to be desired.

So, show us some science that supports your view that Dr. Offit’s vaccine recommendations “are not as safe as they could be” and that “the way we vaccinate ‘triggers’ autism in some children. Anything less is nothing more than your weakly supported opinion.

Again, based on my experience and interpretation of existing research and data, I think that Paul Offit’s vaccine recommendations are not as safe as they could be and that the way we vaccinate “triggers” autism in some children.

And based upon my experience of reading your comments, and your credulousness with respect to ridiculous fears of things like formaldehyde in vaccines (which anybody who paid attention in biochemistry class should know instantly to be nonsense), I think that you lack the fundamental knowledge required to understand the research, and likely lack the judgment to form useful conclusions from your clinical experience.

Your assertion that Hannah’s condition is of genetic origin is far from certain. According to Dr. Poling: Dr. Shoffner performed genetic testing on both Hannah’s muscle and her mother’s leukocytes subsequent to our case report. Hannah (muscle mtDNA) and her mother (leukocyte mtDNA) were both found to be HOMOPLASMIC for the mtDNA T2387C transition mutation. Our analysis of this genetic finding in the mtDNA was significantly different than those of other physicians that I’ve seen in scientific blogs or commentary. I suspect it would have been fatal to both Hannah and her mother if this homoplasmic mutation was pathogenic since (as I am sure you are aware) the mutation is on the 16S ribosomal subunit which is highly conserved. Thus, this mutation probably represents a benign polymorphism rather than pathogenic mutation. It is unlikely, but possible, that the mutation is significant to Hannah

Yes, I am aware that Dr. Poling is understandably emotionally involved, and has refused to accept the conclusions of the vaccine court and other physicians who agree that Hannah suffered from a pre-existing genetic condition (which likely played a factor in the poor health that led to her vaccines being delayed). He would prefer to believe that vaccines somehow caused her mitochondrial disorder (although frankly, space aliens is rather more likely). The argument that her mutation could not have been the cause of her disease because this position is “highly conserved” is ridiculous, because it is the other way around–highly conserved positions are more, not less, likely to cause disease when mutated, and mutations are less likely to be benign, not more. The notion that a mutation in a conserved region must be either lethal or harmless has been disproved by literally hundreds of mutagenesis studies. yWith mitochondrial disorders, it is possible for some tissues to have the mutation and others not to have it. So while he claims that the mutation is “homoplasmic,” nobody has sampled Hannah’s mother’s brain to determine if the cells there have the mutation.

I am a pediatrician, and we have a 92% vaccination rate at our practice. But, I still cant understand how some doctors are so unwilling to accept any form of observation into their medical results. Just some thoughts…

“How about based on science?”

This phrase is consistently misused here. Since most scientific research and results are subject to ‘interpretation of those results’, that leaves us to depend on other people’s “opinions” all the time. This holds true for us in medicine as well. Alot of the patient’s response to medications, surgery, therapy, what have you, is based on what the patient tells you, how you interpret the progress, how you interpret the lab results and so on. If a pain medication is not perceived to be helping, you would probably try another. Even if the research says that first pain medication should have worked, you go with your patient’s opinion and your judgement to change it. Alot of medicine is based on anecdotal evidence from the patients. So why, is so hard to admit that vaccines could “trigger” autism? Why is ok to accept some patient’s unscientific opinions, but not others. Personally, I recommend vaccination to all my patients, family and friends because the risk is still much greater to not vaccinate. But, I would be remiss, actually flat out lying, if I didnt mention possible side effects including the suspicion that it could trigger autism in SOME. Anecdotal or not, you cannot simply dismiss case after case of children regressing into autism very soon after vaccines. Even if I only counted the children who were developing normally until 1 to 7 days after vaccination, there are too many cases to simply call it a coincidence. It isnt possible to do a scientific study that would show how the cummulative effects of genetics, environment, diet, medications, vaccinations, etc affect each individual child, but you cant simply discount medical observations just because the science isnt there yet. (and no, I dont believe in or want to study the stupid tea pot thing so please dont bring that up)

case in point Todd, I know you were being sarcastic about the aluminum fed to babies, but that is an example where children are being exposed to higher levels of aluminum and more, in their food source already… the addition of that small amount of aluminum in the vaccinations may be just the ‘straw to break the camels back’ in some children. Do you site the vaccine as the cause, no, but starvation, as you pointed out, isnt an option either.

Are vaccines required for public health? yes
Are they as safe as they could be for the lack of health I see in alot of babies and children these days? no
More work needs to be done.
Thanks

@EJB

Even if I only counted the children who were developing normally until 1 to 7 days after vaccination, there are too many cases to simply call it a coincidence.

Actually, yes, you can call it a coincidence. Pat Cahalan did a some calculations in a post over at Bad Astronomy (http://tinyurl.com/nu7csn) to show that it would actually be surprising to not see anyone develop autism shortly after a vaccination. You’re falling into a post hoc, ergo propter hoc fallacy.

As it stands, the only pattern that we’ve seen suggested is regression after MMR. So, we looked at it to see if anything was there, and, when we controlled for confounding variables, we found that there really was no difference in autism rates between those receiving MMR and those who did not.

The other major theory was that it was thimerosal, because it contains mercury, and, as some claim, mercury is bad, no matter the form or amount. So, we looked at that, too, and, like MMR, found that there was no correlation. Indeed, even after it was removed from childhood vaccines to pre-1980 levels, autism rates still have not changed.

Yet, people who, for whatever reason, don’t like vaccines or just need something to blame to make themselves feel somewhat better, shifted tactics and, with absolutely no plausible reason to suspect it, declared that it must be aluminum, or formaldehyde, or antifreeze (which isn’t even in vaccines), or squalene, or, or, or. Furthermore, a lot of the kids who supposedly regressed after a vaccine showed signs of autism before being vaccinated.

In short, there has been no plausible mechanism or reason suggested, after all the studies have been done, to show that vaccines have any more than a coincidental association with autism. The only things that are left are vague “But anything’s possible” protestations.

The only way to definitively show that vaccines have no effect on autism incidence is to conduct a randomized, controlled trial of vaccinated vs. unvaccinated, but, as has been discussed before, such a trial would be extraordinarily expensive to achieve the necessary power, be a logistical nightmare, and, most importantly, be grossly unethical.

Now, if someone comes forward and proposes a plausible connection and they want to study it, more power to them. We’ll eagerly await the results and change our tone as the evidence requires.

My suggestion to you, insofar as the vaccine-autism “controversy” goes, is to do a bit of reading on how it all got started. Science-Based Medicine blog has a whole section devoted specifically to vaccines and autism. I would start there.

EJB:
Here is an article that provides a good response to your suspicions about vaccination. It also demonstrates the problems of relying on anecdotes alone:
http://www.skepdic.com/confirmbias.html

In brief, when you have a hammer, everything looks like a nail.

BTW, for my “followers” (if they exist, ha, ha), I am not singling out EJB for civility because he or she is a pediatrician. I am going to continue to be civil to newbies and those with whom I disagree. However, no mercy will be shown to fools and liars.

EJB @175: So why, is so hard to admit that vaccines could “trigger” autism?

Allow me to admit it: vaccines could trigger autism. However, there is no good quality research to support the notion that vaccines do trigger autism.

Similarly and relatedly, there is no good quality research to support the various “biomedical” modalities being marketed to parents to “treat” autism, nor support for the “alternative” vaccination recommedations of fearmongering apologists like Gordon & Sears.

Let me turn it around: why is it so hard for anti-vaccinationists to admit that there is only very low-quality evidence in favor of a vaccine-autism link and fairly good evidence that reduced vaccine uptake (due to their own hyperbole) has contributed to a greater incidence of vaccine-preventable illnesses?

Anecdotal evidence is great for forming a testable hypothesis; it’s not good for much else beyond that due to its inherent unreliability. It was not unreasonable to test the hypotheses that the MMR vaccine or thiomersal contributed to the etiology of autism. It is unreasonable to continue to move the goalposts, on even lower-quality evidence, because the previously hypothesized links were found to be highly unlikely.

EJB, if you haven’t read it yet, go read Orac’s recent post: “There must be a reason”

TBMcNeely,
I agree with every single thing you have said, and have read almost every link in the past that you provided. I have no problem with any of the research done already, and I know it is not plausible to fund some of the extensive studies that have been suggested here in the past. My whole point, was that although I fully trust the science behind vaccines, all the science is not there yet. Therefore, when I see cases of regression very soon after vacc (and I am only talking of the ones with no signs ahead of time), I have to question why this ‘coincidence’ keeps happening right then? That makes it not a coincidence anymore. I know the studies prove it is not caused by the vaccine alone, my problem is with the cumulative. I believe more care in overall health is needed. I cant outright dismiss the slight chance of vaccines being a trigger in ‘some’ cases, just because it has not been proven yet. The civility is much appreciated.

@EJB

I have to question why this ‘coincidence’ keeps happening right then?

Because the symptoms of autism typically appear right around the same time as many of these vaccinations (e.g., MMR), even in unvaccinated children. The chances of the symptoms being observable after a vaccine are actually pretty high. Again, take a look at the post by Pat Cahalan that I linked to above.

EJB:
Thanks for your reply.
BTW, I didn’t phrase my second paragraph in comment 177 very well. What I meant was that I will strive from now on to be civil to newbies and those with whom I disagree, since I freely admit that I have had a bit of a “hair trigger” up till now.
The rest still stands.

Therefore, when I see cases of regression very soon after vacc (and I am only talking of the ones with no signs ahead of time), I have to question why this ‘coincidence’ keeps happening right then?

OK, fine. But the next thing to do is to ask, is it really true that this happens more often after vaccines than not?

I mean, you’ve even admitted that you have selected the data – you focus only on those with no signs ahead of time.

If I ignore all the red, black, purple, green, yellow, and orange jellybeans from the package, does it make sense to wonder why I keep grabbing the white ones? I blame Brachs! They put way too way more white jellybeans in a package. I know because, if I don’t count the other colors, all I get are white ones…

Therefore, when I see cases of regression very soon after vacc (and I am only talking of the ones with no signs ahead of time), I have to question why this ‘coincidence’ keeps happening right then? That makes it not a coincidence anymore.

Is it coincidence that many children enter puberty shortly after entering Junior High School? In the sense that there is no causal relationship, obviously it is. But in another sense, it is not coincidental, because they are two different events that occur on a similar developmental schedule, so in fact those two events are expected to frequently correlate in time.

Autistic children frequently exhibit an apparently sudden onset of symptoms around 2 or 3 years of age. It is now know that autism begins well before that, but the early symptoms are often not recognized or denied by parents (although they can be detected by clinicians viewing early childhood videos). The apparent sudden development of symptoms can lead parent to search for a proximate cause. Moreover, now that the putative vaccination/autism link has been widely reported in the media, parents are likely to more sensitive to symptoms that may previously have been present but unnoticed.

It is worth noting that the phenomenon of regression is also observed in Rett Syndrome, a disease with a known genetic cause. The brain goes through a lot of changes during the first few years of life, and while the details are yet to be elucidated, it is likely that there are critical points at which the process can go badly wrong.

@Todd W

See, every child that has autism was either breast fed or received formula, both of which have significantly more aluminum in them than, say, a vaccine.

Todd, you do understand a substance affects the body differently when injected. That’s why we don’t eat vaccine.

Todd, you do understand a substance affects the body differently when injected. That’s why we don’t eat vaccine.

A claim with no basis in evidence, and one that makes little sense physiologically. We have a century of pharmacological research proving that the vast majority of substances affect the body the same when taken orally as when injected. The exceptions all have to do with bioavailability–things that aren’t effective orally because they never get out of the gut or are broken down in the gut or the liver before they reach the general circulation. We do in fact take some vaccines orally–live vaccines like polio vaccine that are able to get out of the gut on their own. The vaccines that we don’t take orally are protein or killed organism vaccines that would be digested in the gut, and would never reach the circulation.

@trrll

Your certitude regarding genetics as the underlying cause of Hannah’s MD is founded on likelihoods, suggestions and a affinity for space alien analogies

http://www.scientificamerican.com/article.cfm?id=vaccine-injury-case-offer
Hannah’s disorder is likely due to a rare mutation in her DNA. Salvatore DiMauro, a mitochondria expert at Columbia University, notes that the point mutation mentioned in Poling’s case history… would imply that both she and her mother carried the genetic variation in all their tissues. So, he says, “you would expect to see the same results” in both the mother and the daughter. But Poling’s mother, Terry, who is an attorney and a registered nurse, is not autistic.

That suggests the genetic defect responsible for Poling’s condition is part of her nuclear DNA, which is separate from the mitochondrial variety, says DiMauro

John Shoffner, a mitochondrial disease expert who runs a
laboratory in Atlanta, agrees

———————————————————–

From the Poling concession
In his assessment, Dr. Kelley affirmed that CHILD’s history and lab results were consistent with “an etiologically unexplained metabolic disorder that appear[ed] to be a common cause of developmental regression.”

On October 4, 2001, Dr. John Schoffner, examined CHILD to assess whether her clinical manifestations were related to a defect in cellular energetics. After reviewing her history, Dr. Schoffner agreed that the previous metabolic testing was “suggestive of a defect in cellular energetics.”

In February 2004, a mitochondrial DNA (“mtDNA”) point mutation analysis revealed a single nucleotide change in the 16S ribosomal RNA gene (T2387C). Id. at 11.
——————————————————————

And Steve Novella

It is probably not a coincidence that the child has a point mutation in a gene that has been previously linked to these very mitochondrial disorders

Further testing regarding the physiological effects of this child’s specific mutation would be helpful. It is theoretically possible that the identified mutation does not cause a change in the gene product or mitochondrial function, and is therefore just a coincidence.

ORAC and others: In EJB, we now have a second pediatrician in the room who has accumulated a series of observed regressions shortly after vaccination.

I agree with the assembled skeptics here that these occurrences don’t supply proof that vaccines cause autism.

But, now you are forced to ignore the experience of two pediatricians who have seen these series of temporally-associated events. A good scientist uses his eyes and ears and not just randomized, blinded controlled studies.

I am not dissembling nor trying to excessively flatter anyone here when I tell you that I have learned a lot from many of you who post on RI. I’d appreciate your keeping an open mind to the possibility that experienced doctors’ observations are a useful addition to this discussion and not just fodder for disdain and sarcasm.

Best,

Jay

ORAC and others: In EJB, we now have a second pediatrician in the room who has accumulated a series of observed regressions shortly after vaccination.

I agree with the assembled skeptics here that these occurrences don’t supply proof that vaccines cause autism.

But, now you are forced to ignore the experience of two pediatricians who have seen these series of temporally-associated events. A good scientist uses his eyes and ears and not just randomized, blinded controlled studies.

Who’s ignoring it? The point is that since the age at which prominent autistic symptoms emerge is about the same as the age at which children customarily receive vaccinations, that we expect a temporal association even in the absence of a causal association. Not only is it not proof, it is not even evidence.

Back to my analogy: It doesn’t matter how many children you observe to enter puberty shortly after they enter junior high school. It doesn’t provide evidence–not even suggestive evidence–that junior high school causes puberty. Jumping up and down about your “experience” as a pediatrician doesn’t help you here, because the issue is not whether you know how to give an injection or diagnose fever in a child, but whether you have have anything to offer other than a anecdotal observations of temporal association–which would be expected to be frequent anyway, even in the absence of a causal association. This is the sort of thing that can mislead even experienced researchers with good scientific judgment–and it is clear that you lack both research experience and scientific judgement (the latter failing clearly evidenced by the fact that you took seriously the ridiculous notion that formaldehyde traces in vaccines could be a hazard).

EJB and Jay: In order to determine whether or not the reports of autistic regressions after vaccines are more than a coincidence, you need to know how many autistic regressions occur at other times. You can’t determine this by only looking at anecdotal reports because, for example, if a child experienced a regression a week before she was scheduled to receive a vaccine, her parents would have no reason to mention the latter fact unless they believe that effects can temporally precede their causes. But if, say, there are just as many regressions in the week before a scheduled vaccination as in the week afterward, then you don’t even have a non-causal correlation; you have no correlation at all.

Again, the only thing that would even suggest further observation would be more regressions occurring after vaccination than before. The only conclusion that you can draw from the fact that there are some regressions after vaccination is that vaccination does not prevent regressions 100%. Since nobody’s ever made that argument, and nobody’s ever going to make it, you can safely ignore it.

Todd: I’m going to be terminally pedantic and nit-picking and point out that there is *not* a high correlation between having consumed breastmilk or formula and developing autism. Correlation refers to the tendency of one measure to vary in concert with another. If one of those measures doesn’t vary at all, then it’s meaningless to talk about correlation (and calculating Pearson’s coefficient will involve dividing by zero; Kendall’s coefficient will be exactly zero, but uninterpretable).

But, now you are forced to ignore the experience of two pediatricians who have seen these series of temporally-associated events. A good scientist uses his eyes and ears and not just randomized, blinded controlled studies.

Straw man argument. No one’s “ignoring” anecdotal experience. We’re pointing out that experience such as yours and your partner are a small number that can easily mislead, particularly if you are predisposed to believe there is a correlation between vaccines and autism. It’s called confirmation bias. In any case, vastly larger study sets have failed to find a correlation between vaccination and autism.

In science-based medicine, anecdotal evidence is simply the beginning. It’s OK for generating hypotheses but not for making conclusions. Your problem is that you see it as the be-all and end-all. You cling to anecdotes but ignore the much larger and more rigorously collected datasets that contradict your anecdotal evidence.

A good scientist is aware of where anecdotal evidence lays on the hierarchy of evidence and also why the hierarchy looks the way it does.

A good scientist would be more than aware of what to do if the higher order evidence contradicts their own anecdotal evidence. Either find out why and do something about it or find equal or greater evidence.

“In any case, vastly larger study sets have failed to find a correlation between vaccination and autism.”

My whole point was to say that vaccines as a final ‘trigger’ in some children has never been studied. It would be a ‘vastly large’ impossible study to show the role that genetics, environment, nutrition, medications, etc play together to trigger the regression of autism in some cases. Therefore, I keep an open mind.

HX I have never in 21 yrs of pediatric practice recommended a child not be vaccinated unless there was a medical reason. I have read the research, I know the risks of not vaccinating outweigh the risk for side effects. Most every parent I have spoken with will decide for vaccination when they are provided the answers they seek. Actually, the very few that are still completely against vaccination, usually end up going elsewhere. Of course, we do not harrass them in any way to leave. We continue to do our best to educate them and try to protect the children. In the end though, they know we do not agree and they find a better fit elsewhere.

“But the next thing to do is to ask, is it really true that this happens more often after vaccines than not?”

No, this does not happen more often in my practice, and I never implied that it did.

“I mean, you’ve even admitted that you have selected the data – you focus only on those with no signs ahead of time.”

No, I have seen the regression to autism at many age levels. I said the ones that regress very quickly after vaccination are the ones that bother me and lead me to consider vaccines as a final trigger in certain cases. To be more specific, the ones with no signs of autism from my earlier exams, nothing suspicious from the parents and family’s observations, and nothing from reviewing their home movies either. Calling those a ‘mere coincidence’ is borderline malpractice. (189, puberty is a bad comparison, that is biology not coincidence)
(ex.) 2yo singing all the words to the star bangled at the top of her lungs in the waiting room. No prior evidence of regression. Gets vaccinations. Next day, will not communicate at all, and just sits there playing with the button on her dress. 6yrs later, considered low spectrum
(ex) 21mos, developing normal, racing cars up and down the walls, 2 hrs after vaccination presents to the ER limp and has been high on the autism spectrum since.
Of course there are more. However, my point was that it is very hard to call cases like these just a coincidence. I would never suggest to a parent that her child would have stopped playing forever within 2 hrs even if he had not been vaccinated. Would I tell the parent that the child may have eventually started to regress regardless? yes. But to discount the vaccine as a possible trigger in that particular instance would be a medical lie.

Funny thing is, the parents who have been educated about vaccines, and know the importance even though there may a risk of side effects (including the slight risk of triggering autism in susceptible children), do not start attacking vaccines as the primary cause. They did not feel like things were hidden from them, or that they were lied to, and they realize that with the evidence available at this time they made the right choice. I have overheard them tell other parents that vaccines did not cause their child’s autism.

I

Calling those a ‘mere coincidence’ is borderline malpractice. (189, puberty is a bad comparison, that is biology not coincidence)

And my suggestion is that the age at which autism symptoms emerge is also biology, and has exactly the same association with vaccination as puberty has with entry into high school.

It would be a ‘vastly large’ impossible study to show the role that genetics, environment, nutrition, medications, etc play together to trigger the regression of autism in some cases.

Especially considering that there is no real evidence that environment, nutrition, and medications play any role at all in the emergence of autism. A few things we do know: 1) “Regression” does not necessarily indicate an environmental trigger. Patients with Rett Syndrome, which has a known genetic cause, also frequently exhibit regression. Autistic children who exhibit regression are not different in any measurable way from those that do not. 2) Autism exhibits an extremely high genetic concordance, suggesting that it is predominantly, and perhaps entirely, genetic in origin. 3) Studies of brain tissue of autistic patients are more consistent with a brain that has developed abnormally from a very early age. 4) Studies have shown that children who develop autism begin to exhibit symptoms very early, although those early symptoms frequently go unrecognized until symptoms worsen around age 2-3.

So far as I know, the only evidence that is even suggestive of an environmental influence is that while autism is virtually always shared by identical twins, one twin may be more severely autistic than the other. However, there are other possible explanations. Identical twins do not develop exactly identically (their fingerprints are similar but not identical, for example) and there may still be epigenetic differences or differences in distribution of mitochondrial mutations (or X-chromosome mutations in girls).

@EJB

To be more specific, the ones with no signs of autism from my earlier exams, nothing suspicious from the parents and family’s observations, and nothing from reviewing their home movies either. Calling those a ‘mere coincidence’ is borderline malpractice.

Quick question: have you been trained specifically in the diagnosis of autism? I ask, because at least one of the behaviors your described in the sample cases before vaccination could very well be signs of autism.

@ebohlman

Yeah, I know my breast milk/formula thing was not spot-on as far as correlation goes. I should’ve probably included a “satire” tag to make it clearer. At any rate, it amounts to a similar argument as the vaccines-cause-autism mantra.

@Sid Offit

Todd, you do understand a substance affects the body differently when injected. That’s why we don’t eat vaccine.

First off, it appears satire is lost on you. That aside, as trrll pointed out, it’s the bioavailability. Whether you inject a substance or swallow a substance, it will have the same effect if the same amount ends up making it through the intervening organs and metabolic systems (stomach, liver, etc.). So, if you say that the aluminum in breast milk won’t have any negative effect, but the aluminum in vaccines would, then please provide citations showing that there is less bioavailable aluminum in the body after ingesting breast milk/formula than there is after receiving a vaccine.

“And my suggestion is that the age at which autism symptoms emerge is also biology, and has exactly the same association with vaccination as puberty has with entry into high school. ”

You are splitting hairs here. I gave only 2 examples of drastic change within 2 and 14 hrs. Of course there are more. As I mentioned, I have seen cases of regression that did not occur around the time of vaccination, but not one of those cases regressed that drastically within hours. Yes, that is the usual age, but that is not the usual rate.

“at least one of the behaviors you described in the sample cases before vaccination could very well be signs of autism.”

You were given very simplified, abbreviated descriptions of those children’s cases. I had seen those 2 children since birth. If any of their behavior was considered autistic then all 7 of my children would have to be dx as autistic for doing the exact same things as them. They are not.

“who has accumulated a series of observed regressions shortly after vaccination.”

I dont want Dr J’s comment to give the impression that I have seen an above average number of autism cases at my practice. We have not. If anything, we have less than the reported average, and a very impressive immunization percentage too.

Thank you for the informative replies and useful links. I will use some of these notes in my parental conferences as needed. I believe there is a big difference between causing autism and multiple factors triggering a genetic predispostion. This would be an implausible study to do, so for now, I will agree to disagree that it has not been ruled out.

I am having a hard time finding the parents who witnessed your children fall into this black hole represented in this group. I am likely a minority but that is fine.

I don’t think you then spent 9 months trying to get a so called PROFESSIONAL – like you all either are supposed to be or you worship – to diagnos a child who was so obviously suffered from a vaccine injury, which resulted in loss of ALL language and eye contact.

My child’s personality and abilities died that day and you SOB’s don’t care about anything but your own personal and egotistical petty political conversations with each other. Enjoy while we go seek truth. This is not a game. I dare you to do the actual research. Get the money to DISPROVE what we as parents know we saw. If all of you are so sure that we are WRONG it shouldn’t be so hard to come up with the funding to run real research on this topic. Not these made up, engineered literature reviews that conveniently leave out anything we’ve PAID for, much of which is peer reviewed and published.

Dr. Wakefield, Krigsman and the other DAN doctors are the first ones to slow down and actually LISTEN to what we are saying we witnessed in our own homes. I know what I saw and experienced. I will NEVER hire another doctor who won’t at least listen to me. That is not being a doctor that is being a scientist and maybe only being an employee of the government and paid off by the pharmacy companies.

So sad that you all are not really willing to pursue being the high quality individuals that you paid exorbinent tuition fees to become. Isn’t that a violation of some oath you took? I have higher research standards than that and I am “just a mom.”

REALLY do the research then maybe we’ll give a SH#$ what you think! Until then I’ll continue to share the truth. Light always displaces dark – that is scientific and spirtual. Don’t forget to guard your hearts.

If you moderate me YOU are a coward.

You are splitting hairs here. I gave only 2 examples of drastic change within 2 and 14 hrs. Of course there are more.

And I can give you lots and lots of examples of children entering puberty shortly after entering high school.

Of course there are more! The age at which children frequently begin to exhibit obvious symptoms of autism is about the same as the age at which they get their shots (although the vaccination that is most frequently associated in time with the onset of autistic symptoms–the MMR–is the one that has been most definitively excluded as contributing to autism.

As I mentioned, I have seen cases of regression that did not occur around the time of vaccination, but not one of those cases regressed that drastically within hours. Yes, that is the usual age, but that is not the usual rate.

Please describe how you determined the “usual” rate. Don’t forget to include number of subjects, standard deviation, and controls for bias such as blind evaluation.

Most children do not start to exhibit clear symptoms of puberty immediately after starting junior high school. But if you look for them, you will certainly find some that do.

I had seen those 2 children since birth. If any of their behavior was considered autistic then all 7 of my children would have to be dx as autistic for doing the exact same things as them. They are not.

The way that actual researchers do this is to have early videos (such as birthday party videos) of autistic and nonautistic children evaluated “blind” by autism specialists This is the only way to eliminate confirmation bias.

And isn’t it funny that despite the claim that vaccine-induced autistic regression is so common that it is routinely observed by pediatricians who do not specialize in children at risk for autism, the Generation Rescue phone survey was unable to document any greater risk of autism in vaccinated than in unvaccinated children? Do you think that perhaps the puberty/junior high school analogy might not be so unreasonable, after all?

@EJB

Again, I’ll ask: have you been trained specifically in the diagnosis of autism? If you have not been trained in the diagnosis of autism, then how do you know what the rate is? How do you know that you did not miss early symptoms? trrll raised some good questions.

I also wonder, for those kids who do not “rapidly regress”, how soon did you see them before this regression occurred? Chances are, you are noticing the “rapid” ones because they are being brought back to you within a short time frame.

@gm

First off, I just want to wish you well. I’m not a doctor, and I have no connections to any pharma company, so I am not benefiting financially from any of the info I share.

Get the money to DISPROVE what we as parents know we saw. If all of you are so sure that we are WRONG it shouldn’t be so hard to come up with the funding to run real research on this topic. Not these made up, engineered literature reviews that conveniently leave out anything we’ve PAID for, much of which is peer reviewed and published.

Where would you have the research start? Which vaccine? Which ingredient? The studies looking at the MMR and at thimerosal have been well-designed and failed to find any correlation. So, what’s next? Keep in mind that the money going toward research into vaccines and autism is money that does not go toward more promising research, like genetics.

And what studies have you read that show a connection? Have they been well-designed with proper controls to eliminate bias? Did they have sufficient sample sizes? In which journals were they published?

I know what I saw and experienced.

But the question to ask is, did your brain accurately interpret the reality of the situation? I do not ask this to be condescending or to be a jerk, but rather to point out that humans, every one of us, can very easily be fooled by not only other, but also by ourselves. We can’t see every last detail, so we fill in the gaps with our best guess. Unfortunately, that can often be wrong.

@trrll

you would want to acknowledge that Dr. Offit’s financial interest is only in a single vaccine, RotaTeq. As the developer of a vaccine that has saved millions of lives worldwide, Dr. Offit certainly deserves whatever profits he has made.

Please describe how you determined that Paul Offit’s vaccine has saved millions of lives since it has only been approved since 2006; there have been no reports of a substantial decline in mortality and it has not been adopted by countries experienceing the most severe rates of death due to rotavirus

MMWR
November 21, 2008 / 57(46);1255-1257
Rotavirus Surveillance — Worldwide, 2001–2008
Rotavirus infection is the leading cause of severe acute diarrhea among young children worldwide (1,2). An estimated 527,000 children aged <5 years die from rotavirus diarrhea each year, with >85% of these deaths occurring in low-income countries of Africa and Asia (3). Two licensed rotavirus vaccines have shown efficacy of 85%–98% against severe rotavirus diarrhea in trials conducted in the Americas and Europe (4,5), and they have been introduced into routine immunization programs in 11 countries in these regions and in Australia. Additional trials of these vaccines are ongoing to assess efficacy in low-income countries of Asia and Africa, where vaccine performance might be affected by factors such as concurrent enteric infections, greater prevalence of malnutrition, and a greater prevalence of unusual rotavirus strains. Results of these additional trials are expected within the next 1–2 years

The thread winds down. OK, I’m sure there’ll be another equally interesting discussion about this soon.

Trrll, Todd W and many of the rest of you speak with absolutely no experience or compassion. As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

The connection between vaccines and benefit to children is not questioned by me or by most of my colleagues who are ambivalent about the current vaccine schedule.

The connection between vaccines and harm to children is also supported sufficiently to merit a lot more lightand a lot less heat. Think harder about what it’s like to be a doctor with this much experience.

Best,

Jay

I’m amused by Dr Jays post, but not as much as I will be by the ass-handing that’s about to commence at his expense.

Lay it on, I say, lay it on.

Yet again for dr’r Jay and e, where is the evidence?.

if all these children are dramatically regressing within hours of their vax’s you’d really think someone other than anti vax propagandists would have noticed.
Confirmation bias anyone?.

Am i the only one getting a bit tired of the “i’m not anti vaccine but… ( insert- too many too soon..dr bobs selective schedule..green our vax etc)” schtick?
and jay, you go on about your “experience”, but where the hell is your knowledge?. “i feel” and “i believe” don’t cut it here.
Perhaps you could explain to the parents of the little boy in the UK who died of complications caused by chickenpox how dangerous vaccines are?.

http://www.dailymail.co.uk/health/article-1210300/chicken-pox-killed-son-How-little-boy-died-just-weeks-spots-appeared.html

9 chidren died in the UK from chickenpox in 2007.

(you know, harmless chickenpox that the nutters at MDC all want their kids to get) Too many too soon?. not enough , soon enough for the poor little boy. A fair few dead babies over here in Oz due to the drop in whooping cough vax take up too, but again, the vax is worse right?.
better a dead kid than an autistic one….right dr jay?

best..
best you actually start looking at the evidence rather than making decisions based on your “feelings”.
This is real life Dr jay, kids are dying because of the anti vax propaganda shills like yourself.

As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

That argument makes little sense. Assuming this was such a common phenomenon, science would have no trouble finding the connection.

Think harder about what it’s like to be a doctor with this much experience.

It’s funny you mention this since it’s well-established that older docs (aka “this much experience”) are massively prone to bias.

@Jay Gordon

Since you didn’t bother answering my question, here it is again:

What evidence do you have that brings you to the belief that vaccines “trigger” autism? Further, at what rate do you believe this happens?

Still waiting. And I’ll ignore the “lack of compassion” BS.

@flimflam:
“Perhaps you could explain to the parents of the little boy in the UK who died of complications caused by chickenpox how dangerous vaccines are?.”

‘But the receptionist told me a home visit wasn’t necessary and that I should give him a cool bath and some Calpol.

“But the doctor simply prescribed antibiotics and said I should carry on giving him Nurofen

What parents need explained to them is how dangerous it is to administer antipyretics to an already immune-suppressed child, or even a healthy child, for that matter. (My goodness, how our species managed to evolve without the use of antipyretics is beyond my comprehension.)

Fever is not the enemy!

Flim-Flam’s talking about deaths from chicken pox and you respond by nattering away about Don’t Fear The Fever (hey, wasn’t that a Blue Oyster Cult hit?). Nice goalpost-shifting, Jen.

Dr. Gordon,
Compassion is exactly the reason so many here stand up in support of vaccination and against those that oppose it.

Dr. Jay @ #201: …there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence.

Quick exercise in basic math and the null hypothesis, Dr. Jay:
1. Null hypothesis: no temporal link exists between vaccination and onset of autism symptoms because no causative link exists between vaccination and the etiology of autism.
2. How many vaccination visits does an average child have between 18 and 36 months of age? We’ll call this variable NV.
3. What proportion of children have diagnosable autism spectrum symptoms by the age of 36 months? We’ll call this variable P.
4. What is a sufficiently close temporal association (expressed in months) of “regression” symptomology following vaccination make it most plausible that a vaccination event was a likely “trigger” event for the regression? We’ll call this variable T.

If the vast majority of autism diagnoses are made between 18-36 months of age (correct me if I’m wrong), then chance alone would predict that in this 18 month period of development, approximately P*[NV*(T/18)] percent of children would have a temporal association that meet the defined criteria.

Put in numbers that are reasonable, say NV=2, T=1 mo. Therefore P*(1/9) of all children would be hypothesized to have a temporal association between ASD diagnosis and vaccination within that time frame. If NV and/or T increases, that associated fraction increases: e.g., if NV=2.5, T=1.5 mo., a full quarter of all diagnoses appear temporally associated. Even if T is decreased to 1 week or one day, NV=2 predicts approximately 1/40 to 1/270 — a small but significant fraction — of all regressions will appear in very close proximity to a vaccination event by chance alone.

That gives us a general idea of what would need to be studied. If the null hypothesis is to be discarded, one would need convincing evidence that the onset of regression symptomology is significantly higher in the defined period following vaccination than prior to vaccination or sufficiently after vaccination. The first level of evidence–the low-quality anecdotal evidence–is only sufficient to identify that this may be worth studying…it is only sufficient this far because of the natural, very often mistaken, human tendency to interpret causation with only correlation; the additional confound of confirmation bias no doubt reinforces this notion as self-selected populations commiserate in various fora.

What would produce more compelling evidence? Retrospective analyses and case-control studies can be performed to evaluate the onset of diagnosable symptoms (e.g., PMID 14754936 & 15364187, which found no temporal link between MMR vaccination and ASD diagnosis). The most convincing evidence would come from a prospective study, but that would necessitate comprehensive monitoring over the entire test period and a very large number of children (due to the small proportion of children that would be expected to be diagnosable within a reasonable time-frame), so it’s probably not feasible from a time, money, or workload standpoint nor currently justified from a foundational science perspective.

So…tell me Dr. Jay, what evidence beyond anecdotes (yours and others) suggests that there is a real incidence of vaccine-induced regression? I don’t discount the possibility that there is a causative relationship; however no reliable dataset yet supports such a hypothesis. It’s entirely reasonable, in my opinion, to consider “coincidence” as a probable explanation for a large fraction of ASD diagnoses said to be temporally associated with a vaccine event.

I see no reason to reject the null hypothesis, yet, in this case. On the other hand, with the increases in morbidity and mortality associated with vaccine-preventable illnesses, I do see a reason to reject what appears to be bad advice regarding the delay or avoidance of vaccination based upon the current data.

“Flim-Flam’s talking about deaths from chicken pox and you respond by nattering away about Don’t Fear The Fever (hey, wasn’t that a Blue Oyster Cult hit?). Nice goalpost-shifting, Jen.”

Excuse me? No goal-post shift here. I propose that this child might not have died had his body not been bombarded with pharmaceuticals, antipyretics in particular. (I assume you’ve read some of the studies linking use of NSAIDS during varicella infections to an increased risk of developing secondary bacterial infections?)

Where’s the evidence that shows that the benefits of fever suppression outweigh the risks?

Dr. Jay @ #201: [many of you] speak with absolutely no experience or compassion.

Regarding “compassion and experience,” Dr. Jay is making a fool of himself. A significant portion of the posters in this forum have ASD children and/or are themselves on the spectrum; I doubt Dr. Jay knows the relevant details of more than a few of those he might paint as without passion or experience. (This is similar to the recent thread in which Dr. Jay tried to broadly tar the posters here as corporate shills, paid to post on RI by Big Pharma.) This assertion is presumptuous, factually inaccurate, and dripping with condescension.

Dr. Jay, for the sake of argument, let’s presume that you are quite possibly the most compassionate man in the world on the subject of vaccines and autism. Does that compassion mean in any way that you are more likely to be “right” about the medical question discussed here? No. In fact, the scientific method you seem to readily dismiss over and over is decidedly dis-passionate out of necessity. Those too emotionally attached to a particular outcome are the ones that too-often into pseudoscientific crankery when they refuse to let go of their un-supported beliefs. Compassion may be great for the bedside, but it doesn’t help understand scientific facts.

Your experience (Think harder about what it’s like to be a doctor with this much experience) has been covered many times in these pages, and appears to be your greatest strength and a glaring weakness. You have seen a lot of patients first-hand, but you actually seem to lack a big-picture view; that is, you can’t zoom out from your clinical practical experience to truly assess whether your “gut feelings” extend to the population at large. You see an increasingly self-selected population (as your fame grows in the anti-vax crowd, they come to you), rely primarily on evidence in the form of anecdotal experience (which is the lowest quality evidence), and are repeatedly dismissive of the scientific method in general and those who promote it (Pound your keyboards about science as much as like).

Dr. Jay, think harder about what it’s like to be a doctor with your experience and how entirely likely it is that you’re falling prey to the cognitive biases that affect every one of us, biases that are only reliably countered by systematic scientific analyses. Then, think harder about how understanding objective reality requires some careful and dis-passionate analysis of the facts at hand. Finally, think harder about how your smarmy, self-righteous statements undermine your constant pleas ’round these parts for people to be nicer to you and for greater civility in discourse.

Scientizzle, excellent posts. The first is a great refresher course for me and I appreciate it.

The second is offensively worded but reminds me that I have to keep an open mind to the possibility that I am prone to selection bias, as you point out.

The most interesting part of your posts posits that many people writing here are on the autism spectrum. I have thought about that, too. What do you think the implications might be?

Best,

Jay

Trrll, Todd W and many of the rest of you speak with absolutely no experience or compassion. As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

I guess I don’t understand the meaning of the word “compassion.” I thought that it meant empathy for the suffering of others. Like the way I feel for parents who are led by doctors such as Jay Gordon to believe that their child’s autism is their fault for allowing their child to be vaccinated and exposed to “toxins,” such as the formaldehyde that Dr. Gordon so foolishly believed to be a dangerous contaminant of vaccines (apparently, his experience does not include recollection of basic biochemistry).

But based upon Dr. Gordon’s comment, I guess that “compassion” must really mean “absence of skepticism regarding unsupported post hoc ergo propter hoc arguments.”

The first is NOT ‘a refresher course’ for you Dr Jay, if you truly were competantly aware of the concept it would not have required explaining to you.

The second is offensively worded……and totally unaddressed by Dr Jay. Dr Jay needs to be reminded at this point that you need to address the substance of a persons post.

“I see you made a post – well done” is NOT a sufficient rebuttal of the numerous errors of logic pointed out by Scientizzle.

In short, it was a “”smarmy and self-righteous” dodge, and a insultingly obvious one too.

Have the decency to address the numerous concerns raised Dr Jay or don’t bother to waste our time. If you want more civility then you might want to start by being a lot less blithely condescending in your replies.

Jay Gordon appears to have difficulty answering questions. He still hasn’t answered mine, either.

What evidence do you have that brings you to the belief that vaccines “trigger” autism? Further, at what rate do you believe this happens?

And, in terms of the NBC special, what evidence do you feel was presented to support Wakefield’s contention that vaccines are involved.

Jen: just one small argument. People have been using antipyretics for hundreds of years. The first documented use by a physician was in 1763. Although Aspirin was first patented in the late 1800’s, if you read any of the old herbals, they will discuss the use of willow and other plants in the Spirea family. The active ingredient of a tea made from the Spireas is salicylic acid. Aspirin is simply a buffered, purified version (leading to more uniform dosage and fewer problems with toxicity).

So, antipyretics have been used for many generations, and we humans evolved quite well with their use.

That being said, I agree partially with you. I think parents are too prone to using antipyretics when they are not needed (although I don’t agree with you regarding their part in autism).

Many parents are afraid of fevers (one friend of mine – who actually is, like me, a nurse – verbalized she was afraid of her child’s brain melting…and yes, she was serious). I usually based my usage on how the child was acting. Normal behavior and a fever: leave alone, encourage fluids, monitor. Abnormal behavior (lethergy, unusual crankiness, fluid refusal) I would give antipyretics for.

The most interesting part of your posts posits that many people writing here are on the autism spectrum. I have thought about that, too. What do you think the implications might be?

I have seen several of the “regulars” around here mention that they are on the spectrum. I cannot presume to speak for anyone’s opinions but my own, but I have heard enough comments from many in the autism community to feel confident that a significant portion of them would agree with a statement along these lines:

Research into the etiology of autism is very important. Vaccination, specifically the MMR vaccine and the preservative thiomersal, was hypothesized to play a role in the development of autism by some hypothetical concerns and preliminary data. These were not unreasonable hypotheses to test. Extensive studies were performed regarding MMR & thiomersal, which in toto do not support the hypotheses of either as a causative agent. Furthermore, much of the earlier work appearing to support these hypotheses has also been found to be terribly flawed and/or likely fraudulent. In the mean time, genetic studies have progressed and there is greater confidence in the hypothesis that genetics plays a substantial role in the etiology of autism.

Unfortunately, many have refused to accept the best science rejecting the MMR & thiomersal hypotheses, are ignorant of those findings and/or deliberately misinformed. The goalposts have also been shifted to far less-tractable claims (too many, too soon; generic “toxicity”), and demands continue for further studies, absent substantive increases in the veracity of the evidence supporting a vaccine-ASD link. This is fueled by irresponsible practitioners, within medicine and within CAM, that continue to promote these fears…

This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortality. ASD children are still subjected to treatments, some dangerous, with insufficient evidence of efficacy or prior plausibility (e.g., chelation, anti-fungals). Research efforts and funding, not to mention public relations and education man-hours, are diverted away from avenues more likely to bear fruit in the efforts to continue a wild goose chase seeking some vaccine-related effect.

Thus, many in the autism community are frustrated that autism research and awareness have been co-opted by a distinctly anti-science crowd, at the expense of public health, on the basis of low-quality evidence. They also dislike the hyperbolic message purveyed by many anti-vaccinationists that ASD patients are (vaccine-) damaged goods.

Those are the implications, in my opinion.

You all should really not feed the “Sid Offit” troll. Even though s/he/it has finally written about a child, I am still convinced that in trying to that s/he/it is a better parent than the rest of us by announcing that there has never been food on her/his/its floor s/he/it admitted to never having any children. S/he/it is immune to logic, and will never provide the real evidence that is demanded.

The same goes for Sue (who posts the fact free insults with various names like “The Hypocrisy!! It Burns!!!”), who does have children. Though her children do not have autism but diabetes and celiac (“celiacdaughter” is a hint), she has been posting the same kind of nonsense for years.

The same for for Dr. Jay.

By the way, “Dr.” EJB you should really start documenting all those kids in your practice that come down with autism after vaccination. Actually use your very well written notes on their development and put it into a paper, even if it takes you five years to come up with a sufficient amount of data. Something along the line of An office-based prospective study of deafness in mumps.

Now remember: The science has been done, the link between vaccines and autism does not exist. It is a dead link… “It’s not pinin’! ‘It’s passed on! This link is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! If you hadn’t nailed it to the perch it’d be pushing up the daisies! Its metabolic processes are now ‘istory! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!! THIS IS AN EX-LINK!! ” (hat-tip to Monty Python and the dead parrot sketch)

Here is some reading for “givemethetruth” (perhaps “Sid Offit” and the two pediatricians could produce equivalent data), take note the author of the first paper had written a paper about “autistic mice”:
Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study.
Hornig M et al.
PLoS ONE 2008; 3(9): e3140 doi:10.1371/journal.pone.0003140
*Subjects: 25 children with autism and GI disturbances and 13 children with GI disturbances alone (controls)

Measles Vaccination and Antibody Response in Autism Spectrum Disorders.
Baird G et al.
Arch Dis Child 2008; 93(10):832-7.
Subjects: 98 vaccinated children aged 10-12 years in the UK with autism spectrum disorder (ASD); two control groups of similar age: 52 children with special educational needs but no ASD and 90 children in the typically developing group

MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan.
Uchiyama T et al.
J Autism Dev Disord 2007; 37(2):210-7
*Subjects: 904 children with autism spectrum disorder
(Note: MMR was used in Japan only between 1989 and 1993.)

No Evidence of Persisting Measles Virus in Peripheral Blood Mononuclear Cells from Children with Autism Spectrum Disorder.
D’Souza Y et al.
Pediatrics 2006; 118(4):1664-75
*Subjects: 54 children with autism spectrum disorder and 34 developmentally normal children

Immunizations and Autism: A Review of the Literature.
Doja A, Roberts W.
Can J Neurol Sci. 2006; 33(4):341-6
*Literature review

Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links with Immunizations.
Fombonne E et al.
Pediatrics. 2006;118(1):e139-50
*Subjects: 27,749 children born from 1987 to 1998 attending 55 schools

Relationship between MMR Vaccine and Autism.
Klein KC, Diehl EB.
Ann Pharmacother. 2004; 38(7-8):1297-300
*Literature review of 10 studies

Immunization Safety Review: Vaccines and Autism. Institute of Medicine.
The National Academies Press: 2004
(w w w . nap.edu/books/030909237X/html) *Literature review

MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study.
Smeeth L et al.
Lancet 2004; 364(9438):963-9
*Subjects: 1294 cases and 4469 controls

Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta.
DeStefano F et al. Pediatrics 2004; 113(2): 259-66
*Subjects: 624 children with autism and 1,824 controls

Prevalence of Autism and Parentally Reported Triggers in a North East London Population.
Lingam R et al.
Arch Dis Child 2003; 88(8):666-70
*Subjects: 567 children with autistic spectrum disorder

Neurologic Disorders after Measles-Mumps-Rubella Vaccination.
Makela A et al.
Pediatrics 2002; 110:957-63
*Subjects: 535,544 children vaccinated between November 1982 and June 1986 in Finland

A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism.
Madsen KM et al.
N Engl J Med 2002; 347(19):1477-82
*Subjects: All 537,303 children born 1/91–12/98 in Denmark

Relation of Childhood Gastrointestinal Disorders to Autism: Nested Case Control Study Using Data from the UK General Practice Research Database.
Black C et al.
BMJ 2002; 325:419-21
*Subjects: 96 children diagnosed with autism and 449 controls

Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.
Taylor B et al.
BMJ 2002; 324(7334):393-6
*Subjects: 278 children with core autism and 195 with atypical autism

No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism.
Fombonne E et al.
Pediatrics 2001;108(4):E58
*Subjects: 262 autistic children (pre- and post-MMR samples)

Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study from the Vaccine Safety Datalink Project.
Davis RL et al.
Arch Pediatr Adolesc Med 2001;155(3):354-9
*Subjects: 155 persons with IBD with up to 5 controls each

Time Trends in Autism and in MMR Immunization Coverage in California.
Dales L et al.
JAMA 2001; 285(9):1183-5
*Subjects: Children born in 1980-94 who were enrolled in California kindergartens (survey samples of 600–1,900 children each year)

Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis.
Kaye JA et al.
BMJ 2001; 322:460-63
*Subjects: 305 children with autism

Further Evidence of the Absence of Measles Virus Genome Sequence in Full Thickness Intestinal Specimens from Patients with Crohn’s Disease.
Afzal MA, et al.
J Med Virol 2000; 62(3):377-82
*Subjects: Specimens from patients with Crohn’s disease

Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.
Taylor B et al.
Lancet 1999;353 (9169):2026-9
*Subjects: 498 children with autism

Absence of Detectable Measles Virus Genome Sequence in Inflammatory Bowel Disease Tissues and Peripheral Blood Lymphocytes.
Afzal MA et al.
J Med Virol 1998; 55(3):243-9
*Subjects: 93 colonoscopic biopsies and 31 peripheral blood lymphocyte preparations

No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-year Prospective Study.
Peltola H et al.
Lancet 1998; 351:1327-8
*Subjects: 3,000,000 doses of MMR vaccine

Exposure to Measles in Utero and Crohn’s Disease: Danish Register Study.
Nielsen LL et al.
BMJ 1998; 316(7126):196-7
*Subjects: 472 women with measles

Immunocytochemical Evidence of Listeria, Escherichia coli, and Streptococcus Antigens in Crohn’s Disease.
Liu Y et al.
Gastroenterology 1995; 108(5):1396-1404
*Subjects: Intestines and mesenteric lymph node specimens from 21 persons from families with a high frequency of Crohn’s disease

Neuropsychological Performance 10 years after Immunization in Infancy with Thimerosal-Containing Vaccines
Tozzi AE, Bisiacchi P, Tarantino V, De Mei B, D’Elia L, Chiarotti F, Salmaso S.
Pediatrics, February 2009, Vol. 123(2):475-82

Mercury Levels in Newborns and Infants after Receipt of Thimerosal-Containing Vaccines
Pichichero ME, Gentile A, Giglio N, et al
Pediatrics, February 2008; 121(2) e208-214

Mercury, Vaccines, And Autism: One Controversy, Three Histories
Baker JP
American Journal of Public Health, February 2008;98(2): 244-253

Continuing Increases in Autism Reported to California’s Developmental Services System: Mercury in Retrograde
Schechter R, Grether JK
Arch Gen Psychiatry, January 2008; 65(1):19-24

Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years
Thompson WW, Price C, Goodson B, et al; Vaccine Safety Datalink Team
N Engl J Med, Sep 27, 2007; 357(13):1281-1292

Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links with Immunizations
Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D
Pediatrics, July 2006, Vol. 118(1):e139-e150

Vaccine Adverse Event Reporting System Reporting Source: A Possible Source of Bias in Longitudinal Studies
Goodman MJ, Nordin J
Pediatrics, February 2006, Vol. 117(2):387-390

Thimerosal in Vaccines: Balancing the Risk of Adverse Effects with the Risk of Vaccine-Preventable Disease
Bigham M, Copes R
Drug Safety, 2005, Vol. 28(2):89-101

Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal
Burbacher TM, Shen DD, Liberato N, Grant KS, Cernichiari E, Clarkson T
National Institute of Environmental Health Sciences, April 21, 2005

Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association
Heron J, Golding J, ALSPAC Study Team
Pediatrics, September 2004, Vol. 114(3):577-583

Thimerosal Exposure in Infants and Developmental Disorders: A Retrospective Cohort Study in the United Kingdom Does Not Support a Causal Association
Andrews N, Miller E, Grant A, Stowe J, Osborne V, Taylor B
Pediatrics, September 2004, Vol. 114(3):584-591

Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data
Parker SK, Schwartz B, Todd J, Pickering LK
Pediatrics, September 2004, Vol. 114(3):793-804

The Evidence for the Safety of Thimerosal in Newborn and Infant Vaccines
Clements CJ
Vaccine, May 7, 2004, Vol. 22(15-16):1854-1861

Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization Databases
Verstraeten T, Davis RL, DeStefano F, et al
Pediatrics, November 2003, Vol. 112(5):1039-1048

The Toxicology of Mercury–Current Exposures and Clinical Manifestations
Clarkson TW, Magos L, Myers GJ
New England Journal of Medicine, October 30, 2003, Vol. 349(18):1731-7

Association Between Thimerosal-Containing Vaccine and Autism
Hviid A, Stellfeld M, Wohlfahrt J, Melbye M
Journal of the American Medical Association, October 1, 2003, Vol. 290(13):1763-6

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data
Madsen KM, Lauritsen MB, Pedersen CB, et al
Pediatrics, Sept. 2003, Vol. 112(3 Pt 1):604-606

Autism and Thimerosal-Containing Vaccines. Lack of Consistent Evidence for an Association
Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D
American Journal of Preventive Medicine, August 2003, Vol. 25(2):101-6

Impact of the Thimerosal Controversy on Hepatitis B Vaccine Coverage of Infants Born to Women of Unknown Hepatitis B Surface Antigen Status in Michigan
Biroscak BJ, Fiore AE, Fasano N, Fineis P, Collins MP, Stoltman G
Pediatrics, June 2003, Vol. 111(6):e645-9

Vaccine Safety Policy Analysis in Three European Countries: The Case of Thimerosal
Freed GL, Andreae MC, Cowan AE, et al
Health Policy, December 2002, Vol. 62(3):291-307

Mercury Concentrations and Metabolism in Infants Receiving Vaccines Containing Thimerosal: A Descriptive Study
Pichichero ME, Cernichiari E, Lopreiato J, Treanor J
The Lancet, November 30, 2002, Vol. 360:1737-1741

An Assessment of Thimerosal Use in Childhood Vaccines
Ball LK, Ball R, Pratt RD
Pediatrics, May 2001, Vol. 107(5):1147-1154

Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001
Zhou F, Santoli J, Messonnier ML, Yusuf HR, Shefer A, Chu SY, Rodewald L, Harpaz R.
Arch Pediatr Adolesc Med. 2005;159:1136-1144.

An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.
Zhou F, Reef S, Massoudi M, Papania MJ, Yusuf HR, Bardenheier B, Zimmerman L, McCauley MM.
J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.

Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis.
Zhou F, Bisgard KM, Yusuf HR, Deuson RR, Bath SK, Murphy TV.
Pediatrics. 2002 Oct;110(4):653-61.

Impact of specific medical interventions on reducing the prevalence of mental retardation.
Brosco JP, Mattingly M, Sanders LM.
Arch Pediatr Adolesc Med. 2006;160:302-309.

Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.
Ray P, Hayward J, Michelson D, Lewis E, Schwalbe J, Black S, Shinefield H, Marcy M, Huff K, Ward J, Mullooly J, Chen R, Davis R; Vaccine Safety Datalink Group.
Pediatr Infect Dis J. 2006 Sep;25(9):768-73.

Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team.
Pediatrics. 2001 Dec;108(6):E112.

“Many parents are afraid of fevers (one friend of mine – who actually is, like me, a nurse – verbalized she was afraid of her child’s brain melting…and yes, she was serious).”

Your anecdote about your friend illustrates just how pervasive “fever phobia” really is, even among us nurses who should know better!

Fevers can indeed be very scary, especially if your child is prone to febrile seizures. My younger son had his first one only a couple of weeks ago, and even though it lasted just a few seconds, and I knew it would cause him no lasting harm, it was still scary as hell to watch, nonetheless. An hour later, though, the fever was completely gone and he was up and playing like nothing had happened.

Most of the time, I think parents use antipyretics to make themselves feel better; to feel like they are doing something, when in reality, it would be better to do more nothing.

Thank you, Scientizzle.

Trrll, formaldehyde was never in vaccines in an amount proven to hurt children and I was uninformed whenever I said it was.

Todd, you’ve been here a while and so have I. I have no proof of the connection between vaccines and autism and I’ll say that as often and in as many ways as you need. I rely my experience and observations. Create any hierarchy of science that appeals to you but in mine, this counts for a lot.

Dr. Wakefield’s study was not sufficient to prove anything either. I think he could be criticized but not vilified for conflict of interest.

Jay

@Jay Gordon

I have no proof of the connection between vaccines and autism and I’ll say that as often and in as many ways as you need. I rely my experience and observations. Create any hierarchy of science that appeals to you but in mine, this counts for a lot.

I haven’t been a regular reader for all that long, actually. I was interested in whether you actually had actual evidence that suggested to you that vaccines cause autism. I take this statement to mean that, despite lacking any actual evidence, you choose to believe that vaccines might still play a role.

So, a followup question: what efforts have you made to determine whether or not you are correct in your anecdote-based hunch?

As to Wakefield, the conflict of interest issue, I feel, is one of the least of the problems with his study and his conduct.

Trrll, formaldehyde was never in vaccines in an amount proven to hurt children and I was uninformed whenever I said it was.

“Uninformed” is putting it mildly. That’s like saying that somebody who thinks that babies are brought by the stork is “uninformed.”

More accurately, you were lacking very basic biochemical knowledge–knowledge that anybody who presumes to put “MD” after his name should have acquired in medical school, if not before. I knew instantly that it was bullshit, and I expect most of the people who frequent this blog knew it. How did we know? Because we knew that formaldehyde is a product of intermediary metabolism, and we knew that the volume of a vaccine injection is very small compared to the volume of the body. Basic reasoning.

I am frankly amazed that somebody who would make an error this elementary–and as the result of this error contribute to spreading fear, anxiety, and guilt to parents of autistic children–would still have the incredible hubris to pontificate about how his “compassion” and “experience” enables him to magically distinguish between a causal relationship and the mere coincidental relationship of two things that are known to independently occur at about the same time. Compassion and experience are all very fine, but they are no substitute for good sense and critical thinking.

@trrll
Offit’s vaccine saves millions? Are you serious?

@Chris
Thanks for all the MMR and mercury studies. The economic analysis studies were also quite informative – although entirely irrelevant to the discussion. To bad you couldn’t find anything on vaccines in general.

@Scientizzle

[This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortaliy

What are you talking about? Vaccination rates are at all time highs.

@Sid Offit

[This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortaliy

What are you talking about? Vaccination rates are at all time highs.

Antivax fear-mongering leads to pockets of reduced vaccine uptake. For example, in the U.K., after Wakefield published his study and gave press releases suggesting a link between MMR and autism, vaccination rates for the MMR plummeted, leading to a surge of measles cases. A disease that was once on the decline, there, is, sadly, now endemic once again.

Similarly, California has seen pockets of measles outbreaks due to decreases in vaccination rates. In the Midwest, there were a couple small outbreaks of HiB, resulting in at least one death. In Australia, there have been outbreaks of pertussis, again due to antivax fear-mongering.

Those are the types of things to which Scientizzle was referring.

Sid Troll:

To bad you couldn’t find anything on vaccines in general.

That is because you refuse to read the epidemiological studies, and you are always moving the goalposts. Just like Sallie Redwood who participated in the design of a study, but decided to denigrate it because it did not come out with the results she wanted. Like her you have blinders that prevent you from seeing what you do not want to see.

You are intellectually dishonest, and cannot engage in honest debate. Especially when you chose to ignore that vaccination rates have declined in certain populations that have resulted in outbreaks in those groups. These are usually include schools with like thinking families (like the charter school in San Diego, CA and the parochial school in Grant Co., WA).

Again, this is a dead debate. Vaccines have been studied, and the limited funds available for real research needs to move on to other areas. Go find another hobby.

A correction for Chris’ comment above (#225) – it was Sallie Bernard who bitterly denounced the NIH study of thimerosal and neurological disorders after having been a part of the group designing the study.

As Chris states, Ms. Bernard waited until the results were in (and didn’t support her beliefs) to criticise the study design. To be credible, she should have protested the study design before she knew the results.

Like Ms. Bernard, “Sid Offit” has fixed beliefs about the subject of medicine in general and vaccines in specific. As a result, “he” cannot accept data that is contrary to “his” immutable dogma.

They should both be more pitied than scorned, although it is hard not to scorn them. The “arrogance of ignorance” is strong with them both.

Prometheus

Chris: “Dr.” EJB you should really start documenting all those kids in your practice that come down with autism after vaccination. Actually use your very well written notes on their development and put it…”

I thought I had no other comments, but your interpretations are off. I never said I had ‘many many’ cases (that was Dr Jay’s misquote). To the contrary, I said we had less than the average total cases and very few immediately after vaccination. I was referring to the cases over a 21yr span that showed profound regression and which did not, in my medical opinion (experience answered below), warrant the explanation of ‘just a mere coincidence’ to the parents. There are the few bodies that don’t follow the list of side effects and research, and they react to all kinds of medications for whatever underlying reason they may have. I was reviewing through each year, case after case, but did not say ‘many’. Actually, I went out of my way to say that compared to the national average, we have seen less autism cases and have not seen the rise in the last 10-20yrs even with strong recommendations for vaccination. The risk for a preventable disease in that same sensitive individual is higher, so vaccine is definitely recommended. Also, the ‘notes’ to which you refer, were just my constantly updated information about research and safety of vaccines that I share with parents (2 links which I recently received from trll and Todd). Please get your quotes correct.

hi Todd: “Again, I’ll ask: have you been trained specifically in the diagnosis of autism?”

Sorry you had to ask twice…I seldom have my husband’s laptop(problems with mine), and I knew my answer would be long. I didn’t think you would be content with a simple “yes”. I specialized in Developmental Pediatrics, trained in neurodevelopmental disabilites, continue to attend and teach inservices and workshops to teachers, military healthcare providers at the base nearby, early intervention, and parents. I am part of a team for final diagnosis in all children screened with autism which consists of but not limited to; a second devel pediatrician, neurologist, clinical psychologist, speech eval, and structured observation. We are able to rule out several other conditions and disorders and not just diagnose all neurodevel disabilities as autism. The decrease in false + is probably why we have less than the avg cases, and we haven’t seen a dramatic rise in new cases because we have been diagnosing the lower spectrum cases for years. In addition, I have probably learned more from my life experience with child behavior and development than from my medical training. By the time I was 10, I was helping raise 8 younger siblings. 4 of which were adopted and had varying levels of developmental delays. Later, 2 were diagnosed with autism, 1 had hydrocephalus and 1 was diagnosed with hemi-paresis due to stroke.(fyi to the anti-vax, they were not vaccinated before adoption and they still had delays due to autism even 28 yrs ago, with or without the name). I was my mom’s sole help for playmate, teacher, daily therapist (followed orders) sport coordinator, feeder, bather, and observer for all my siblings. I worked at a preschool/daycare for typical and devel delayed children in high school and undergrad. I continued working and volunteering in children centers through my residency. Finally, as I mentioned before, I have 7 of my own children plus 2 grandchildren. I have a well trained eye for typical and non-typical developing children that goes way beyond what you just learn in school and ped practice. I am sorry I did not give more history on the singing 2yo whose mother is the high school drama teacher and has siblings that are performing singers… and the car playing boy who always used to kiss the receptionist after she gave him paper and crayons to draw a picture for our waiting room. I used them as an example because they specifically did not have any ‘red flags’. As I mentioned, even the interviews, observations, evaluations and reviewed videos did not invoke suspicion from our panel. However, these particular children did have a cousin and uncle, respectively, with autism. The relatives are very low on the spectrum compared to these children, and they are both over 35. Currently, they both have typical siblings and one autistic sibling as well as relatives further removed diagnosed with autism. I have had discussions with their providers since they moved out of state to share information of ongoing studies that are trying to isolate genes and the different influences on gene expression.

@trrll

‘ “Uninformed” is putting it mildly. That’s like saying that somebody who thinks that babies are brought by the stork is “uninformed.” ‘

Formaldehyde is present in vaccines. As you well know, it’s part of the manufacturing process. The trace amounts found in an individual vaccine are probably harmless.

I have a scientific question for you, a propos your response to my innocuous post: Why do you feel the need to respond like someone completely lacking in civility? Please take your time in formulating an answer. My guesses will come later.

Jay

Prometheus:

A correction for Chris’ comment above (#225) – it was Sallie Bernard who bitterly denounced the NIH study of thimerosal and neurological disorders after having been a part of the group designing the study

Oops, thanks for the correction. I am always getting them mixed up.

Dr. EJB, I also apologize for misunderstanding how many chldren seemed to change after vaccination. But you should understand that the plural of anecdote is anecdotes, not data. It read like it was enough to catch your attention, because you said:

Even if I only counted the children who were developing normally until 1 to 7 days after vaccination, there are too many cases to simply call it a coincidence.

…. but if the numbers are very small and the children were actually susceptible to any medication, then there really is no real correlation to claim that vaccines are associated with the development of autism (you can see that there is data in more than one country, and there was no real association between vaccines and autism: Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of
Computerized Health Maintenance Organization Databases
… and one can be certain these children also received the MMR, but there are also studies for MMR that have been done in the UK, Denmark, Japan and Finland).

I have a scientific question for you, a propos your response to my innocuous post: Why do you feel the need to respond like someone completely lacking in civility? Please take your time in formulating an answer. My guesses will come later.

Oh, now we have the “ooh, you’re mean” defense. Sorry that I don’t have a great deal of sympathy or respect for somebody whose ignorance of elementary biochemistry has led him to participate in the “toxin” fear-mongoring that not only puts children at risk of death and disability from vaccine-preventable diseases, but also encourages parents of autistic children to feel guilty for having vaccinated their children.

I don’t think there is really any excuse for a physician to be this ignorant of basic biology, but in any case, it would have taken a reasonable person no more than a few minutes of internet research to determine that it is absurd to worry about formaldehyde in vaccines. That you would presume to speak with the authority of a physician (as you sign your posts with MD) without bothering to do this basic due diligence strikes me as gross irresponsibility, for which “I was uninformed” is a wholly inadequate apology.

EJB “yes, as I mentioned, I have seen cases of regression that did not occur around the time of vaccination, but not one of those cases regressed that drastically within hours. Yes, that is the usual age, but that is not the usua”

How convenient for your conscience that only the children with drastic autistic regression close to the time of vaccination bothers you. Since you obviously recommend vaccination and most of your patients are vaccinated, then I assume that most of your autistic patients have in actuality been vaccinated since birth. I guess the fact that they have received several vaccines before their diagnosis of autism doesnt matter to you as long as the neuro-inflammation doesnt show right away?? As you said, some specific cases are sensitive to medications and vaccines. Maybe we are ALL sensitive, but in some it shows right away, some later, and some never. It doesnt mean the vaccine damage isnt there just because it wasnt seen. I hope you sleep well at night.

Justice, EJB later said “Actually, I went out of my way to say that compared to the national average, we have seen less autism cases and have not seen the rise in the last 10-20yrs even with strong recommendations for vaccination.”

233 234 My point was that since almost every patient of Dr EJB’s is vaccinated, and they have seen cases of autism, maybe the vaccines had something to do with ALL of them. Why only be concerned with the ones that react within minutes? The vaccines could have triggered the autism in all of them whether it took longer to show or not. The studies you continue to link to, cannot isolate who is sensitive or not. NONE of your studies check for when children were given all the vaccines, while also being exposed to possible environmental neuro triggers, and all the possible prenatal triggers etc all in those first years of life. Apparently, several children on this earth might have genetic tendencies for autism, so we need to find all possible triggers. That is why even children that have not been vaccinated can still have autism, because it is the total amount of triggers which can influence the genes for autism. Vaccines are just part of the big picture for some. But, given that they do cause neuro inflammation, they are definitely a trigger in those cases of autism.

Justice, you still make no sense. Most of the large epidemiological studies included children who were fully vaccinated according to the schedule of that time.

Right, so you were just talking out of your arse then. Good to know, thought it was me failing to understand you for a bit there.

You are a bunch of idiots living in complete denial. You will still be in denial the day you die, and they will autopsy your brain and find the measles virus from your vaccine 30-40yrs ago, and all the aluminum plaques that caused your alzheimers, and all the evidence of a life of inlammation. Maybe that is why you are so obviously stupid now. You probably have stupid kids too. That is also genetic. Nothing but a bunch of stupid people passing on their damaged dna from a lifetime of exposure. May all you liars rot in hell.

If any of what Justice said was true, they’d be able to provide undeniable real world evidence of people that it has happened to now.

Nothing speaks louder than the absence of evidence where evidence should be abundant.

Have a nice life raging at everyone that disagrees with you.

Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that. You can disagree on your demented way to the grave. Actually, maybe this memory will come back to you as you go. bye bye

Justine:

Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that.

Evidence works better than argument by assertion. Evidence also works better than a string of insults.

“Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that”

You’ll have no problem referencing them then.

Toodle off and don’t come back until you have a peer-reviewed journal article or two that expressly link public vaccination caused aluminium plaques to alzheimers.

Not, high-alu exposure linked to a minority of alzheimers.

Actual vaccination induced aluminium plaques causing alzheimers.

My guess is we won’t be seeing you again.

No major loss there. Enjoy hating everyone that disagrees with you. I’m sure you’ve made lots of friends doing that.

Those medical records are not available to the public. I see the damage first hand at my job. So you go ahead and make yourself feel better by continuing to deny. Those little links to research have nothing to do with you and they wont help you. The only crazy thing is how some people continue to live in denial. No matter how many arguments you come up with, it wont save you. I never disagreed with anybody, I told you what I see and know first hand, you have the problem with it.

The measles vaccine has been available since the early 1960s. The mumps and rubella came out in the late 1960s. All three were combined in a vaccine which was approved for use in 1971. If you have evidence that the MMR causes more problems than those three diseases, please present your evidence (secret knowledge not allowed, limit yourself to stuff on PubMed, but not Medical Hypotheses).

Nobody asked for the medical records.

Researchers can ask to look at anonymised medical records and then produce work based upon thier observations. This can be checked by other researchers at other centres, who can look at similar medical records locally.

All of this can be done without releasing any medical record to the public, can be done respecting confidentiality to the deceased and family, and can be done without breaching ethics.

So, your assertion that you ‘see it first hand’ is pretty much worthless unless you can provide some substance to it.

You were told not to come back until you had done so. Deny your complete failure as much as you want, you have still failed to provide any reason to believe that you hold the position you allude to, much less that you see what you claim.

Pony it up and stop pretending that your say-so matters.

Exactly what part of show your evidence is hard to understand?

I see the damage first hand at my job.

You don’t even say what your job is, why would you expect us to take you seriously when all you do is make vague references to the source of your ‘knowlege’ without any detail or supporting evidence?

@jaygordon
Don’t worry about anything TTRL says, the guy is a deranged loser. He’s just a nut that can’t think and so are his pals. We debated HIV and I Kept asking him to describe the papers he read that proved HIV was a fatal disease that Justified AZT’s release in 1987, all he could do is spam a website, something that would him laughed out of a classroom or courtroom.

Now the moron Ttrl is complaining about how anecdotal correlations were parents and doctors swear their kids got autistic right after the shots are irrelevent, but uncontrolled half assed correlations where the cause and effect are seperated by 10-30 years (HIV and Hepatitis c) prove causality. Guy is a whackjob.

Is Jay Gordon an AIDS denier as well? Or is it a variant of crank magnetism (one holds a crank idea, and other cranks are attracted to you)?

Diane, Jay Gordon is one of the doctors Christine Maggiore took her daughter to prior to the child death from HIV/AIDS.

(ignore the troll that posted before Diane)

True, but in all fairness to Dr. Jay, he’s expressed great remorse about missing the boat on that one and not correctly assessing the seriousness of the condition of that child. He has also said since then that he accepts that HIV causes AIDS.

@245-247 Pub Med has nothing to do with my job. Actually, the limited skewed research listed at pub med proves nothing that is going to help you either. Let’s just say I handle all the paper work of all autopsies of every dead person at 7 different facilities. It isnt some stupid study, it is the real world. In the real world, there are alot of ‘contaminants’ affecting your brain right now. I am stating what is there in the records, black and white, you are arguing with yourself. Sleep well.

Pub Med has nothing to do with my job. Actually, the limited skewed research listed at pub med proves nothing that is going to help you either. Let’s just say I handle all the paper work of all autopsies of every dead person at 7 different facilities. It isnt some stupid study, it is the real world. In the real world, there are alot of ‘contaminants’ affecting your brain right now. I am stating what is there in the records, black and white, you are arguing with yourself. Sleep well.

Let’s play count the fallacies:

1) Argument from authority even though you don’t even claim to be a pathologist.

2) Appeal to special or secret knowledge.

3) Bashing, misunderstanding, and downplaying science.

4) Fear mongering.

We know there are lots of contaminents that can affect the brain.

7 different centres all seeing the same thing? Something so obvious even a clerk has spotted it? And no study in sight? Not even on the numerous alternative to pub-med?

That story is so fishy it’s got scales on.

Dedj, maybe she is telling at least a form of the truth. Since the number of autopsies actually performed these days is quite low (I believe the last statistic I read on it was that only about 10% of all deaths have autopsies performed), maybe she can handle “all autopsies of every dead person for 7 facilities.”

(Of course, being a smart ass I would say that ONLY dead people get autopsies.)

Autopsies are not required on most deaths, even in a hospital. Legally, autopsies are usually required on sudden deaths for persons not under a physician’s care. They are usually done on homicides, etc. They will be done if the family requests one, or the physician requests one and the family approves.

But 7 facilities? The only way I can see that being true is if she works for a medical transcriptionist service that has contracts with 7 facilities. Most hospitals have the services in-house. However, I suppose 7 rural hospitals might band together and hire a transcriptionist service for dictations. And, given the average number of autopsies a small facility does in a month, it is manageable for one person. (I’ve worked in several small hospitals, and a friend of mine was a pathologist. On average, he would do 1-3 autopsies a month. Other work made up the bulk of his time)

Oh, and don’t you know that Big Pharma is preventing the studies that the centers are seeing? They are EVERYWHERE!!

Dawn, that actually makes sense. Being a medical transcriptionist would explain why she does not know about the PubMed index.

@Dawn, an interesting possibility but my first thought was that justice is in fact a fax machine…

“Here, at Brian Deer’s website, is the issued patent document for Dr Wakefield’s vaccine.

http://briandeer.com/mmr/1998-vaccine-patent.pdf

You may notice that the patent BEGINS:

“The present invention relates to a new vaccine/immunisation for the prevention and/or prophylaxis against measles virus infection…” ”

Nooooo! Dr Roo say it ain’t so….

Thought I would follow up on this issue after nearly 18 months. I have a few comments regarding some posts above.

First of all Orac,

You point out:
“Perhaps the most disturbing part of the show occurs near the end, when NBC went into Thoughtful House and followed parents of an autistic child through an endoscopy by Dr. Arthur Krigsman. Tim Kasemodel is interviewed about his son Thomas,…”

An endoscopy DISTURBS you? Are you a doctor or a what? I did think that the producer went overboard showing Thomas in distress getting his anethsesia.. we actually wanted Dateline to show what happened before that, when his gut pain was unbearable… that is what America needed to see.

And this on comment by Pablo:
“I don’t know if you caught Mrs. Kasemodal’s comment about why they brought their son to the place. “We think he has a hidden intestinal problem.”
The beauty is that, now, after nothing was found, they can still claim it is a HIDDEN problem. Oh, he has an intestinal problem, and we’ll find it, darn it! A win for Wakefield!”

You are one sick puppy. Do you really believe my son did not have any G.I. issues? We did a pill cam and it did indeed show exactly what Dr. Wakefield described 15 damn years ago. You are so blinded by your hatred for Dr Wakefield you forget about the children like mine who suffer every day – you must be one heartless …….

And this by Just a mom:
“The story about the family who traveled for those GI scopes, as if Wakefield is the oooooooonly doctor in the whole world who can locate this hidden gut problem,…”

As matter of fact I said “we thought we could get help in Minnesota, burt we were wrong”.

The pediatrician we worked with was with the University of Minnesota and she knew by his medical history that we would find bowel disease in our son. She also knew that her career with the University was threatened if she referred our son to a G. I. doc in Minnesota for what Wakefield described. She has since left the University position and is with a private clinic.

Yes, we still go out of state for our G.I. services. We simply do not trust anyone else.

BTW, our son’s bowel issues are not 100% resolved but he is nearly pain free after years on suffering thanks to Dr. Krigsman. You don’t cure a lifetime of bowel disease overnight, especially when we spent the last 15 years pretending it does not exist.

Not that any of you or even Orac cares.

Tim Kasemodel

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