Categories
Antivaccine nonsense Bad science Cancer Medicine Skepticism/critical thinking

A dumpster fire of a study about HPV vaccination and female fertility, courtesy of Gayle Delong

Gayle Delong is an economist who thinks she’s an epidemiologist. Consistent with that delusion, her latest study of HPV vaccination is all amateurs hour, in which she misses a major potential confounder on her way to “proving” that HPV vaccination could be associated with decreased fertility in young women.

If there’s one thing about antivaccine activists (a.k.a. antivaxers), it’s that, no matter what, it’s always about the vaccines. Always. Whatever chronic health issue it might be, autism, autoimmune disease, diabetes, or whatever, to the antivaxer, it’s always the vaccines that did it. Always. I’ve just come across a new “study” by Gayle Delong supposedly implicating the HPV vaccine with female infertility that demonstrates this principle again through its sheer awfulness, as you will see.

Before we dive into the study, first I have to make a brief observation about HPV vaccines. To antivaxers, lthough it’s always about the vaccines, to antivaxers, some vaccines are more detested than others. Arguably the vaccine most detested by antivaxers is the HPV vaccine. Be it Gardasil or Cervarix, the HPV vaccine is the target of special fear and loathing among antivaxers. Scientists turned antivaxers like Christopher Exley do horribly designed and executed studies to “prove” that the aluminum adjuvants in Gardasil are dangerous or cause behavioral problems. Others try to link the HPV vaccine to premature ovarian failure using studies that fall apart on the most minimal dissection. If that fails, antivaxers try to convince parents that Gardasil and Cervarix kill again and again and again and again, based on the thinnest of evidence.

Indeed, there’s something about HPV vaccines that imbues them with a strange power over people who are often otherwise reasonable about vaccines. For some reason, HPV vaccines seem to have an uncanny ability to turn such people into raging antivaccinationists almost as loony as the merry band of antivaccine loons over at Age of Autism. At the very least, they seem to make seemingly reasonable people susceptible to blandishments and tropes for which they’d normally otherwise never fall. Truly, Gardasil and Cervarix seem to be vaccines that make reasonable people lose their minds. I tend to think it’s about the sex. After all, HPV is largely a sexually-transmitted virus, hence the tendency for fundamentalist Christians to find it particularly objectionable. Whatever the reason for the outsized negative reaction to Gardasil and Cervarix, antivaccinationists are aware of it. Indeed, they nurture it and take advantage of the undeservedly bad reputation that HPV vaccines have. This brings us back to Gayle Delong’s latest horrible “study” claiming to suggest an adverse health effect from Gardasil.

We’ve met Gayle Delong before, first in 2011 when she published a paper that was the ecological fallacy writ large trying to show that vaccines cause autism. Then, a year later, she published an equally risible paper about “conflicts of interest” in vaccine science that was really an attack on the Vaccine Court. Then, in 2014, Delong blamed her breast cancer diagnosis on dealing with her child’s autism and made it clear that she viewed autism as worse than breast cancer. Another thing that you need to know about Gayle Delong is that she is not a scientist, physician, or epidemiologist. She is, rather, Associate Professor of Economics and Finance in the Bert W. Wasserman Department of Economics and Finance at Baruch’s Zicklin School of Business. None of that’s stopped her from bravely paddling up the river of pseudoscience in topics where she has no expertise. The likely reason is that she filed a claim under the Vaccine Injury Compensation Program on behalf of her autistic daughter and the Special Master dismissed the claim due to untimely filing.

The title of the study, A lowered probability of pregnancy in females in the USA aged 25–29 who received a human papillomavirus vaccine injection, pretty much tells you what Delong claims to have found. She didn’t find anything of the sort (as I will show), but that’s what she thinks she’s found. Basically, Delong thinks she can do epidemiology, but I’m a better epidemiologist than she is and I’m not an epidemiologist, if you know what I mean. In any case, the idea is that, among women 25-29, fertility is lower, supposedly independently from the decline in birthrate that occurred in the wake of the 2007-2008 financial crisis.

Before I get to the science, let me just point out some red flags in the paper. First, in the acknowledgments section, Delong notes:

The author thanks David Geier, Sabastiano Manzan, Jonathan Rose, and Paul Turner as well as Sam Kacew (the editor) and three anonymous reviewers for insightful comments. Any errors are solely the responsibility of the author.

Yes, you read that right: David Geier, the fils from the père et fils team of antivaccine pseudoscientists, a not-so-dynamic duo whose crimes against vaccine science and utter antivaccine quackery I’ve written about more times than I care to remember.

Then, in the introduction, Delong lays down the antivaccine tropes about HPV vaccines:

Reports of young women experiencing primary or premature ovarian failure (POF) after receiving the vaccine were noted (Colafrancesco et al. 2013; Little and Ward 2012, 2014). POF—defined as the onset of menopause before the age of 40—is sometimes referred to as premature ovarian insufficiency and thought to be extremely rare. Symptoms include menstrual disturbances such as primary or secondary amenorrhea as well as hot flashes and mood swings. The estimated incidence for females under the age of 30 is 1 in 1000, rising to 1 in 100 for females under the age of 40 (Rafique, Sterling, and Nelson 2012). However, the use of the birth control pill might mask the existence of POF and thereby understate the incidence of the disorder. Islam and Cartwright (2011) noted that of the 4968 females in a UK birth cohort that had been born in 1958, the number of women who experienced POF was 370 (7.4%). Underlying conditions such as radiation and chemotherapy might give rise to the malady, but 80–90% of POF cases have no apparent cause. POF may be an autoimmune disorder and between 10% and 30% of women with POF also have other autoimmune disorders (Maclaran and Panay 2015).

No. Just no. I’ve written about nearly all of the above antivaccine studies claiming to have found a link between vaccination against HPV and premature ovarian failure. As I said above, there’s no there there.

As if this weren’t enough, Delong goes on to credulously quote the Geiers (always a bad idea if you want to be perceived as anything other than an antivaccine loon):

Geier and Geier (2017) examined the Vaccine Adverse Events Reporting System (VAERS) database to determine whether uptake of the HPV vaccine affected the number of reports of autoimmune reactions. VAERS is a passive system where vaccine administrators or recipients report adverse effects after receiving a vaccine. Between 2006 and 2014, HPV vaccine recipients or their health care providers noted 48 cases of ovarian damage associated with autoimmune reactions. In addition to the Geier and Geier findings, the VAERS database between 2006 and 2017 indicated other symptoms that affect the ability to bear children: spontaneous abortion (214 cases), amenorrhea (130 cases), and irregular menstruation (123 cases).

As I’ve described, again more times than I can remember, the VAERS database is highly unreliable for estimating the frequency or even whether reported adverse reactions are related to vaccines. At best, it can function as an “early warning” system, but at worst it’s hopelessly tainted by antivaxers and their lawyers urging parents of autistic children to report their children’s autism (and any other “vaccine injury” they believe their children have suffered) to VAERS. It’s not for nothing that I refer to the frequent antivaccine technique of doing studies searching VAERS for dubious “vaccine injuries” of the sort that the Geiers do “dumpster diving.”

So we’ve established that Delong’s version of vaccine “science” is hopelessly biased and clueless. Unfortunately, so is the “science” that she does herself. Here’s what she did. She used two databases. The first was the Natality Information section of the CDC Wide-ranging OnLine Data for Epidemiologic Research (WONDER) database recording live births. There didn’t seem to me to be much point to this because all Delong did with it was to show that there was a sharp decline in the US birthrate beginning in 2007 associated with the economic meltdown that hasn’t recovered yet. As they say on Game of Thrones, it is (already) known.

Next, Delong used responses to the National Health and Nutrition Examination Survey (NHANES). This is a survey that collects data on health status of individuals in the United States along with demographic and socioeconomic information. The National Center for Health Statistic (NCHS) at the CDC administers the survey and selected a representative sample of the US population based upon complex sampling procedure. Delong notes that in 1999 NHANES asked females aged 12 and up whether they’ve ever been pregnant (or are pregnant now) and, if so, how many live births, miscarriages, stillbirths, tubal pregnancies, and abortions they’ve had. Then, starting in 2007, the survey started asking females aged 9 or above whether they’ve had an HPV vaccine. Delong then justifies the age range selected thusly:

In 2015, the NCHS moved these questions to the National Health Interview Survey, an annual survey that is not directly compatible with NHANES. The years of study are therefore 2007—when NHANES first asked about HPV vaccine uptake—to 2014, the final year NHANES included the questions concerning pregnancy and HPV shots.

Of course, that makes me suspicious right there. These are CDC-administered surveys and the databases are maintained by the CDC. The NHANES and NHIS datasets can both be accessed through the CDC website. Moreover, if the same basic survey questions were simply moved from one survey to the other, there’s little reason why Delong couldn’t have accessed later data.

Be that as it may, Delong used the dataset as described above. The study thus used various analyses to determine whether the odds of having been pregnant (the response variable) were influenced by explanatory variables such as receiving the HPV vaccine. What she found was this. Approximately 61% of women who had never received the HPV vaccine had become pregnant at least once, whereas only 35% of those who were exposed to the vaccine did. Among married women, 77% of women who had not received the vaccine had conceived, while only 51% of those who had received the vaccine had become pregnant. She then estimates that if 100% of females in the study had received the HPV vaccine there would have been 2 million fewer pregnancies. Among never-married women 44% of those who did not receive the HPV vaccine had been pregnant, while 28% of those who had received it had conceived. By univariate analyses, the results for all women and married women were statistically significant. However, when covariates (factors that could be confounders) were included in the model and logistic regression carried out, the results for never-married were no longer statistically significant.

Where it really gets interesting is the logistic regression including covariates in which the number of HPV shots received (one, two, or three) was related to the likelihood of getting pregnant. In this model, almost none of the comparisons were statistically significant. The only two where there was a statistically significant result were for the full sample, one shot versus no shots and three shots versus no shots. To me this is a huge red flag that the results are not robust and that there is no dose-response observed. If HPV vaccination was truly causative for infertility, there should be a dose-response curve. The effect seen should be bigger and more robust across more groups as the number of HPV vaccines received increases. It’s not.

There’s also another huge problem with this study. One of the most important covariates that could impact pregnancy rates is (obviously) usage of contraception. Yet nowhere in the analysis is there a consideration of contraception usage. Yes, Delong brings up the lack of statistical significance of the results among never-married women by suggesting that maybe most of them want to avoid pregnancy (which could be true), but, again, contraceptive use is an incredibly important factor, which was not even included as a covariate. My first thought was that maybe it was a question that wasn’t asked. It’s possible. Oh, wait. It’s not. The questionnaire asks whether a female has ever used oral contraceptives, if she is taking them now, and how long she’s taken them. So why did Delong not include oral contraceptive use in her analysis? She could have. She doesn’t even really discuss it other than discussion of contraceptive failure rates. I strongly suspect there was a reason for this. I also strongly suspect that a correlation between HPV uptake and oral contraceptive use (which is not unreasonable to hypothesize) could explain the results Delong observed and that correcting for oral contraceptive use in the survey sample would likely have resulted in the results of the logistic regression no longer being statistically significant. In fairness, if the correlation is not positive but negative (i.e., HPV vaccination is associated with less oral contraceptive use), the results could be more robust than what Gayle found.

In any case, I can see only two explanations for Gayle Delong’s not having done this analysis, given that the data appear to have been available. Either she was clueless and didn’t even consider it as a covariate, or she did some exploratory analyses and with contraceptive use included the effects that she saw disappeared. After all, they weren’t very robust; so I suspect that it wouldn’t take much. I welcome comments from the epidemiologists who read this blog. After all, existing evidence largely contradicts Delong’s findings, with HPV vaccination having no effect on fertility except in one group. The group? In females with a history of sexually transmitted infections or pelvic inflammatory disease (i.e. a group at high risk of exposure to HPV infection), HPV vaccination made pregnancy more likely.

In the end, though, regardless of whether the inclusion of oral contraceptive use as a covariate would have affected the analysis, what we have here is another example of amateur hour. Gayle Delong did the analysis basically by herself with the help of an incompetent (David Geier), another economist (Sabastiano Manzano), and a professor of history who is her husband (Jonathan Rose). Having read a number of epidemiology papers and co-authored a couple (with, I hasten to add, actual epidemiologists, population scientists, and statisticians), I got the distinct feeling reading Delong’s paper that she didn’t know what she was doing.

That’s why my sincere advice to her is two-fold. First, if you publish in a journal like the Journal of Toxicology and Environmental Health, don’t expect to be taken seriously. It’s where Delong’s published antivaccine nonsense before—at least twice!—as have other antivaccinationists. Second and finally, the next time you think you want to do a population studies/epidemiology paper like this, get yourself an actual epidemiologist and an actual statistician as co-authors.

Really. You’ll thank me later.

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]

144 replies on “A dumpster fire of a study about HPV vaccination and female fertility, courtesy of Gayle Delong”

I overheard people at INSERM in France complaining about statisticians. Too picky to their taste, which led to less significant results and more difficult to interpret. They ultimately did away with the statisticians to get along with their work.

Yes, statisticians are picky because they know how data can get messy.

The gap between them and public health specialists is yet far from being fully bridged.

Is Gayle Delong a follower of Geert Ryke Hamer? I mean if you’re blaming your breastcancer to dealing with an autistic child, it sure sounds like it.

For myself, I was in my mid 20’s when the HPV vaccine became available. I was on the very end of the age range for it, but since I was already sexually active it wasn’t recommended that I get it.

It sounds like I would have been the correct age to participate in this study. If so, I would have been a subject that did not get the vaccine, but had three births.

I wonder if there would have been a lot of woman like me. This would have definitely skewed the results.

Indeed, not to mention that there has been a shift towards older maternal age which DeLong does not address. This is just another anti-vaxx fail that only the true believers will glom onto.

Interesting. I was in the same position. I was approaching the end of the eligibility window when it was finally approved for public use. I was also sexually active, but my Dr. just ordered a blood screening for prior HPV infection before starting the series.

Also interesting is that the survey databases only considered oral contraceptive use, and the particular study in question didn’t use it, but in roughly the same time frame since these vaccines have been released alternate forms of contraceptives (rings, patches, and new gen IUD’s) have also become more popular, so even adjusting for oral contraceptive use is going to miss a large population of women using other forms of contraception.

Side question: Is a previous HPV infection an actual contraindication or does it just reduce the effect in cancer prevention?

HPV infection is much like herpes: once you’ve got it you’ve got it. So vaccination won’t cure your current infection.

However, if you’re in the appropriate age group, it could prevent you from acquiring another form and may still reduce your risk for cervical cancer, so the CDC still recommends people in the correct age group (12-25) get the vaccine.

Why is menopause before 40 is necessarily considered a pathology and not just one end of a bell curve (I’m assuming that plotting age of menopause would result in such a curve). Especially in an otherwise healthy woman. I understand that if you’re a woman who put off having children, it would be quite devastating to have less time than you thought.

I eyeballed a few histograms of age of onset of menopause (didn’t have time to go find the underlying data and do a real analysis) but given the graphs I would suspect this may be a 2 standard deviations off the mean which is a pretty common way to cut of the ends of the bell curve.

It may be normal for you to be on the ends of the bell curve, but usually the “normal range” isn’t every value measured in someone you suspect has no reason to be abnormal. I am not sure on why that 2 standard deviations from the mean was chosen (but typically something like 95% of people will be “normal” and the other few percent will be close to normal values). Another factor for some things can be how far the range of numbers where it is obvious something bad is going on from the normal range can vary. So often there is a bit of abnormal, but not clinically relevant space before you hit the we better run a bunch of tests on you stat! I do know that there are somethings that they test for if you go into menopause before 40 as the chance of it being natural are low enough they want to make sure it isn’t a something else.

Now for women who have artificial menopause I do think that cut off is sometimes used to make decisions about hormone replacement.

2 standard deviations from “normal” isn’t enough to qualify a condition as an illness. Take high IQ for instance. There is no long term data that shows that high IQ above 2 standard deviations induces or is correlated to various forms of psychiatric conditions such as anxiety.

For a 2 standard deviation cutoff to qualify as an illness, you have to exhibit some form of association with some form of distress.

That may be the case with menopause in some cases. Dunno if this is fully justified though.

Yes, as I tried to say the cut off for “normal” and the start of the disease range may have a gap. Sometimes it is pretty big, but other times the line is decided by where symptoms of a disease start rather than where do we find very few normal healthy people. Normal isn’t just numbers where diseased people never have that number, it usually has something to do with where people who are normal and healthy usually are. Why sometimes they can do the “pre” thing. There is a gap between healthy and frank disease and so that may indicate you either need to watch more closely or do lifestyle modificatio to see if you can get it back in range,

Anecdotally I know that usually if they don’t know why you started menopause before 40 they usually run a bunch of tests (the younger you are the more aggressive they are about those). At least based on people I know. They usually don’t seem to care much if you are in the abnormal but way late category. Possibly because there are not disease.

Anyway the usually get 95% of the healthy range as “normal” is why people often wonder why their docs aren’t all freaked out about a slightly abnormal value. Like I said, this isn’t all tests as sometimes there are lines drawn for other reasons. But so many things have that gap between where you usually see the numbers and where the symptoms start and they don’t want too broad of a range as sometimes you do want to note when something could be a little off but not “hair on fire” off.

I’m not technically a statistician, but I do statistical computations professionally, and I wanted to offer a semi-technical response:

I don’t know the answer to your question, but a one possible explanation is that the distribution is meaningfully non-normal. Take for example the distribution observed in this paper: https://www.maturitas.org/article/S0378-5122(03)00215-9/fulltext Figure 1

Leaving aside the question of whether these findings generalize to Western women (this paper describes Saudi women), what I can say is that the left tail of the curve is far “fatter” than it would be if the age of menopause were normally distributed. You can see in figure 4, they show that adding one main bell curve centered at ~50 and another smaller one at ~36 fits the data rather well. So, simplifying drastically, it could be that there’s one process that tends to lead to menopause at 50+-5 and another that tends to lead to menopause around 36+-5, and if you had menopause before 40, it would therefore be likely that the second process is the cause.

More generally, we sometimes talk about a distribution having a “shoulder” https://1.bp.blogspot.com/-O7jtwat9gW0/Tfzi440K96I/AAAAAAAAACw/zatnB-x_gJA/s1600/mixfig02.png which is what the study on Saudi women shows.

Again, I don’t know if this is anything remotely close to the real answer to your question, but my point is that “just cutting the bell curve” isn’t necessarily what’s been done: it could be that the distribution has a shoulder.

I’m not technically a statistician, but I do statistical computations professionally, and I wanted to offer a semi-technical response:

I don’t know the answer to your question, but a one possible explanation is that the distribution is meaningfully non-normal. Take for example the distribution observed in this paper: https://www.maturitas.org/article/S0378-5122(03)00215-9/fulltext Figure 1

Leaving aside the question of whether these findings generalize to Western women (this paper describes Saudi women), what I can say is that the left tail of the curve is far “fatter” than it would be if the age of menopause were normally distributed. You can see in figure 4, they show that adding one main bell curve centered at ~50 and another smaller one at ~36 fits the data rather well. So, simplifying drastically, it could be that there’s one process that tends to lead to menopause at 50+-5 and another that tends to lead to menopause around 36+-5, and if you had menopause before 40, it would therefore be likely that the second process is the cause.

More generally, we sometimes talk about a distribution having a “shoulder” https://1.bp.blogspot.com/-O7jtwat9gW0/Tfzi440K96I/AAAAAAAAACw/zatnB-x_gJA/s1600/mixfig02.png which is what the study on Saudi women shows.

Again, I don’t know if this is anything remotely close to the real answer to your question, but my point is that “just cutting the bell curve” isn’t necessarily what’s been done: it could be that the distribution has a shoulder.

I asked AOA about contraception rates yesterday and they didn’t post my comment:)
I also wonder why the Wasserman endowment funded the study. Anyone know about them?

The more I think of it, the more I’m coming to believe that Delong did do the multivariate analysis including contraception rates as a covariate and that when she did that the negative associations between HPV uptake and pregnancy rates ceased to be statistically significant any more.

It’s a common thing to find seemingly statistically significant results in univariate analyses (as she did) that disappear when a multivariate analysis with the appropriate covariates to correct for confounders is carried out. It happens all the time in epidemiology.

So why did Delong not include oral contraceptive use in her analysis? She could have. She doesn’t even really discuss it other than discussion of contraceptive failure rates.

We know that Delong knows how to control for a covariate because her 2011 paper was all about controlling for covariates (there is no sign of the desired association in the raw data, so she tried various combinations of covariates until she found one that did achieve the desired result),

Here’s a followup on AoA. Apparently DeLong claims that including birth control use as a covariate wouldn’t matter.

http://www.ageofautism.com/2018/06/update-new-study-links-lowered-probability-of-pregnancy-in-females-25-29-to-hpv-vaccination.html

DeLong claims that she did the analysis, but she didn’t, not really. There’s no evidence in her response that she ever included the answers to the three questions (condom use, birth control pills, implantable birth control depot) as covariates in her analysis. She’s just handwaving, and pathetically at that by looking at birth control use among married and unmarried woman and claiming that more married women should have gotten pregnant because of the lower birth control use. This is basically no different than the handwaving she did in the text of the paper itself.

She didn’t, as far as I can tell, do the multivariate analysis including birth control use as a covariate. Or, as I said before, I suspect that she did and that including those three questions, either individually or as an aggregate, as a covariate and resulted in the differences in pregnancy rates ceasing to be statistically significant. After all, if she had and the results remained statistically significant, why not just show them? She isn’t. Instead, she’s relying on a whole lot of handwaving, and that is very telling to me.

Perhaps she is.

The response of an honest scientist to criticism that she left out a very important potential confounder as a covariate in her multivariate analysis would be to ask herself if maybe the critics have a point and then to go back and redo the analysis including the covariate the right way. She didn’t do that. That’s why I suspect that she actually did do the analysis and that including birth control use as a covariate, whether as an aggregate of condom, oral contraceptive, or long-term depot use or including each of those three individually in the analysis, and wiped out the “effect” she claims to have observed. Otherwise, why all the handwaving? Why not just do the analysis?

“I ran a rigorous analysis and an informal version, but the results were the same so I only published the non-rigorous results”. Said no statistician ever.

“The response of an honest scientist to criticism …”

She is neither a scientist, nor for this topic is she honest. She may not want to be dishonest, but for some reason she has too much motivation to find the answers she wants.

Which is exactly why she it not a scientist. Though this may make her good at finance.

Just out of interest, the Colafrancesco is not only a three case reports paper (with Shoenfeld and Tomljenovic), but Dr. Shoenfeld was serving as expert witness on two of them, and although he mentioned general serving as expert witness did not mention that (when it was called out he claimed an innocent error).

Her basis for doing this very flawed research at all is very, very limited.
https://www.ncbi.nlm.nih.gov/pubmed/24985338

Among the myriad causes of premature ovarian failure are infections – including mumps and varicella.

Did DeLong look to see whether POF patients had been vaccinated against these two pathogens or not? 🙂

Unless I missed something, there is also no mention of the HPV infection status of these patients. It would of course stand to reason that women who’ve had to undergo surgical procedures such as cervical LEEP excisions and hysterectomies for high grade HPV-associated dysplasias or invasive carcinomas would tend to have lowered fertility rates as a consequence.

Delong has a child with autism. Doesn’t that say it all?

I once looked over bios of believers in anti-vax hysteria and found that they fit easily into two groups with an outlier or two:

parents of children with autism which includes most of the people who write at places like AoA and TMR ( although the Prof’s kids have other conditions). Some of them have even created a secondary career as advocates, speakers and authors.
people whose careers/ bankrolls benefit like doctors, (bad) researchers, woo-meisters, supplement suppliers, lawyers, (bad) journalists, writers, bloggers, publishers, rabble rousers ( Bolen, Kennedy, Schecter, Bigtree, etc) and natural health advocates like Adams, Mercola and Null.

Then there are a few like Jake Crosby who has an ASD and is trying to make it into the secondary category.

In other words, they are motivated to believe -and even if they don’t really believe- they appear as if they do in order to promote an agenda.

“Delong has a child with autism. Doesn’t that say it all?” I know what you’re trying to say and you’re not really wrong. But you come across as painting with too broad a brush here. I have a child with ASD. I’m a researcher and a proponent of vaccinations. My wife runs a support group for parents with children on the spectrum and while her group is large (she’s good at what she does) she has had members leave because she said positive things about the book, “Neurotribes,” which debunks the ASD-vaccine connection. My point is that there are plenty of ASD parents who are researchers or autism advocates and pro-vaccine. We may be less visible, however, because when I write a paper I don’t preface it with, “I have a child with autism.” (I save that for comments on blogs). And when my wife is trying to help parents get the appropriate educational support for their children, she doesn’t withhold her help from those who are not only desperate but misinformed. Delong is wrong because she’s making a bad argument. Shame on her for using her kid to enhance her own credibility, but her child’s diagnosis has no bearing on her argument one way or the other.

@ Bend:

Sorry that you didn’t get my shorthand:
of course, I’m referring to anti-vaxxers not normal people. I have no reason to follow and discuss people like you and your wife because you know what you’re talking about and don’t mis-educate anyone.

And yes, I realise that anti-vaxxers are not average people: I see that websites like AoA, TMR etc aren’t especially popular across the net although they can get followers. If you look at parents who get exemptions from vaccines or homeschool children to avoid vaccines, they are a tiny portion of parents in general. I used to quote a survey that showed actual numbers. Even if the deepest, darkest mountain glades of Marin County, most people vaccinate
( although there are particular private schools there that are hot spots)

BUT small numbers of alties can cause harm.

Delong, unlike most parents of kids with autism, is emotionally affected in a way that distorts her relationship to reality: I’m sure that other serious life situations might affect her in a similar fashion – say, a divorce, loss of a job,
death of a close friend or relative.

Similarly, I don’t much discuss SBM but look at the intricacies of woo.

I thank you for this. I have premature ovarian insufficiency (the preferred nomenclature for POF these days) and run a Facebook group for women with this condition. About once a year we have to debunk the HPV myth and, sure enough, someone posted this study today. I was really hoping you had covered it!

As for me, I am too old to have had the HPV vaccine, but my daughters just turned 11 and you can bet they’ll be getting their first dose at their well-child checkup scheduled for August. I have zero hesitation.

It would interest me to see this looked at from a socioeconomic viewpoint. In addition to contraceptive use, are there groups in the population who have less access to, or use, the kind of primary care that would offer the vaccine, and if so, do the girls start sexual activity earlier, and do they tend to become pregnant earlier and/or more frequently than more advantaged segments of the population? This of course goes to contraceptive use, but does poorer access or less exposure to valid sexual information add up to lower use?
I feel like I am expressing myself poorly, stumbling around the edges of a concept here, so if someone here has a better grasp of my question, feel free to say so.

@ Old Rockin’ Dave:

You’re not stumbling at all.

You’re talking about socioeconomic factors :
perhaps a lower SES would have less access to medical care ( including birth control and vaccines), less general education and might get pregnant at earlier ages.

I’m not sure if the study considered any of this.

Would you phrase part of your question as: Is there a positive relationship between receiving the HPV vaccine and contraceptive use?
I would follow it up with: Is there a positive relationship between receiving the HPV vaccine and use of long-acting reversible contraception?

I think I see the question you’re asking, and I’d be really interested to see some data on the relationships among use of health care overall, use of reproductive health care, getting the HPV vaccine and number of pregnancies.

I saw on the electric Twitter machine today something about homeopathic birth control. I mean, Jesus, what is it, jizz at a 30 C dilution?

Homeopathic birth control probably has a particularly long lasting (ca 9 month) initial detoriation, which should prove it works.

I tried to get the homeopathic website in English but it wouldn’t open, so I am left with many questions.
The most important one is what they would do to “cure” me of bisexuality. Would it be the same substance? If so,would they need a greater or a lesser dilution? If not, what would they use? Would it also cure me of heterosexual attraction? Worse, them being German and Catholic, would they surreptitiously try to cure me of being Jewish? How would they do that? Dilution of a Torah? 30C dilution of a prepuce?
Also, they say “sexual peculiarities such as anal intercourse”. Just ridiculous. Straight people do it too, and far more commonly than most people think. I know we all don’t put much stock in anecdotal evidence, but here’s mine – (cue Tony the Tiger voice) done right, it’s great. If ever there’s a website relating to it, they can always ask me for an endorsement.

JP, I find nothing funny about a homeopathic “cure” for homosexuality.

The LGBTQ community has enough to contend with, with conversion therapy.

This “study” dovetails so nicely with all those news stories I see about “millennials aren’t having kids!” stories. They’re right there next to the “millennials aren’t buying houses!” stories.

So, to posit: most (all?) of the women and girls who have had the HPV vaccine are either millennials or Gen Y (is that what the kids are called these days?).
The economic situation for young people is less good than for older people (more student debt, lower wage jobs). This is known to reduce birth rates.
Modern contraceptives come in a much wider variety of formats with greater efficacy. (IUD, implant, ring as well as pill).

So it looks to me like a population that is choosing to not have children, for a myriad of reasons, have also been vaccinated against HPV.

Why does Delong assume that a lower birth rate means “can’t have kids” rather than “don’t want kids” or “don’t want kids right now”?

As an aside: to hell with everyone who thinks HPV is no big deal. I have family who have had to have hysterectomies because of HPV-caused pre-cancerous cells, and even that didn’t get rid of the bad cells. And so what if this person was long past menopause? It’s still a worry and a hassle and effing surgery.

“Why does Delong assume that a lower birth rate means “can’t have kids” rather than “don’t want kids” or “don’t want kids right now”?”

I wondered that too. I did not start having kids until I was thirty years old.

Among my friends in my age cohort (a seriously limited sample, I know), some people had kids years ago, some people will never, ever, ever have kids (because of nasty genetic diseases), some people are just now having kids, some people are planning kids in the near future, and some just don’t want kids.

I have no idea about HPV vaccination rates in this group (we’re on the old end and would only have gotten the quadravalent vaccine), but to think that somehow that’s the only factor, that’s just wrong.

I want kids of my own; sadly for that particular desire, I raised other peoples’ kids and loved it. I still want mines.

Alain (passive work in progress)

It kind of goes along with the obsession with female reproduction and the idea that the HPV vaccine somehow ok impairs it, I’d say.

I don’t see them being champions for reproductive rights.

Obviously one of their big problems with HPV is that it is a sexually transmitted disease, and somehow if a woman gets cervical cancer it is a just punishment for sinful behavior. It is obviously not because it could cause autism since it is given long past most are diagnosed.

I am just peeved at certain old white guys making laws that restrict access to health care by women and their children. My “fave” was the guy who wondered since he cannot get pregnant why should he help pay for prenatal care. It is like he did not realize what caused pregnancy and that the desired outcome is a healthy baby.

Ugh. By the way I just binge watched HULU’s “The Handmaid’s Tale.” There were times I was thinking it could be an actual documentary in the future.

My wife and I are about halfway through season two. It’s been going slow because the show is so damned intense that we can’t watch more than two episodes in a sitting and we need a break between viewings.

@ Chris:

I won’t watch that series because I saw a film of it already

the woman who wrote the original book was disturbed by the rise of conservatives and fundamentalist Christians in the 1980s and it thus was her vision of a future dystopia.

At least though, IIRC, Canada remains an oasis of sanity- just like today.

@ DB:

I know.

Today AoA informs us that IQs are falling and the anti-vaccine social movement is GROWING ( actually, it’s two separate articles but it sounds funnier this way).
The second article quoted is by Peter Hotez which graphically illustrates how small isolated pockets of vaccine exemptions have arisen- and NOT where you would think them to be ( California- which is not singled out). It’s worth a look.

Although Idaho, Utah and Arizona would be suspected because of political trends.

Oh the irony that Gayle Delong thinks it’s ok– in her failed quest to link HPV vaccine to POF–to receive help from someone who unethically chemically castrated children with autism (David Geier). I guess the ends justify the means for these folk.

Interesting that somehow use of lupron immediately qualifies as chemical castration in one instance, even though this same drug is approved for use to treat prostate cancer, endometriosis and fibroids. Are those patients also being castrated?

David Foster “Interesting that somehow use of lupron immediately qualifies as chemical castration in one instance”
The focus is not how other doctors treat other patients with the drug, but how David Geier, a man without a medical degree, mis-used it in conjunction with his father.

State of Maryland filing on Dr Mark G: https://www.mbp.state.md.us/bpqapp/Orders/D2425004.271.PDF
And the one for the son, via LB/RB blog: https://lbrbblog.files.wordpress.com/2012/08/d_geier_order28946600.pdf

though this same drug is approved for use to treat prostate cancer… Are those patients also being castrated?

Yes. You could look it up.

@Smut Clyde “treat prostate cancer… Are those patients also being castrated? Yes.”

Sure, but your ellipses jump over endometriosis and fibroids: medical conditions suffered by women. I’m pretty sure that by definition, women cannot be castrated (yeah, I know, why you used the ellipses).

why you used the ellipses
I have been working out on the elliptical trainer.
I think we can agree that when Lupron is administered to boys or men with the specific purpose of switching off their testicular production of testosterone and freeing them from the effects of chronic testosterone poisoning, “chemical castration” is as good a term for it as any. We can also agree that David Foster is being a barmpot and an eedjit for dragging in other uses of the drug.

Sure, but your ellipses jump over endometriosis and fibroids: medical conditions suffered by women.

Hey, I’m male and have a fibroid. On the sole of my foot. In related news, I regret to report that going door-to-door fundraising for MSF was not a sustainable gig for me.

You know Foster, with that question, a cold-stone psychopath would feel his or her first blush in life with pleasure. I’ll leave out my opinion about what that kind of statement compare to but I do think that the Geiers are a worse version of the moral equivalent with Hitler.

Alain

https://explore.org/livecams/panda-bears/happiness-village-garden

Excellent piece, David. If anyone has a reference to a good study of HPV and head and neck malignancy in men, please direct me to it. I have been recommending the vaccine to teen boys but the studies I’ve seen excluded higher risk groups without adequate reasons given. In the meantime, the above link is well worth your time.

Best,

Jay

Pandas from the panderer. How nice. And how ridiculous to bloviate here about any vaccine recommendation you are making, Gordon as: (1) you don’t actually do any vaccine research which makes you utterly unqualified to make such a recommendation, (2) you are anti-vaccine even if you are too addled to admit it.

Hi Chris! Haven’t spoken in a while. I looked up “bloviate” and will try to use it a few times this week so I can add it to my vocabulary. “Pandas from the panderer” might be the greatest line you’ve ever tossed at me here and I must compliment you on turning that phrase. Anybody here want to hear me complain about the inaccurate “antivax” epithet? Me neither.

Hi Dr Jay!

I’m glad to hear that you recommend the vaccine for boys. Can we quote you on that?

Many parents who fear vaccines in general- and this one in particular- might be assured that it’s safe because you believe it is . You have a great deal of influence amongst certain parents who want to choose “safe” and “healthy” options.

And hey, you and Orac can actually agree on something !

Someone who goes on local TV not once but twice during separate measles outbreaks to tell parents not to vaccinate is in no way shape or form pro-vaccine. It’s also equates to being a really incompetent physician. Pretend all you want but you are anti-vaccine and you don’t deserve to have a medical license either.

It’d be nice if Jay Gordon shared his complete recommendations (or lack of them) for HPV vaccination. Does he for instance promote Gardasil or Cervarix for young girls, since their susceptibility to HPV infection and cervical cancer/precancers puts them in a high risk group? And how old are the “teen boys” Jay says he recommends HPV vaccination to? You don’t want to delay giving the shots to young men until they’re in their mid teens or later, by which time many have already begun sexual activity. Is Jay’s conditional support mentioned on his website, to counterbalance antivax jargon and support for woo like homeopathy?

In any event I suppose Jay’s professed support represents minimal progress, since he’s been known for fearmongering against HPV vaccination.

“I don’t like this vaccine… Heaven help us if we have a generation of kids who get a hepatitis B vaccine and a HPV vaccine and they think that now unprotected sex is okay…

I don’t think it is really clear that this vaccine is really as safe as they say it is and it is certainly not as dangerous as they say it is, but I recommend against it in my practice.”

Dr. Jay Gordon discussing the HPV vaccine on the Ricki Lake Show

http://vaxopedia.org/2017/07/16/is-the-hpv-vaccine-a-savior-or-the-most-dangerous-vaccine-ever-made/

Less than a year ago Jay was on Twitter blathering about “worrisome” findings concerning HPV vaccination (a topic that Orac addressed).

Remember, when it comes to antivax stylings and attempts at revisionism and self-back patting, no one knows Jay Gordon like we do. 🙂

Hi Dangerous Bacon! The Lake show segment was was shot five years ago. In the time since, I’ve watched the literature and my recommendation has changed. If a doctor doesn’t adjust to current medical literature he’s not thinking.

I’m interested to know also what changes in the literature came out in the last five years that said measles vaccine was definitely a good idea, as opposed to all the information that was available prior to that…..

So says the expert on “current medical literature” who was so worried about “current medical literature” in his “Preventing Autism” book that he inexplicably omitted all references for Chapter 8.

I’m just surprised she’s gone for the “Autoimmune premature ovarian failure” hypothesis, and ignored the low hanging fruit.
Evil Pharma have been spiking vaccines with female sterilising drugs for decades, so it’s obvious they will be doing it to newer vaccines like HPV too!

She won’t have been able to factor contraceptive use into the analysis unless this was also collated in the NHANES data set.
Was it?
If it was, then you are right, there is reason for not considering it as a factor unless she is either (a) Stupid, or (b) Deceitful.

Speaking of dumpster fires, J.B. Handley’s book “How To End The Autism Epidemic” is due out in September. An excerpt from the promo is indicative of the quality evidence J.B. will be providing readers:

“While many parents have heard the rhetoric that vaccines are safe and effective and that the science is settled about the relationship between vaccines and autism, few realize that in the 1960s, American children received three vaccines compared to the thirty-eight they receive today.”

It’s more like 13 recommended vaccines up through age 18, so J.B. (like so many of his fellow antivaxers) is lying through his teeth.*

*in other news, the sun rose in the east today, the Mets lost again and Trump told another fib.
**given the regularity with which the Usual Suspects crank out antivax books, aren’t even their most devout supporters tired of shelling out $$ for crankery they can read on myriad websites for free?

@ DB:

According to Kim Rossi, who has written several books, her earnings are minuscule.**

Indeed, it seems as though TMs and AoA contributors are trying to create their own section in brick and mortar libraries/ book shops. Perhaps next to the Ancient Aliens shelf ?

** however, she still insults Dr Hotez who has a new book arriving in Sept.

Do you really not understand the difference between vaccine doses received vs. number of different vaccines received? Just look at the recommended schedule and to the math. It’s simple math.

Please tell how the vaccines on the present American pediatric schedule post a harm greater than kids getting diseases like measles, mumps, pertussis, rotavirus, Hib, etc. Just post the PubMed indexed studies by reputable qualified researchers that the number of antigens in vaccines are more hazardous than the antigens in the wild diseases.

Please cite peer reviewed medical literature, linked on PubMed, that describes the effects of any difference between vaccine doses received vs number of vaccines received.

We do get the math that the vaccine schedule does mean many doses are given (often combined into a single injection). What you can’t show, is how that is somehow harmful given there is no link between vaccination and autism or any other medical disorder.

Panacea, Mr. Foster seems to be going on about the number of vaccines. Yes, we can count them, but that does not mean much. He forgets you come up with numbers, you need to actually find out their meaning from context.

Now for more on his rather amusing “too many vaccines!” diatribe, check out his claim further down where it “must be the number of vaccines because autism has risen so much in the past 18 years“. Um, yeah.

He obviously has no clue how little the American pediatric schedule has changed for preschoolers since 2000. Other than special cases, the only actual additional vaccine is for rotavirus.

Considering my oldest actually suffered through rotavirus as a toddler, and was still nonverbal when he was three years old — I am assuming the vaccine is not the culprit. Nor Hib, nor varicella, nor HepB… which my kid also did not get. He did get very sick from chicken pox. (he also never got the DTP vaccine due to neonatal seizures, he only got the DT vaccine, during a time our county was having a pertussis outbreak).

He must really wonder why I need actual veritable scientific evidence for his claims. Obviously he does not understand why a parent who has actually cared for kids with vaccine preventable diseases would want to protect kids from diseases.

Hi, Chris,

David is pulling the blankety blanky number of vaccines trope by counting up the total number of doses and treating them as if they were each given individually, which of course they’re not. As you point out, there’s no context for what he’s trying to get us to look at. Hence, my demand of proof of a problem.

Don’t be proud: a mediocre student in the first year of statistics understands it immediately.

What you wrote after a mention of a Geier chemically castrating children: “Interesting that somehow use of lupron immediately qualifies as chemical castration in one instance, even though this same drug is approved for use to treat prostate cancer, endometriosis and fibroids. Are those patients also being castrated?”

So you are not defending “Not a Doctor” David Geier? Good to know. Then explain why you wrote that comment.

Sigh…you really are that obtuse. I was pointing out that lupron has approved uses for other conditions, and I would guess that the pseudo-skeptics which frequent this site would not argue that doctors using lupron for those other conditions are “castrating” anyone.

I’m not familiar with lupron and I was in no way suggesting that it’s either ok or not ok to use it for children with autism.

So you were changing the subject for no particular reason. It looks more like a deflection from the bad things the Geiers did to kids. I don’t think we are the ones being obtuse.

Especially when you cannot comprehend the significance of the following large research study:
https://sparkforautism.org/discover/

I comprehend that study’s significance, what you do not seem to appreciate is the limitations of that study. Do you really believe that a condition which has, according to the CDC itself, seen an increase in prevalence of nearly 300% in the past 18 years, is solely due to genetics?

If you can answer “yes” to that question then we have nothing left to discuss, you are not worth my time.

Perhaps, but you don’t seem to understand that it includes that there has been an expansion of diagnoses. Also many of those conditions were listed as other things, not autism.

So where are you getting those statistics for the past 18 years, and how does it compare to other diagnoses? Post those CDC links.

Also what has changed in the last 18 years vaccine wise? That was when the thimerosal was removed. This was the schedule in 2000:
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5001a3.htm

The rotavirus is the only thing added for under four years old. Many of the others are for older kids, like HPV. So are you suggesting that the rotavirus caused an increase in autism, or that HPV causes a trip in a time machine for a kid?

By the way, my kid was obviously no speaking when he was three years old. He only got diagnosed about three years ago when he was 26 years old. Plus ten years ago he was rejected by the Developmental Disabilities Administration because his behaviors, etc were not on their list. They added criteria for autism later.

So, yeah, I know how the changes in diagnoses has happened. You need get out of your anti-vax bubble.

If you can answer “yes” to that question then we have nothing left to discuss, you are not worth my time.

The irony, it burns.

Sigh…you really are that obtuse. I was pointing out that lupron has approved uses for other conditions, and I would guess that the pseudo-skeptics

Do not test my patience, yobbo passive-aggressive prick. Who in the motherfucking hell did you think would be here who didn’t know that Lupron had legitimate uses? Go to AoA. You backed yourself into a fucking corner and are now claiming that it was a simple matter of irrelevancy. That’s just0 fucking hemorrhoidal.

I would guess that the pseudo-skeptics which frequent this site would not argue that doctors using lupron for those other conditions are “castrating” anyone.

Hold my beer…
When lupron is used to slow the growth of hormone-sensitive prostate cancer, how in the name of Azathoth do you think it works?

Given how, before the development of androgen deprivation therapy, the treatment for hormone sensitive prostate cancer was surgical castration….

Yeah, no, it’s chemical castration.

David, I have had patients with prostate cancer. Many have undergone surgical castration (no way to disguise that!)
We also certainly tell them they are undergoing the equivalent of “castration” when they receive antiandrogen drugs or Gonadotrophin releasing hormone agonists.
Of course doctors are usually very honest (Wakefield and some others excepted)

Perhaps read this info on prostate cancer before shooting yourself in the foot again.
https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet

Why do pseudoskeptics about Big Pharma drugs ignore/gloss over unapproved/risky/ineffective prescribing of a powerful Big Pharma drug (Lupron) for autistic boys?

It’s similar to pseudoskeptics who go on about shills and money-grubbing doctors, but who idolize Andrew Wakefield.

Or the pseudoskeptics who tell us M.D.s and PhDs can’t be trusted, but eagerly endorse the opinions of the tiny minority of antivax M.D.s and PhDs who tell them what they want to hear, because they hold such degrees.

The mental disconnects and hypocrisy are stunning.

“but eagerly endorse the opinions of the tiny minority of antivax M.D.s and PhDs who tell them what they want to hear, because they hold such degrees.”

But but but, those are special PhDs. The ones that are special are Gayle DeLong’s Phd in finance and Brian Hooker’s in chemical engineering. Let us not forget Gary Goldman’s in computer science.

Actually it is not just the mental disconnect and hypocrisy that are stunning, it is the sheer idiocy.

Classic example of character assassination which is rampant on pseudo-skeptic sites like this. For instance:

“Dr. Goldman has served as a reviewer for the Journal of the American Medical Association (JAMA), Human and Experimental Toxicology (HET), Vaccine, The American Journal of Managed Care (AJMC), Expert Review of Vaccines (ERV), Expert Review of Dermatology (ERD), Journal of the European Academy of Dermatology and Venereology (JEADV), Epidemiology and Infection, The Open Allergy Journal, BioMed Research International (Biomed Res Int), and British Medical Journal (BMJ). He is included on the Editorial Board of Research and Reviews in BioSciences.”

For his work on varicella and shingles surveillance while he was at the CDC, he was uniquely qualified for this research. But lets just call him a computer geek.

Dr. Brian Hooker has a PhD in biochemical engineering, and has published a wide variety of research papers.

So what? Are you sure those are actual journals?

Neither of them could statistic themselves out of a paper bag. Just punch their names in the search feature of this blog, get someone to help you parse what has been written about their pitiful attempts to do statistics.

All Hooker managed to do is prove autism can be avoided by making sure kids get their MMR vaccine on time. Obviously the less than half dozen young black boys who got their MMR vaccines late had been diagnosed with autism, and needed a catch up vaccine to access public school services as required by the Individuals with Disabilities Education Act (mostly because poor folk in this country do not have adequate access to medical care, like vaccines).

For fun and excitement, here is some fun reading for you, Mr. Foster. Do tell us how Hooker did (from the looks of it, he tended to ignore his kid’s doctor for a while). Final Hooker ruling: https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2002vv0472-118-0

Some key quotes:

“On August 20, 2013, Respondent filed a Response to Petitioners’ Expert Report and Motion to Dismiss this case, alleging that Dr. Mark Geier lacked appropriate qualifications to opine on this matter.”

“This screening tool allows medical personnel to indicate a “pass” (“P”) or “fail” (“F”) for each infant milestone, on a chart divided into age groups. At four months of age, Dr. Heller-Bair noted “fail” for three developmental milestones that SRH had not achieved. (Ex. 35, p. 24.) At six months of age, there are again notations indicating that SRH failed to achieve three milestones. (Id.) At nine months, he failed two milestones, as he was not using “mama/dada” and could not sit up alone. (Id.) At his twelve-month check-up, on February 25, 1999, he could only speak two words, and was not yet able to drink from a cup. (Id.)”

“One major reason that both Petitioners’ causation claims must be denied is that Petitioners’ experts relied on assumptions of fact, concerning SRH’s medical history, that are contradicted by the contemporaneous medical records.”

“In addition to his history as an expert witness of dubious honesty and credibility, as well as his medical license revocation, it is also noteworthy that Dr. Geier’s medical professional training is poorly suited to providing an opinion in this case about the causation of ASDs.”

“After studying the extensive evidence in this case, I am convinced that the opinions provided by Petitioners’ experts in this case, advising the Hooker family that there is a causal connection between SRH’s vaccinations and either the initial causation or aggravation of SRH’s ASD, were quite wrong.”

Mr. Foster, you are a “pseudo-autism advocate.” You keep pounding the old tired “vaccines cause autism” trope, while totally ignoring the research that has been done in the last two decades. You cannot even get the changes to the pediatric schedule over the past two decades straight, yet you claim those changes are “horrible.”

The last few sentences of that ruling are very true. It is terrible that not more can be done for families with disabled kids. There are programs that exist, my kid gets SSI disability, but the present US administration is working to destroy them. The present administration wants to reorganize the departments in order take away safety nets:
https://www.nytimes.com/2018/06/21/us/politics/trump-government-overhaul-safety-net.html

I bet you don’t even care. Or understand.

Everyone needs to stop misrepresenting my words. First someone claims I supported treatment of autistic children with lupron. I never said any such thing. You claim that I am glossing over it. I am not.

I was merely pointing out that while use of this drug for autistic children was labeled “chemical castration”, there are other FDA approved uses for this drug and I don’t hear anyone denigrating doctors who prescribe lupron for those conditions.

Perhaps you need to work on learning some basic rhetoric. You seem to say some very silly things. Here is a trick I taught my kids: read the stuff you write out loud to see if it makes any sense.

You may need to work on that.

So, exactly what horrible changes were made to the American pediatric schedule eighteen years ago? Are you lamenting the lack of thimerosal? Or do you miss the days when toddlers would become dehydrated due to a bout with rotavirus. Be specific and include the PubMed indexed studies by reputable qualified researchers to support your answer.

I was merely pointing out that while use of this drug for autistic children was labeled “chemical castration”, there are other FDA approved uses for this drug…

Everybody here is aware of that.

…and I don’t hear anyone denigrating doctors who prescribe lupron for those conditions.

Is that your argument? Seriously? That because Geier uses lupron for a treatment that not only has precious little evidence in support of it but is actively harmful we should condemn physicians who use it for treatments that have solid evidence?

Everyone needs to stop misrepresenting my words.

I was merely pointing out that while use of this drug for autistic children was labeled “chemical castration”, there are other FDA approved uses for this drug and I don’t hear anyone denigrating doctors who prescribe lupron for those conditions.

You seem to be misrepresenting your own words there, or editing them in retrospect to make them seem less stupid. Your initial comment said nothing about “denigrating doctors”. You didn’t even mention doctors.
https://respectfulinsolence.com/2018/06/13/antivaccine-pseudoscience-about-hpv-vaccination-gayle-delong/#comment-396503

David Foster, for the record since these replies are mis-threaded. Apologies in advance for any html errors.

No one is misrepresenting your words.

You don’t get to feign innocence on this.

You responded to Chris Hickie’s comment on June 14, 2018 https://respectfulinsolence.com/2018/06/13/antivaccine-pseudoscience-about-hpv-vaccination-gayle-delong/#comment-396408>at 3:31 pm criticizing David Geier’s involvement in use of Lupron as a treatment for autistic children(and, by inference, the author of the study that is the subject of this post, DeLong) someone who unethically chemically castrated children with autism (David Geier) with a complaint that the same terminology wasn’t applied to other uses of the drug (June 18, 2018 at 2:20 pm).

You were corrected about this quite quickly: see Smut Clyde, June 18, 2018 at 8:12 pm, and since then multiple times in this portion of the thread.

I get it, David Foster. You don’t want to deal with the fact people you hold in high esteem simply because they support your misguided idea that vaccines are related to autism could possibly behave in unethical manner. Because obviously since they agree with you their thoughts, motivations, and actions must be unequivocally good — in spite of ample evidence to the contrary (see my own reply to your first comment). Instead, you attempt to distract folks’ attention away from that unethical behavior.

Your wish that vaccines and autism are indeed somehow linked does not excuse unethical behavior.

The original point here is that the Geiers had a crank fantasy (it did not reach the level of being a ‘theory’) about mercury and testosterone somehow binding together in the body chemistry of young boys to form a permanent autism-causing deposit, which they proposed to treat by suppressing testicular activity in those boys (i.e. chemical castration).

David Foster objected to this terminology, and asked if we would apply the same term to other uses of Lupron:

Interesting that somehow use of lupron immediately qualifies as chemical castration in one instance, even though this same drug is approved for use to treat prostate cancer, endometriosis and fibroids. Are those patients also being castrated?

The answer to his rhetorical question is that when Lupron is administered with the intention of switching off a guy’s testicles and reducing his testosterone exposure, e.g. in his example of prostate cancer, YES that is castration.

That answer does not seem to be the one that was desired, so now Mr Foster is doing the whole ‘Gaslight” thing of denying that he ever made the comment recorded upstream, and claiming instead to have made a completely different comment, not recorded anywhere in the thread, about the denigration of doctors.

David, prostate cancer patients understand they are undergoing chemical castration.
Do you think these 12 year old boys who get Lupron for autism understand that?

While attempting to prop up Gary Goldman’s reputation mostly due to his having served as a reviewer for some journals (as though that establishes expert credentials), David Foster forgot to mention Goldman’s unique contribution as founder and editor of Medical Veritas, the all-time top journal for providing the scientific community with comic relief.

“Medical Veritas is the name of a “medical journal” invented by promoters of alternative and homeopathic medicine. They have even coined the phrase “Journal of Medical Truth” as if to suggest they are the only journal interested in finding truth and fact, and they have recently featured such articles as “Ending Vaccination Humanicide”, “American Academy of Pediatrics’ Shaken Baby Syndrome Fraud”, and my personal favorite “Musical Cult Control: The Rockefeller Foundation’s War of Consciousness Through the Imposition of A=440Hz Frequency Standard Tuning”…One of their Senior Editors is a man (Michael K. Primero) who holds a masters in science and technology and who wrote his masters thesis based upon the premise that HIV is not the cause for AIDS. Another (Tomas Teskey) is a DMV… which is a Veterinarian. His self-proclaimed expertise is not in vaccines or humans, but rather in horses where this expertise (and I quote) is “taking a specialty approach to the equine hoof”.

Not as if we could make this any more entertaining, but the chief editor and founder (Gary Goldman) holds a PhD in Computer Science but no education in any medical related field nor has he spent any time as a medical researcher, and one of the editors is actually Andrew Wakefield… yes that Andrew Wakefield.”

http://vaccineconspiracytheorist.blogspot.com/2011/03/medical-veritas-journal-for-quacks.html

Goldman also has a co-entry in the Encyclopedia Of American Loons, which one could dismiss as “character assassination” if it wasn’t based on fact.

Medical Veritas

There seems to have been a buyout in 2010 by Leonard G Horowitz where it has become an online blog for Horowitz’s conspiraciesthoughts. It apparently retains an editorial board minus Goldman and Wakefield and having accreted Vera Scheibner, Biswaroop Roy Chowdhury and Gabriel Cousens. Several members of the board have been dead for some years, but this should be of no concern, because there is nothing for the editorial board to do.

“published antivaccine nonsense before at least twice”
No at least once (the other link is about a paper published in Accountability in Research. Minor point obviously but still wanted to make it.

Here is an addendum from the author, posted on Age of Autism (see if you can keep your focus on the science here):

http://www.ageofautism.com/2018/06/new-study-links-lowered-probability-of-pregnancy-in-females-25-29-to-hpv-vaccination.html

Executive Summary:

There was indeed a statistically different rate of contraceptive use between women receiving the HPV vaccine and those not receiving the vaccine. Problem is, this difference works in the wrong direction…it can’t explain the main finding in this study.

Any questions?

“In connection with my paper, the question has been raised: Given that married women who had the HPV shot were less likely to conceive than those who did not receive the shot, were the former more likely to use birth control than the latter? My result that married women who received the shot were less likely to conceive could be explained if those women were more actively trying to prevent pregnancy than married women who did not receive the shot.

The three questions on NHANES that provide insights into contraception are 1) SXQ251: In the past 12 months, how often had you had sex without a condom? 2) RHD442: Are you taking birth control pills now? 3) RHQ520: Are you now using Depo-Provera or injectables to prevent pregnancy?

I seek to determine whether married women who received the HPV shot are more actively seeking to prevent pregnancy than married women who did not receive the shot. I define “actively seeking to prevent pregnancy” as women who at the time of the interview were using condoms at least half the time or taking the birth control pill or receiving an injectable. I find 51.5% of married women who did not receive the shot and 36.6% of married women who received the shot were actively seeking to prevent pregnancy. The 14.9% difference is statistically significant at the 1% level.

This finding suggests that a greater percentage of married women who received the shot should be conceiving compared with married women who did not receive the shot. However, my original study finds that married women who received the shot are less likely to conceive than married women who did not receive the shot. The finding of my original study is not the result of married women who received the HPV vaccine actively avoiding pregnancy more than women who did not receive the HPV shot. I’m happy to discuss details of my results with researchers who are interested.”

Gayle DeLong is a prime example of why business professors do not understand medical statistics.

Many women who are married use other forms of contraception than the three listed in the NHANES questionnaire. It did not ask about IUDs, which have become more popular recently with the Affordable Care Act. Plus it ignores the possibility of sterility in women due to other reasons. And it definitely ignores that there are several reasons a husband could be sterile (like having had mumps after puberty). Also, there are other medical reasons for a woman to be sterile that have been documented decades before there was any kind HPV vaccine.

Contraception is a huge confounder. As explained by Orac in a comment mentioned by Dorit, Gayle DeLong is doing the numbers to get the answer she wants. That is just one factor in her incompetence. The other is that she simply does not know how to the math for epidemiology.

When I was taking calculus as a college freshman majoring in engineering, there was a common joke scribbled on the blackboard. It was written using math symbols that essentially said as the math grade point average of the engineering student tends towards zero then the student tends towards a business major. (by the way, I did get an engineering degree, but I know that I am not competent with epidemiology, though I understand it a whole lot more than DeLong).

Any questions?

Yes, one. ¿Cómo se dice? Data, not hand-waving.

“Keep your focus on the science here,” my fucking prolapsed hemorrhoid.

Those questions don’t cover IUDs (very effective) the Ring or the Patch. So the analysis is still missing a huge part of the story.
Here’s another factor: the US is a hot mess right now and maybe, just maybe, women don’t think this is the kind of place to raise a child. Why not compare fertility rates in a similar country with strong HPV coverage that isn’t currently in semi-turmoil? How about Australia?

And more to the point, you (and DeLong) haven’t actually shown a problem, let alone a causal relationship.

I forgot about two of those. But, then again, I hit menopause almost twenty years ago, so not an issue (in addition to dear hubby getting snipped after youngest was born 24 years ago, the other option I allowed was abstinence). I still remember the rather annoying diaphragm that caused bladder infections. Are they still in use?

Remember this is the woman who tried to mangle the numbers of kids with autism by claiming those who were getting school services for Speech/Language Impairments. Uh, huh. Sure, yeah. This lumps in kids who have hearing impairments, stutters, strokes, head trauma, cerebral palsy, and on and on.

She teachers finance. I would hate to see how she mangles the numbers for someone’s retirement savings. (by the way, when you hit about age sixty you will get lots of invitations for free dinners by financial planners who really really want to work with your retirement plan)

Orac addressed this in a comment here. I’ll just add that doing a separate analysis of whether women who get HPV vaccine are more likely to be taking oral contraceptives than those who did not get the vaccine is not a substitute to controlling for that factor in her original analysis.

She’s not trying to answer whether there’s an association between HPV vaccines and contraceptive use. She’s trying to look at a link between HPV vaccines and fertility, and contraceptive use is a confounder. This additional analysis does not substitute for controlling for contraceptive use.

Yes of course according to the highly educated social programmers, it is education and the “great recession” that has people not getting pregnant anymore.

JUST A COINCIDENCE that Gardasil hit the market in 2007 and that was when the amazing decline started. Those kids sitting around playing bridge saying, “Gosh you know, with this recession we shouldn’t be having sex and even if we wanted to I know so much more about it now that I will just pass.”

Nothing worse than highly educated, uninformed and ignorant people.

So when you got married, did you automatically decide to become a baby making machine? Or did you actually plan when to start your family?

If you read the comments you will see that several forms of modern birth control were not included in Prof. DeLong’s study. This seems to be a pattern with this business school professor, just like kind of forgetting to count things that are important or adding things that are not relevant (by the way, kids who need speech therapy for stuttering, cerebral palsy or hearing loss are not automatically considered autistic).

And yes, it is just a coincidence that Gardasil hit the market a year before very bad international real estate crash and recession. The family of hubby’s Dutch cousin lost their home due to this global recession. My mother-in-law could not sell her home of forty five years so she could move to a retirement community after becoming a widow. My sister and her hubby would love to sell their home to move elsewhere but its value is still below what they bought it for in 2006.

Yeah, sure… a couple is thinking that it is a good idea to have kids when there is a good chance they will lose their house. Uh, huh. What kind of alternate world do you live in? Obviously it is one where reading comprehension is not valued.

I was referring specifically to teenagers that they claim are using the economy as a determining factor to decide to not have sex – that was the laughable point. That’s why I said KIDS sitting around deciding to not have sex because of the economy, which is utter BS.

The only age range that did not have a decline in pregnancy is women over 40. Again I am sure it’s just a coincidence that none of them would have gotten the Gardasil shots but every other age group would have and ALL had a decline.

Shari Peterson: Yeah, but “kids” these days are just plain having less sex, and girls are more likely to use long-acting forms of birth control which are more effective than short-acting ones. And the long-acting forms of birth control were not included in the data set used in this analysis.

also, here’s a thought: It’s the recession, teenage people can’t get jobs so they can’t afford the car or the gas to get together to have sex.

Or, another consideration: kids these days spend less time hanging out in physical proximity to each other than they have in the past. Now they hang on Snapchat or Instagram, not at the mall. It’s remarkably hard to have reproductive sex over the internet. (This is also seen with the drop in teen drinking.)

Le sigh: birth rate reduction has actually been documented during the last recession:
http://www.pewsocialtrends.org/2010/04/06/us-birth-rate-decline-linked-to-recession/

Here is a another suggestion: Ms. Peterson should stop making blatant assertions without any evidence. Perhaps actually look up some research.

Hey, I can make a blatant assertion: perhaps sex ed got better and teenagers actually know how use birth control. It helps to have teachers like the gentleman who had to explain something very important even though Mississippi censors what they can teach:

(courtesy of a recent Radiolab episode).

So on down a bit Chris said this:

“So you also hate both ice cream and kids playing outside:

Polysorbate 80 is an emulsifier commonly used in ice cream.

A kid gets more aluminum by running around outside and scraping their knees in the dirt. Soil is made up of minerals with lots of aluminum since it is the third most common element on this planet’s crust.”

I’m sorry, but someone who says things this patently stupid really should stop being condescending. To anyone.

This is way over the NWMT threshold.

Oh, Mr. Foster, you are just hilarious! I have actually taken and passed my college chemistry courses, so I do understand what I have written. Even though you do not.

Have you found any of those PubMed indexed studies by reputable qualified researchers not on the Dwoskin payroll that show any vaccine on the present American pediatric cause more harm than the diseases?

Have you figured out why this research project pretty much destroys much of your “vaccines did it” arguments: https://sparkforautism.org/discover/

This is way over the NWMT threshold.

Apparently not, unless there’s some additional “threshold.”

Yes of course according to the highly educated social programmers

Do go on. I’m pretty well educated, looking for work, and in with the Jews.

you won’t get paid for it but maybe updating your knowledge base might find appeal. Somehow all the educated folks out there in Internet land aren’t aware that both Polysorbate 80 (aka Tween 80) and aluminum (all put in the Gardasil shots) have negative reproductive impacts. Do a little research on the pubmed website and see what has gone down in rat studies with those chemicals.

But yes for sure it’s about the economy and not the chemicals contained in the vaccines that are positively correlated to reduced reproductive capacity.

So you also hate both ice cream and kids playing outside:

Polysorbate 80 is an emulsifier commonly used in ice cream.

A kid gets more aluminum by running around outside and scraping their knees in the dirt. Soil is made up of minerals with lots of aluminum since it is the third most common element on this planet’s crust.

Do a little research on the pubmed website and see what has gone down in rat studies with those chemicals.

Well, I could do with fewer rats, and it seems like a more appealing approach than outright poisoning. Put them in bait, and you have a large-scale study for peanuts.

Somehow all the educated folks out there in Internet land aren’t aware that both Polysorbate 80 (aka Tween 80) and aluminum (all put in the Gardasil shots) have negative reproductive impacts.

Citation needed.

Do a little research on the pubmed website and see what has gone down in rat studies with those chemicals.

Nope. You made the claim, so you produce the evidence. That’s how it works round here. Also, rats are not humans. Produce proof that this occurs in humans.

The study fails to consider the very high rate of chlamydia causing PID which directly lowers fertility odds. Is there a correlation, as in a culture, in which a physician and parents who vaccinate for HPV are more likely to be open minded about sexual activity, which in turn leads to higher rates of promiscuity and STDs in those patients? If you take cervical cancer off the table, is a girl more likely to have unprotected sex figuring there’s an easy cure for the other STDs (and abortion for pregnancy)? My family practice doctor pushed (sets of 3) HPV vaccines on my 2 daughters, assuming they would be sexually active “so let’s be proactive about it.” Ten years later, one of them has had 2 pregnancies that were aborted, chlamydia twice, and now has PCOS with 4 complex cysts and a mass, plus she has UC. There was a study (I believe UK) that suggested a correlation between chlamydia and the antibiotics used being a trigger for the onset of UC. This was the timing in my daughter’s case, I believe that is how/when the UC started. Long story short, the promiscuity and unprotected sex DID lead to pregnancies, it also lead to chlamydia and PID and possibly PCOS and autoimmune disease. The sexual activity did this, not the vaccine. Underlying all of it is the possibility that the culture in our home, backed up by our physician, lead to the assumption that sexual promiscuity was a foregone conclusion. The failure was mine, not Gardasil’s. BTW, she does NOT have HPV after all of this. One last question, do people lie about abortions out of guilt and shame? It is possible that aborted pregnancies were not self-reported in the study.

Is there a correlation, as in a culture, in which a physician and parents who vaccinate for HPV are more likely to be open minded about sexual activity, which in turn leads to higher rates of promiscuity and STDs in those patients? If you take cervical cancer off the table, is a girl more likely to have unprotected sex figuring there’s an easy cure for the other STDs (and abortion for pregnancy)?

Very doubtful. My understanding is that lack of access to contraception does not affect sexual activity.
Further, your comment is one used by antivaxxers. They try to insinuate that access to the protection given by the vaccine leads to promiscuous behaviour. In fact, they call Gardasil the “slut vaccine”.
Finally, revealing that info about your daughter was highly inappropriate, I think.

Comments are closed.