A sad, premature death cynically exploited by antivaccinationists

I must admit, I’ve been enjoying my vacation thus far and have hardly paid attention to the blog, other than a couple of quick posts. For me, this is quite amazing. Still, every so often there pops up a story that I can’t resist commenting on, particularly given that I’m just sitting around watching the Olympics, and I’m deadly tired of beach volleyball. (As an aside, notice how it’s always women’s beach volleyball that NBC shows, not men’s, no doubt because the powers that be think that toned young women in bikinis playing volleyball translate into big ratings. Unfortunately, they seem to be right.)

While I was sitting there thinking about changing the channel out of boredom, I happened to check out the comments on my post from a couple of days ago, when I noticed an off-topic discussion beginning (which, I guess, sometimes happens when my blogging activity falls off) that caught my attention. It’s a story out of New Zealand about an 18-year-old woman named Jasmine Renata, who tragically died nearly three years ago of unclear causes, although what happened sounds consistent with the sort of idiopathic heart conditions that sometimes (and, fortunately, very uncommonly) cut short the lives of young people in their teens and early 20s. Now, Jasmine Renata might never have been known outside of her grieving family and friends, except for one thing. Her mother is convinced she knows the reason why Jasmine died. In brief, she has an explanation for her daughter’s death that is simple, emotionally resonant, and almost certainly wrong, and that explanation is that Gardasil was the cause of her daughter’s untimely death:

The mother of a teenager found dead in her bed has told an inquest that her daughter’s physical and mental health deteriorated sharply when she was given the Gardasil cervical cancer vaccination.

Jasmine Renata, 18, died in September 2009 in a sleepout at her home in Upper Hutt, north of Wellington.

She had received the last of three injections of Gardasil six months earlier.

Once again, whenever I encounter a story like this, I am saddened, first of all because the life of someone so young ended so unexpectedly. It’s quite understandable that a parent, faced with such a tragic loss and consumed with shock and grief, would look for an explanation and grasp at any seemingly plausible explanation she can find. In this case, Rhonda Renata has latched on to Gardasil, even though the timing doesn’t even argue particularly persuasively for causation by Gardasil. In other words, while humans frequently confuse correlation with causation, in this case there doesn’t even appear, on the surface at least, much evidence of correlation. Six months after the last booster shot of Gardasil is a long time. Now, nearly three years after her death, there is a coroner’s inquest into Jasmine’s death, and two familiar figures have entered the picture. More on that later.

By way of background, various reports suggest that Jasmine had suffered symptoms that could indicate that she had a cardiac anomaly. Sudden death among young people is rare, but when it happens, it’s often due to cardiac causes, most commonly hypertrophic cardiomyopathy, coronary artery abnormalities, or the long QT syndrome (LQTS), the latter of which can cause a rapid, chaotic heartbeat and sometimes ventricular fibrillation and cardiac arrest. Since her daughter’s death, Ms. Renata has steadfastly refused to have herself, her husband, or any of her family tested for gene mutations associated with sudden cardiac or tested for idiopathic heart disease because she knows of no history of heart disease in her family if you don’t count the death of her daughter. While on the surface this sounds like a reasonable argument, it is not a good reason to conclude that Jasmine couldn’t possibly have had an idiopathic heart condition. For example, some of the gene mutations that are associated with sudden cardiac death increase the risk of such an outcome; they don’t guarantee it, and carriers might not be symptomatic or might be so mildly symptomatic that they are never worked up for a cardiac condition. More likely, Ms. Renata doesn’t want to look for evidence that might disconfirm her now fixed belief that Gardasil killed her daughter, or, as she wrote two years ago:

Even though we have not yet received a final autopsy report and the pathologist has only recently begun doing tests based on my belief that the vaccine sent Jasmine’s health on a downhill spiral to death. During the autopsy the pathologist did not find any health problem that could have contributed to Jasmine’s death and I know in my every being that the vaccine was the cause.

In the same piece, Rhonda Renata describes a history of vague symptoms suffered by Jasmine:

During a routine visit, Jasmine’s doctor persuaded her to get the Gardisil vaccine because it would help keep her safe from developing cervical cancer in the future. Jasmine received her first Gardisil vaccine in September 2008. Jasmine was always concerned about her appearance and she was quite distressed that shortly after the vaccine she noticed dry skin and warts appearing on her hands. She complained that she thought she was losing more hair than usual and that her pimples were getting worse. On the 20th of October Jasmine visited the doctor to treat her warts and dry skin. Jasmine had 4 or 5 warts frozen off. The doctor also said that her immunity was compromised so he prescribed a multivitamin as well as Locoid cream for the dry skin. The Locoid cream didn’t help the dry skin.

What this means is unclear. For one thing, there appears to be no record, at least none mentioned in the press accounts that I’ve been able to find, of these complaints. Indeed, several press reports state that the nurse testified that she asked Jasmine whether she had had any problems after her Gardasil doses and whether she was feeling well. Jasmine reported no side effects. What we do know is that Ms. Renata somehow hooked up with an antivaccinationist named Hilary Butler, who blogs for the antivaccine crank organization the International Medical Council on Vaccination and blogs on her own at Beyond Conformity. Indeed, she has written several posts about Jasmine Renata, including Did Gardasil Kill Jasmine? It’s full of conspiracy mongering, insinuations that some sort of coverup was occurring. It includes a link to the autopsy report, which showed no structural abnormalities in the heart or evidence of an inflammatory process. The report does note, however, that heart tissue had been taken and submitted to the Inherited Diseases Group in Auckland so that the “decendent’s genetic structure and family can be investigated in case there is a molecular abnormality of the cardiac electrical conduction system that might result in sudden unexpected death.” It was also noted that “this process usually takes many months and requires the cooperation of family members.”

Interestingly, the pathologist also noted that Ms. Renata had contacted Dr. Christopher Shaw, who urged the use of the Morin stain to test for aluminum in Jasmine’s brain. In response to this, the pathologist noted:

The pathology laboratory is unable to offer a routine specific test for aluminum in neurones (I believe that this is very much a research tool rather than a diagnostic tool). Even if aluminum were to be found, I would not know how to interpret its presence. I was unable to see evidence of damage to, or a reactive process involving, neurones in Jasmine’s brain.

You might recall Christopher Shaw. He published a truly awful “review” of the medical and scientific literature trying to link aluminum-containing vaccine adjuvants to autism and appeared in the antivaccine movie The Greater Good arguing—you guessed it—that aluminum adjuvants cause autism. In fact, he went further than that and said in the movie that we’re all living in a “toxic” soup and that vaccines are part of that soup, all overlaid with a cartoon of green, stylized people floating in a disgusting soup of pollution, vaccines, and garbage. It turns out that Dr. Shaw was scheduled to testify at the inquest. Apparently, Dr. Shaw examined some of Jasmine’s brain tissue. Anyone want to bet that Shaw will report that he found aluminum there and that it caused massive damage to Jasmine’s neurons?

No, don’t bother. That’s about as sure a bet as I can think of, and only a sucker would bet against it. After all, Ms. Renata wouldn’t have called Shaw to testify if he hadn’t found what she wanted him to find. Given the time difference between here and New Zealand, it’s likely that by the time you see this he will have already testified, and I’m sure readers will post news accounts in the comments. Oh wait, there already is. (Yes, I added this bit of paragraph after finishing my post and doing one more Google search.) Dr. Shaw behaved as expected, claiming he found both HPV and aluminum in Jasmine’s brain, as well as unspecified abnormalities. This particular news report did not explain how Dr. Shaw found these things, and, given his track record, I’d want to know his methodology, in particular his negative controls for HPV before I’d believe him. Indeed, as I explained before, the amount of HPV DNA in Gardasil is minuscule; so it defies plausibility that the vaccine could be the source of so much HPV, if it really were there. Remember, in order to detect HPV DNA in the vaccines themselves, it took a super-sensitive PCR test (perhaps so sensitive as not to be specific). In other words, the amount of HPV DNA in Gardasil in the vaccine itself is minuscule, barely detectable only with an extremely sensitive assay. Now introduce it subcutaneously into someone’s body, thus diluting it enormously, and then wait six months? No, it’s utterly implausible to assume that the presence of HPV, if what Dr. Shaw is reporting is not a completely spurious result (which it probably is, given his track record), means that it could only have come from the vaccine.

Which brings us to the next “expert,” another member of the rogues’ gallery of antivaccine doctors and scientists, who testified before Dr. Shaw:

Dr San Hang Lee a pathologist at Milford Hospital in Connecticut gave evidence on the second day of the inquest by videolink.

He had been sent Jasmine’s post mortem blood and found her blood and spleen were positive for the human papillomavirus, or HVP.

The Gardasil vaccine is given to prevent some strains of HPV.

He said it was not the result of a nature HVP infection, most likely the DNA was bound to aluminium which was also found in Jasmine.

“The HPV gene is foreign DNA and its detection six months after injection is not normal,’’ he told the inquest.

He said the DNA may cause a reaction that could lead to lethal shock although it was not known if it caused her death but it needed further investigation.

He said it was not known if it was the cause of death but it needed further investigation.

Dr Lee said he also tested five samples of the vaccine sent from New Zealand and found HVP in each.

One wonders if the inquest board was aware that Dr. Lee was unceremoniously given the boot as director of the diagnostic laboratory at Milford Hospital in December 2010. His chairman also didn’t recommend that Dr. Lee’s medical staff privileges be renewed. Given that you can’t get medical staff privileges without the endorsement of the chair of your department or the chief of your clinical service (in a nonacademic hospital that doesn’t have chairmen, for example), that means Dr. Lee’s chair basically fired him from the hospital altogether. The last time I blogged about this (October 2011), Dr. Lee was appealing and still had medical staff privileges. I also said at the time, if I were a new chair of a department and found someone like Dr. Lee consorting with a loony antivaccine group like SaneVax, I’d can him too.

As I pointed out above, the amount of HPV DNA in Gardasil is so tiny that it requires nested PCR to detect it. For all intents and purposes, it might as well be homeopathic. Actually, that gives me an idea. Maybe it was the memory of HPV that resulted in all that HPV being detected in the autopsy specimens! But apparently that tiny amount of HPV is so powerful that it can cause “microcompetition.” Well, not really. As I explained before, the amount of HPV DNA involved is so tiny as to be inconsequential and it is not easy to get DNA into cells, much less to get it to express its proteins.

I do note, however, yet another morphing of a hypothesis. Or maybe I should call it the merging of two woos. Now it’s not just the HPV DNA or the aluminum adjuvants. Now, apparently, somehow the evil aluminum combines with the dastardly HPV DNA (as tiny amount as it is) in order to become synergistically diabolical. One wonders how this came about. Maybe Drs. Lee and Shaw met at a SaneVax meeting. Who knows? However this happened, in retrospect I suppose I should have seen it coming. Now, not surprisingly, SaneVax is all over it, citing Dr. Lee as saying, “The naked DNA in the vaccine was probably stabilized through a chemical binding between the mineral aluminum and the phosphate backbone of the double-stranded DNA.” One notes that there is not a plausible chemical mechanism by which aluminum can do this in the body in the manner that Dr. Lee claims.

In the meantime, what I see is a tragic story of a young woman cut down in the prime of her life, most likely (although not certainly) by a genetic defect in cardiac conduction that led to arrhythmias and sudden cardiac death. A grieving mother, shocked by the suddenness and randomness of the tragedy, is unable to accept the most likely explanation, particularly given the uncertainty, latches onto something she can blame. Why? Who knows? But it didn’t help that she hooked up with antivaccinationists like Hilary Butler, who immediately began flogging the Jasmine Renata case as “proof” that Gardasil kills. The end result causes harm not just to public health but to Rhonda Renata as well. She’ll never be able to let go and heal as long as she is convinced (almost certainly mistakenly) that Gardasil killed her daughter.