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The parrot is still dead, and MMR still doesn’t cause autism

So busy was I writing about America’s quack Dr. Mehmet Oz and, of course, the FDA hearing on regulating homeopathy that I didn’t take note of a story that came out the other day examining a study looking at the association between MMR vaccination and autism. More correctly, the study examines the lack of association between MMR and autism because that’s what every well-designed study that’s looked for such an association has found, a lack of association, as I’ve blogged about more times than I can remember over the last decade. Heck, there’s already been one study like this so far in 2015.

Of course, the myth that the MMR vaccine causes autism is what I like to refer to as a “zombie myth.” It’s undead. Like a herd of walkers in The Walking Dead, it just keeps relentlessly shambling along until it surrounds and devours reason and science. Or maybe a better simile is to liken this myth to slasher movie killers like Jason Voorhees in the Friday the 13th movie franchise or Michael Myers in the Halloween movies. At the end of each movie, the heroes have vanquished the killer. In many of the movies, the killer appears to have died at the end of the movie. Yet, inevitably there’s another movie and it turns out that the killer didn’t die after all. He’s still alive and slashing away. So it is with the myth that the MMR vaccine causes autism. No matter how much science is thrown at it, no matter how much it appears to be dead after each new study failing to find even a hint of a whisper of an association between MMR and autism, it always comes back.

Yet, scientifically, I prefer a different metaphor for the myth, and that’s to invoke Monty Python’s (in)famous Dead Parrot sketch, with antivaccine loons playing the role of the shopkeeper trying to deny to an unhappy customer that the parrot he had sold him was dead, telling the customer that he’s “not dead,” but rather “pinin’ for the fjords.” My response about the hypothesis that MMR causes autism goes along the lines: “It’s not pinin’! It’s passed on! This hypothesis 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 this mortal coil, run down the curtain and joined the bleedin’ choir invisible!! THIS IS AN EX-HYPOTHESIS!!”

And so it is that this study, published in JAMA as a collaboration between the Lewin Group, Optum, and the J. Drexel Autism Institute, Drexel University, entitled Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism, is yet another reason to label the MMR-autism hypothesis an “ex-hypothesis.” In fact, I rarely even bother to refer to it as a hypothesis any more because that grants too much credence to what is now a cranky conspiracy theory. (Is there any other kind?) In fact, I almost wasn’t going to write about this study for the simple reason that it’s just another in a long line of such studies that have all shown the same thing: There is no detectable association between MMR and autism. All of this leads me to wonder (and I’m not the only one) why another such study is even necessary. Certainly there doesn’t seem to be much purpose in studying the same question over and over and over again when the answer has been consistently negative. It’s reinventing the wheel, and in the process wasting resources that might otherwise be devoted to studying questions where there is genuine uncertainty about what the answer is.

Be that as it may, this study is different in that it takes into account families with an older sibling with autism or autism spectrum disorder. The rationale, given by the authors, for doing this is not unreasonable, even though they surely must have known what the result would be:

Two doses of measles-mumps-rubella (MMR) vaccine are currently recommended for children in the United States: the first at age 12 to 15 months and the second at age 4 to 6 years. Although a substantial body of research over the last 15 years has found no link between the MMR vaccine and autism spectrum disorders (ASD), parents and others continue to associate the vaccine with ASD. Parents cite vaccinations, especially MMR, as a cause of ASD6 and have deferred or refused vaccinations for their children as a result. Lower vaccination levels threaten public health by reducing both individual and herd immunity and have been associated with several recent outbreaks of measles, with most cases occurring among unvaccinated individuals.

Families with a child affected by ASD may be particularly concerned about reports linking MMR and ASD, despite the lack of evidence. Surveys of parents who have children with ASD suggest that many believe the MMR vaccine was a contributing cause. This belief, combined with knowing that younger siblings of children with ASD are already at higher genetic risk for ASD compared with the general population, might prompt these parents to avoid vaccinating their younger children. In a recent survey of 486 parents of children with ASD, nearly 20% had declined or delayed MMR immunization in the younger siblings of these children. Furthermore, a Canadian study of 98 younger siblings of children with ASD found that younger siblings were less likely to be fully MMR immunized when compared with their older siblings with ASD. However, there were no statistically significant differences in rates of ASD diagnosis between immunized and nonimmunized children. To our knowledge, this very small study is alone in examining MMR immunization and ASD outcomes among the younger siblings of children with ASD.

Thus, we set out to report on ASD occurrence by MMR vaccine status in a large sample of US children having older siblings with ASD and to compare findings with those among children who have older siblings without ASD.

The study itself is a retrospective cohort study carried out using an administrative claims database, the Optum Research Database, which includes more than 34 million individuals per year and contains both commercially insured individuals and Medicare managed care enrollees. The database contains proprietary deidentified health claims data from a geographically diverse US population whose age and sex distribution is similar to that reported by the US Census Bureau. The previous study I discussed was a case control study, in which individuals with the condition under study (autism) were compared with controls who did not have the condition and risk factors associated with the condition assessed. A cohort study, on the other hand, looks at groups exposed to a putative risk factor and those not. In this case, the risk factor under study was the MMR vaccine. Participants included children continuously enrolled during the period of 2001 to 2012 in the health plan from birth to at least 5 years of age who also had an older sibling continuously enrolled for at least six months between 1997 and 2012. The children in the study were stratified according to how many doses of MMR had been received (0, 1, or 2) between birth and five years of age. There ended up being over 95,727 children in the study group.

So what were the findings? Surprise! Surprise! There was no association detected between MMR and autism:

Of 95,727 children with older siblings, 994 (1.04%) were diagnosed with ASD and 1929 (2.01%) had an older sibling with ASD. Of those with older siblings with ASD, 134 (6.9%) had ASD, vs 860 (0.9%) children with unaffected siblings (P <  .001). MMR vaccination rates (≥1 dose) were 84% (n = 78 564) at age 2 years and 92% (n = 86 063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18; P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55).

Astute readers will note that most of the relative risks are below 1.0, which is actually in the protective range. They are not statistically significant, of course, but one of them, for children with an older sibling with an ASD who received two doses of MMR, the effect almost reaches statistical significance. Of course, no one is saying that the MMR vaccine is protective against autism/ASD, but rather that it is not associated with the condition. So what might explain these low adjusted RRs:

Although there were no statistically significant RR estimates indicating increased ASD risk at any age in either group of children (those whose older siblings had or did not have ASD), the statistically significant interactions in the final Cox model suggest differences in RR by both age and older sibling ASD status. The pattern in RRs across these groups was such that lower RR estimates (commonly extending into the protective range, ie, below 1.0) were observed at younger vs older ages and in children with older siblings with vs without ASD. Although protective estimates tended not to reach statistical significance, this pattern is worth further consideration. It is possible, for example, that this pattern is driven by selective parental decision making around MMR immunization, ie, parents who notice social or communication delays in their children decide to forestall vaccination. Because as a group children with recognized delays are likely to be at higher risk of ASD, such selectivity could result in a tendency for some higher-risk children to be unexposed. To be consistent with observed data, this would need to happen more often at younger ages. This seems feasible because by the time the child is older, developmental concerns are more likely to have been confirmed or ruled out and parents may then be less worried about a new exposure, such as a vaccination, influencing a child’s developmental trajectory. Estimates at older ages would thus be less susceptible to bias related to selective parental decision making, which also aligns with the pattern observed here. This explanation would also suggest that the estimate for the 1-dose RR estimate at age 5 years (1.10; 95% CI, 0.76-1.54) is least vulnerable to this bias because age 5 is several years removed from the time parents are typically deciding about the first MMR dose or weighing the importance of early developmental concerns.

In other words, the myth that MMR causes autism likely influenced these results to give the appearance of a protective effect of MMR against autism in some of these groups. We can’t conclude from this study that MMR is protective against autism, but we can conclude that there is no association suggesting that MMR could cause or contribute to autism. In other words, this study provides no support for a common antivaccine claim that, well, yes, MMR doesn’t cause autism in most kids, just in “high risk” and “genetically susceptible” kids, such as ones who have an older sibling with an ASD diagnosis. In other words, the parrot is still dead.

So why do we keep studying this question of whether MMR causes autism when so many studies have already been done and have all come to the same conclusion, namely that the answer is no? As I keep saying, from a scientific standpoint the parrot has been dead for quite some time, but unfortunately the antivaccine movement remains like the pet shop owner, claiming that the hypothesis isn’t really dead. It’s just pining for the fjords. Besides increasing degradation of herd immunity in pockets of low vaccine uptake with resulting outbreaks like the recent Disneyland measles outbreak, this is one of the significant harms of the antivaccine movement, a major waste of resources and funding expended studying the same question again and again. The problem, of course, is that these studies do not reassure the very parents who need to be reassured; all they do is to provide incrementally more confidence among scientists and pediatricians to their already high level of confidence that MMR does not cause autism.

Same as it ever was.

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]

398 replies on “The parrot is still dead, and MMR still doesn’t cause autism”

That’s certainly a turn-up for the books, but I’m still not impressed with The Daily Fail. They reported on the Italian Court Ruling that vaccines cause autism, but I couldn’t find anything on their site about that verdict being overturned.

From the stats.

If you had an older sib with ASD, you have a 6.9% chance of also having ASD.

If your older sib did not have ASD your risk of ASD is only 0.9%.

As these figures have been shown by the study not to have been affected by MMR uptake, surely this shows the effect of genetics on ASD risk?

@ Fergus

As these figures have been shown by the study not to have been affected by MMR uptake, surely this shows the effect of genetics on ASD risk?

I guess one could still argue for unidentified environmental factors: siblings are after all very likely to be sharing a specific environment and lifestyle.

A more compelling case would be with either studying separated twins or close cousins living in different places.
(I believe one of the “thinking moms” is in this case, with odd people in different branches of her family)

That being said, since MMR vaccination doesn’t significantly modify the risk, whatever this environmental factor is, that’s not the MMR vaccine.
(cue the goalposts shifting among anti-vaxers)

Steve Novella wrote about this yesterday and made the great point that research doesn’t convince true believers. I think a more effective use of resources would be researching what kind of message is most effective for swaying fence sitters. Maybe a study could be designed somewhere that parents need to consult a healthcare provider to obtain a personal belief exemption.

I’m curious as to what nonsense our resident AVers are going to spout here.

@Helianthus

You are right about environmental factors.
It would have to be one hell of a factor to increase your risk so much though. More likely genetic IMO.

@capnkrunch #6

If our resident AVers are anything like the anti science gang at the Daily Kos, they are going to sucker punch random strangers and cry FOUL when anyone objects. Displaced aggression makes for pathetic spectacles.

The meme that forced vaccination = rape is out there again. Timing might be in response to this JAMA report, it might be random. The antis have taken a number of hits in recent months. Some have obviously left a mark.

If one actually forcefully grabbed someone and vaccinated them without consent, it would be a violation of bodily autonomy, much the same way that sexual assault is.

That’s where the similarities between the two end, of course.

This also highlights the mendacity of anti-vaccine activists, because of course no one is actually forced to vaccinate, at least in the US (*). Even in states with no non-medical exemptions for pediatric vaccination, parents have the freedom not to vaccinate their children. They just have to live with the consequence of exercising that freedom in that way, which is coming up with arrangements other than public school (and, I assume, most private schools) to educate their children.

(*) I suppose some exceptional circumstances might arise in which citizens are compelled to be vaccinated, but with the eradication of smallpox such circumstances seem very unlikely.

Autism occurrence by MMR vaccine status among US children with older siblings with and without autism.

DESIGN, SETTING, AND PARTICIPANTS:

A retrospective cohort study using an administrative claims database associated with a large commercial health plan.

This study does not have an unvaccinated cohort to compare with those vaccinated. It is a typical pubmed spin wash. I doubt also that a commercial claims database has much evidence of worth in it either.

Studying a cohort of vaccinated kids and comparing it with a group of vaccinated kids, using the biased autism rate of 1.1% for the norm, made up from studying predominantly vaccinated kids, is hardly worth the pixels on the page.

The autism rate is no different in the cohorts used because both groups had been vaccinated! Weasel words supreme.

But I suppose the heading is rather catchy and in a market led world this is all that matters. “What result do you want, we hear the researchers say.” more like autism doesn’t cause MMR.

Edvard Ernst writes for the Daily Mail, which is no surprise as most of his postings are unsubstantiated tosh

“Maybe a study could be designed somewhere that parents need to consult a healthcare provider to obtain a personal belief exemption.” C button

Maybe there should be proper follow up studies on those who choose to vaccinate against those who choose not to. Perhaps doctors should be compelled to follow legal directives on informed consent when vaccinating kids instead of their own beliefs.

An unvaccinated cohort would be unethical johnny, as you well know. The reason, of course, is that vaccines work.

” Even in states with no non-medical exemptions for pediatric vaccination, parents have the freedom not to vaccinate their children” compost99

Not in Belgium where you can lose your kids if you don’t have a Polio jab. Check out this film by a doctor on the Polio scam and maybe you will understand why so many are shunning vaccination as an out of date procedure.

https://www.youtube.com/watch?v=Twch-T-n8Ns

So if there is less measles and rubella in the population that, though not providing direct protection to the child, would reduce risk to the developing fetus, correct? Congenital rubella has been associated with increased risk of neurodevelopmental disorders.

“An unvaccinated cohort would be unethical johnny, as you well know. The reason, of course, is that vaccines work.”mikeymoo

That is bullshit, another reason why people shun the vaccine process. “They work so don’t need testing” is utter antiscience.

So you admit then that captain Orac’s paper mush at the top of this thread compared kids who had been vaccinated against kids who had been vaccinated and found no increase in the autism rate!!!! Fxxxxxg bullshit

What is unethical is changing the research goalposts to exclude vaccination from real placebo comparative trials by playing the “it’s unethical to use an unvaccinated group card”. If vaccines have only been ‘tested’ against themselves what on earth is the research telling us?

Either you are a megalomaniac who has total vaccine belief, cos you can’t have proof, or you are bonkers! The stats on the outcome don’t look good here

Johnny
“The autism rate is no different in the cohorts used because both groups had been vaccinated! Weasel words supreme.”

16% unvaccinated at age 2 = 15,200 children unvaccinated
8% unvaccinated at age 5 = 7,600 children unvaccinated

Mmm whose using the weasel words or did you not read the report?

Argument by YouTube Video is not accepted here, johnny. Come back when you have better data.

>posits something that’s utter nonsense
>”watch this youtube video”

laughingelfman.jpg

@johnny
“The autism rate is no different in the cohorts used because both groups had been vaccinated! Weasel words supreme.”

Actually, the autism rate is the same in both cohorts because *vaccine don’t fu%?&ing cause autism*.

This is the same type of study that was used to show a correlation between smoking and lung cancer. If vaccines caused autism, the rate of autism would be *greater* in the vaccinated cohort.

Interestingly, the authors mention that parents might *selectively* forestall vaccination in children whom they have observed to have social or communication delays.

I think that there’s a case like that @ TMR: Jameson stopped vaccinating her second child after her older child was diagnosed and the second appeared to have problems as well. She later ‘recovered’** the younger through various woo.

** I despise how they say that. Sounds like they found a child who was missing in the woods or suchlike.

capnkrunch @6

I may be mistaken,but won’t studies like this continue as long as there are antivaxers with very deep pockets to fund them? Kennedy and Trump to name but two.

johnny,

Edvard Ernst writes for the Daily Mail, which is no surprise as most of his postings are unsubstantiated tosh

Assuming you mean Edzard Ernst, perhaps you could provide some examples of the articles he has written for the Daily Mail. All I can find are a couple of reviews for ‘Trick or Treatment’. Or did you just make this up like everything else you excrete here?

Altho’ I’m not sure how the anti-vaxxers will dismiss this study- which they will- there are over 95000 subjects- that’s quite huge and powerful!

Well, they’ll probably insist that one of the authors- possibly the third one ( or as they call it- the ‘lead author’) once was employed by a university that participated in research on SSRIs or that Drexel once received money from the government ((shudder)) or that the statistical method was developed by a person who was sympathetic to the N-zis or was Murdoch’s son-in-law.
They’ll find something.

“a cranky conspiracy theory. (Is there any other kind?)”

There are plausible but evidence-poor conspiracy theories. My go to answer for “most plausible conspiracy theory” is one, Michael Jordan’s first retirement was a secret suspension for gambling. I don’t believe it because there’s no evidence, but if some were to surface I’d have an easy time buying it. Nothing about it is more implausible than the best basketball player in the world, in his prime, deciding he should play baseball.

Julian Frost

Argument by YouTube Video is not accepted here, johnny. Come back when you have better data.

Give the poor guy a break, – he obviously has a problem with reading comprehension.

You all remember the California Senate Bill, SB277? It was passed by the Senate Education Committee yesterday, on a 7-2 vote.

The anti-vaccine, anti-SB277 forces started muttering balefully that the “timing of this study’s release is suspicious”.

I just had to laugh. They are grasping at straws and calling them timber.

Johnny

“If vaccines have only been ‘tested’ against themselves what on earth is the research telling us?”

They weren’t.

“For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18; P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052”

The relevant bits are “vs no vaccine” and “compared to no vaccine”

“Altho’ I’m not sure how the anti-vaxxers will dismiss this study”

1. It used insurance data so it isn’t a real study.
2. The Lewin Group works for an insurance company, so it’s tainted.
3. Because THOMPSON!!!!!!

^ I would suggest not clicking on DrBollocks’ link if you don’t want to see a really repulsive image. (My G-d but the people who came up with that are garbage-y.)

“Altho’ I’m not sure how the anti-vaxxers will dismiss this study- which they will- there are over 95000 subjects- that’s quite huge and powerful!”

Oh they’re already trying. For example:

“This study only goes to age 5.

The study itself admits that the average age for an ASD diagnosis is 4 – which means some people with an ASD diagnosis are diagnosed after age 5.

We know that the average age for Aspergers diagnosis (which is 11% of the ASD population) is over age 6.
http://www.cdc.gov/mmwr/preview/mmwr…cid=ss6302a1_w

I suspect large portions of the ASD population were not captured due to the five-year old cut off.”

I agree that this study is basically beating a dead…er…parrot, but I’m still glad someone did a study looking specifically at siblings of children with ASD, since the antivaxxers’ fallback position is that large epidemiological studies don’t detect an association between vaccination and autism because vaccines only cause autism in a small sub-group of genetically vulnerable children (while simultaneously holding the contradictory belief that vaccines are the driving force behind the autism “epidemic.”) If there were a vulnerable sub-group of children, you’d expect to find them among those with a family history of autism, but this study clearly shows that that isn’t the case. It won’t convince true believers, of course, but hopefully it will reassure parents with one kid on the spectrum that it’s safe to vaccinate the rest of their kids.

Re DrBollocks #34:

Classy stuff from the AVN.

Then again, as we’ve seen from the trolls and from the writings of AoA, TMR, et al, classiness is not a virtue dedicated anti-vaccine activists or online trolls possess in any great abundance.

@ Sarah A:

Actually, at this very moment, TMR’s most recent post discusses how ‘genetics load the gun but vaccines pull the trigger’ and advises genetic tests to look for specific mutations. Now they can sit around and compare mutations on facebook I suppose.They recommend a service run by one of the Team TMR ‘thinkers’.

Johnny #14 “Perhaps doctors should be compelled to follow legal directives on informed consent when vaccinating kids instead of their own beliefs.”

Dunno how the laws work in Merkinania, but over here informed consent definitely applies to vaccination: it is exercised by parents on behalf of their children until such time as the child is deemed competent to consent for themselves (hint – look up Fraser guidelines).

@Annie

Ironically, I was thinking that they’d take the opposite tack and claim that the researchers looked at kids with ASD rather than “classical” autism deliberately in order to “water down” the results by including kids with Asperger’s or HFA, which, of course, isn’t “really” autism. But then, we’ve already seen that antivaxxers will include people at the “high functioning” end of the spectrum when it suits them (i.e., when they’re contributing to an increase in incidence) and exclude them when it doesn’t (i.e., whenever someone tries to point out that autism is not the same thing as brain damage, vaccine-induced or otherwise.)

@Denice – Have you read all that TMR post? There’s pretty much a complete toxin conspiracy bingo card there. Aspartame, anti-perspirants cause breast cancer, GM food, Chemtrails, flame retardants, electrosmog, fluoride, cloud seeding, Chernobyl… Just… wow.

@JP / DrBollocks

^ I would suggest not clicking on DrBollocks’ link if you don’t want to see a really repulsive image.

This disgusting picture has been around for some time, Orac pointed to it in a previous article to show how low the Anti-Vax brigade could go.

While reading the article linked by Dr Bollocks, I noticed a few related articles about anti-vaxers, with other instances of unrestrained “let’s go hyperbolic”.
I liked the one about pro-vax people being like Charlie Hebdo killers because we are opposed to AVN organizing public rallies.

@Rebecca Fisher:

I was particularly amused at the way she tried to sneak chemtrails into the article, as if she didn’t want to just come out and say the word:

We’ve got strange hatch marks in the sky that could be airplane emissions, except many of us get sick shortly after they appear.

I’m only surprised she didn’t mention MANGANESE.

“Altho’ I’m not sure how the anti-vaxxers will dismiss this study”

1. It used insurance data so it isn’t a real study.
2. The Lewin Group works for an insurance company, so it’s tainted.
3. Because THOMPSON!!!!!!” Shay away with the fairies

Are you serious, comparing a group of people with the same group of people then claiming ‘no increase’ is equivalent to bullshit

@ Rebecca:

I certainly did read it!

( I should clarify what I said previously: The Team TMR creature doesn’t provide genetic testing but she advises people after they get results from a standard service at her woo-based business in Denver)

As if this isn’t bad enough, Fearless Parent ( anti-vaxxers Habakus, Ji, Brogan et al) suggest that both deodorants and bras cause breast cancer.

Then there’s this chilling study:

http://www.theonion.com/articles/study-finds-those-with-deceased-family-members-at,38463/

Which got me to thinking: do you realize that there is an absolute correlation between vaccination and death? Everyone who’s gotten a vaccine has a 100% chance of dying at some point! How come these millions of deaths haven’t been reported to VAERS?*

*yes, a pitiful handful have been listed, like the girl who fell down the well and drowned a couple weeks after getting Gardasil (the case is listed on the NVIC website), but just think of all the fatal auto accidents, bathtub falls, heart attacks, pneumonias and other deaths after vaccination that go unreported because physicians are in the pockets of Giant Pharma!!!).

That’s an awesome looking sculpture. It almost makes me want to visit London again. Unless, of course, the parrot flies away before I can get there.

Re: Kent Heckenlively

Here we have a fellow who has subjected his child to all manner of experimental and unapproved treatments, without her consent, comparing supporters of SB277 to Nazis.

Orac, could you hook me up with your irony meter supplier?

@johnny
You clearly don’t understand ethics. A prospective vnt)accinated vs. unvaccined (which seems to be what you wa is unethical regardless of which side you are on. Either you are withholding well proven, effective treatment or you are poisoning children. Not that there’s evidence to support you view but if you really believe vaccines are poisons, how terribly unethical of you to advocate such a study.

Maybe there should be proper follow up studies on those who choose to vaccinate against those who choose not to.

If only Orac would write about such a study…I think what you meant to say was,

Maybe there should be proper follow up studies on those who choose to vaccinate against those who choose not to that support my beliefs.

Perhaps doctors should be compelled to follow legal directives on informed consent when vaccinating kids instead of their own beliefs.

I agree. If only Dr. Bob, et al could be compelled to evidence driven practice.

RE: Shay @32

I would propose what I call ‘The Crosby Deduction’ as a more likely scenario –

1. Vaccines cause autism
2. This study found that vaccines do not cause autism
3. The study is flawed
4. Because THOMPSON!!!!!!
5. Because POUL THORSEN!!!

Johnny
The sane one

Sarah A @39

There are a number of subgroups of children in the general autism population,who might suffer serious consequences of vaccines.But what is not mentioned,either by the antivaxers,or in studies like this,is that these children come from families that have very long histories of medical problems that can fit into,now defined,subtypes.Histories of autoimmune disease,like type 1 diabetes or rheumatoid arthritis.Histories of conditions related to faulty folate metabolism genes,like neural tube defects,infertility,stillbirth,pernicious anemia,or cerebrovascular disease.Diseases that might come under the broad umbrella of mitochondrial disorders.And in a most autism families there is a history of either mental illness or intellectual disability,if not autism.These are children who would have suffered serious consequences from any challenge to their immune systems early in life,as I did from having acute meningitis as an older infant.But even so,vaccines are safer than wild infections,like I had.

Unlike most autism parents,I have spent many years researching the medical literature learning about all the advances in autism medicine,with genetics in mind.Mostly so I could get answers to the serious problems,medical and otherwise,I have had all of my life,and ask my doctors for the right tests.

There is so much we have learned in the last 25 years or so of autism medicine,and it’s so much more interesting than vaccines.

But the one thing I learned from all my years interacting with parents at places like AoA,is these parents are so convinced that their child was “perfect”,that they refuse to connect their own family history to their kid’s autism.

@johnny #14:

Perhaps doctors should be compelled to follow legal directives on informed consent when vaccinating kids instead of their own beliefs.

I suppose you got to this conclusion because you believe that, if parents had “all the information”, more would be choosing not to vaccinate. Most, even. Yes? It never even occurred to you that they *have* all the information and are choosing to vaccinate anyway? In droves?

No, because it only counts at “informed” if it agrees with your views.

@Shadowflash

In anti-vaccine land, “informed consent” means telling parents about all the horrors that anti-vaccine activists attribute to vaccines.

#56 Should read

A prospective vaccinated vs. unvaccined (which seems to be what you want is unethical regardless of which side you are on.

johnny, how many times do we gotta tell you that every single person on this blog that types out bull**** correctly will be moderated.

It was here before you came and it will be here after you leave, it was not invented just for you, nor does it just effect you.

I know you can’t believe the S word is a bad word (as others cannot grasp the A word is a bad word, either) but since these words are often used in personal attacks they tend to bump anything right into the won’t be seen until the moderator approves it.

I don’t understand why you can’t get this simple idea or pay enough attention to your own typing to figure out which words trigger it time and time again. No it all has to be about a vendetta against you, does you ego really need that much feeding and care? Must be such a burden, poor thing.

Are you serious, comparing a group of people with the same group of people then claiming ‘no increase’ is equivalent to bullsh1t

Except the study didn’t do this, did it?

Instead it compared people in one group (who had received MMR vaccination) to people in a different group (who had never recieved the MMR vaccine).

I would propose what I call ‘The Crosby Deduction’ as a more likely scenario –

1. Vaccines cause autism
2. This study found that vaccines do not cause autism
3. The study is flawed

Johnny, your evidence demonstrating that “Vaccines cause autism” would be…what, exactly? be specific.

Oh, wait–that’s right. You don’t have any.

I don’t understand why you can’t get this simple idea or pay enough attention to your own typing to figure out which words trigger it time and time again.

Contemplating simple stupidity is to give Phildo far too much credit.

JGC @64, that’s the sane johnny, and I think he was just saying how the antivaxxers would respond. I don’t believe he was endorsing the belief.

#26 Kreb
edzardernst.com
I qualified as a physician in Germany in 1978 where I also completed my MD and PhD theses. I received hands-on training in acupuncture, autogenic training, herbalism, homoeopathy, massage therapy and spinal manipulation.
Later, I became Professor in Physical Medicine and Rehabilitation (PMR) at Hannover Medical School and Head of the PMR Department at the University of Vienna. In 1993, I moved to the UK and became Chair in Complementary Medicine at the University of Exeter.
 I am founder/Editor-in-Chief of two medical journals (Perfusion and Focus on Alternative and Complementary Therapies).My research focussed on the critical evaluation of all aspects of alternative medicine.
Unlike most of my collegues, I do not aim to promote this or that therapy, my goal is to provide objective evidence and reliable information. It is fair to say that this ambition did not endear me to many quasi-religious believers in alternative medicine.

Assuming you mean Edzard Ernst, perhaps you could provide some examples of the articles he has written for the Daily Mail.

Oh, there’s plenty of evidence. For example, here “mythbuster” reports

That complete arse Edvard Ernst writes for the Daily Mail, avoiding his puerile septic rants is definitely worse a news years resolution. He actually believes chemo works and that the only treatment for arthritis is painkillers!

And here, “Jenson” observes

That’s funny most of what I am posting is from medical peer review and the HPA, did I miss something or is the BMJ now, like Edvard Ernst writing for the Daily Mail?

Same old shіt, year after year.

#26 Kreb
Edzard Ernst- edzardernst.com (if you are interested)
Bio of him is awaiting moderation.

^ The best part of this will be seeing how long it takes him to find the actual item. Phildo, if true to usual form, will require several rounds of spluttering that he knows where it is but everyone else is too stupid to find it, all the while failing to cough it up.

Johnny #14 “Perhaps doctors should be compelled to follow legal directives on informed consent when vaccinating kids instead of their own beliefs.”
Dunno how the laws work in Merkinania, but over here [in the UK] informed consent definitely applies to vaccination:

Johnny himself is writing from darkest Essex.

Assuming you mean Edzard Ernst, perhaps you could provide some examples of the articles he has written for the Daily Mail.

Johnny Chav’s a Daily Mail reader commenter himself, so he should be able to furnish the evidence soon enough.

A prospective vaccinated vs. unvaccined (which seems to be what you want is unethical regardless of which side you are on.

Oh, Phildo has suggested a restrospective study as well:

Maybe there should be proper follow up studies on those who choose to vaccinate against those who choose not to.

Of course, he doesn’t understand basic statistics, either.

It’s the Daily Fail, please and thank you.

There was a fish and chips place my Cockney Dad used to take me in the East End somewhere when I was small and we’d be on a visit to Blighty. The fish and chips were always wrapped in the Daily Fail. My Dad would say, “All it’s good for, that and wiping yer arse.”

“You clearly don’t understand ethics. A prospective vnt)accinated vs. unvaccined (which seems to be what you wa is unethical regardless of which side you are on. Either you are withholding well proven, effective treatment or you are poisoning children.” cockcrunch

The is an elephant in your argument dear boy – testing a group of people who have had the MMR against a group of people who have had the MMR and saying there is no difference in the levels of autism in both groups is bull.

The stat that says the average number of people in a group with autism is 1.1% was based on studying groups of people who had been vaccinated so this stat is based on a vaccinated cohort.

This kind of weasel research is the reason why your average person sees right through the bull. We don’t need to not believe it!!!!!!!!!!! it’s complete crapola – if you can’t see that you must be a ‘proper doctor’.

Stop rubbing it Narad – it’s unethical.

This, this, from herr doktor’s link above: So you are obviously well prepared to start diversions from discussions, you must be a vaccine believer. Now you mention it Jenner returned to all the places he had vaccinated and declared ‘My suppositions were based on a fallacy’ there was more disease than was there in the first place.

Smallpox eradication is the first myth taught to children at school, like the value of milk in schools, vaccination is all about fear propagation and profit, the health issue should be referred to the ASA. Your screaming nutter avatar is straight out of a Merck manual, you need to come up to speed with vaccine facts and stop diverting into propaganda.

http://drtenpenny.com/the_truth_about_the_flu_Shot.aspx

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