Hard Conversations: Vaccines and Autism, Part 1

 Before I get into the meat of this series of posts, let’s start with a word or two for any parents or loved ones of someone with autism reading this, because this whole series of articles is really for you. I understand that receiving a diagnosis of autism is frightening and while I’m not a parent, I understand that nothing could possibly be more important to you than the well-being of your child. I feel for you, and know that it must feel like the world is changing and the ground shifting underneath your feet as you react to this information. I’m sure that what you want is some certainty. It must kill you to hear things like “We don’t really know what causes autism.” Or “We don’t have a cure for autism”.

 I know that you want what is best for your child. Because that’s what you want, I encourage you to not act rashly after getting a diagnosis. Before you make decisions about how to change your lifestyle and how to help your child, you should do some research.  I welcome you to start here, and later on in this series I’ll compile a list of some good resources. Along the way, I hope to also point out the bad resources, and how to determine what is a good or bad resource.

To start with, I’d like to talk about autism in the media. Autism has been in the news a lot lately, most recently TIME magazine had a q&a with Jenny McCarthy who is releasing a new book on the subject.

The biggest problem with how the media has covered Autism is that the media has committed the Gray fallacy. Briefly, the Gray fallacy says “well if you say black, and he says white, surely the truth must be grey”.  This is not correct.

A more nuanced description of this is the Relativity of Wrong. The relativity of Wrong explains that there are differing degrees of correctness. The classic example is that the earth is neither flat, nor spherical. However spherical is much closer to the truth than flat.

How does the media commit these mistakes? When the media covers autism, they often present autism as if “Vaccines cause autism” and “Vaccine’s don’t cause autism” are equally valid points. These points are not equal.

For those who don’t like reading about science, skip down a bit.

There is alot of scientific information suggesting vaccines do not cause, and are not correlated with autism.1,. I have yet to find one good article that supports the hypothesis that vaccines cause autism. If you find such an article, please email me (my contact information is available on the contact page of this blog) and I will read the article, and post my thoughts. I encourage parents to read my references at the bottom of the page here.

The scientific case for “Vaccines cause autism” is just slightly better than the scientific case for “The earth is flat”.

 For those people who struggle to see the science here, at least consider the common sense point. We do not know what causes autism, there are almost as many explanations of autism as there are experts on autism. What are the odds that one particular explanation, which lacks any evidence on its side, is correct?

Extraordinary claims demand extraordinary evidence. While the Anti-Vaccine proponents often offer anecdotal evidence, and then give made up numbers, such as Jenny McCarthy’s

“All you have to do is find a schoolteacher or principal and ask them that question. They would say they’ve never seen so much ADHD, autism, OCD as in the past. I think we’re overdiagnosing it by maybe 1%.”

 You’ll notice, she doesn’t give evidence, she offers an anecdote. Anecdotes are not real evidence, everyone has a story of  a friend of a friend. Thats why we do evidence based medicine. After that she gives a completely unsubstantiated number saying we’re overdiagnosing by maybe “1%”. This is not science. This is not medicine. This is deception.

 In my next few posts, we’ll talk about why you should trust scientists over Jenny McCarthy or any other celebrity. Afterwards I will detail some of the science on this subject, through explanation of at least one scientific study. I will also explain some of the biases that crop up when we use anecdotal evidence instead of science.

Please feel free to post any comments, thoughts, or questions you have. If something I’ve written is unclear, absolutely ask me here to clarify, my goal with this is to make the science as accessible as possible to as many people as possible.

For now, enjoy!

-Whitecoat Tales

Link to Part 2 here.

PS: Hat tip to Orac over at Respectful Insolence both for his numerous posts raising awareness of this issue, and his most recent post bringing the Time magazine article to my attention.
PPS: When commenting, please remember: keep the comments respectful, especially to people with autism, and their parents and loved ones.

References
1.Autism Spectrum Disorder: No causal relationship with vaccines DOI: 10.1111/j.1440-1754.2007.01239.x
2.DeStefano F (2007). “Vaccines and autism: evidence does not support a causal association”. Clin Pharmacol Ther 82 (6): 756–9 doi:10.1038/sj.clpt.6100407. PMID 17928818.

 

Last edit on 4/23/09: added link to part 2

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78 Comments on “Hard Conversations: Vaccines and Autism, Part 1”

  1. irisevelyn Says:

    Your relativity of wrong fallacy is confusing. The way it is written I think it means that there are no differing degrees of wrongness, but that things are either wrong or true. You probably want to say the opposite, don’t you?


  2. Thanks!
    I can see where the language wasn’t perfect. I’ve attempted to edit it slightly, but I’m not sure if it’s a whole lot better.

    For anyone who gets this far and is confused: There ARE degrees of correctness.


  3. Jenny McCarthy Wants Your Children Dead…

    …or at least seriously maimed by allowing them to catch Polio or Measles. She’s been at this for a while, but today Time has an article online where they quote a couple of her gems that are worse than usual:
    I do believe sadly it’s going to take …

  4. Ruth Says:

    As a parent with a PDD-NOS child and lots of odd family members, it is easy for me to see that autism has always been with us. They were just called shy, slow, weird. Thirty years ago, kids with disabilities were not permitted to go to public school, so those older teachers didn’t have them in their classrooms.

    My oldest brother was born in 1946, and always had trouble with reading. Teachers just called him stupid or lazy. If he were going to school today, he would be called dyslexic, and given special ed.


    • Thank you for posting Ruth.
      I agree that alot of the rise in autism can be attributed to changes in diagnostic criteria. Later on in the series I’ll go over some things that agree with that, and why it might be a GOOD thing instead of a bad thing.

      A Photon In The Darkness posted showing some statistics that lean towards exactly what you’re saying.

      http://photoninthedarkness.com/?p=158

  5. Diana Says:

    Nicely done, WT.

    Looking forward to the next installments.

  6. Daniel J. Andrews Says:

    Orac has linked to this article so dropped on by to read it. I’m looking forward to reading more of your postings now. Best wishes on your foray into the blogging world.

  7. Uncle Dave Says:

    “All you have to do is find a schoolteacher or principal and ask them that question. They would say they’ve never seen so much ADHD, autism, OCD as in the past. I think we’re overdiagnosing it by maybe 1%.”

    Agree completely with that.

    There is an interesting dissertation discussion just within that general population diagnosis element alone. Some would claim that it is more than 1%. Although I would tend to agree with your percentage.

    • Landru Says:

      Overdiagnosis isn’t an issue. McCarthy is either deliberately or ignorantly confusing the diagnosis classification issue with “overdiagnosis,” to support her ignorance about the difference between incidence and prevalence, which underpins her denial of science that increasingly pins the increase in autism incidence on diagnostic and awareness changes over the last two decades.

      Whitecoat Tales, thanks, and I look forward to more.

  8. Mu Says:

    Autism has become the political correct diagnosis for what used to be mental retardation. Mental retardation used to be diagnosed in 1 % of kids, and that’s cut in half now. Unsurprisingly, it’s not that the overall intelligence of kids has increased (or correspondingly the overall IQ of the population has sharply decreased, so I’m not too sure about that), but we now have half a percent of autistic kids.
    Now, no one has ever claimed to cure mental retardation with diet and medication, but for some reason this is going to work on the reclassified autistic group? Jenny Mc and her followers are taking the mental repression to the extreme, it’s not an inherited trait, it’s not a defect acquired in early pregnancy, and for sure it’s not the parents fault. Why deal with reality if you can opt out?
    If it’s a curable condition triggered during the toddler stage it becomes societies duty to take care off, and if nothing fails, we can go back to the early 20th century approach of institutionalization, after all, their soul is no longer there.


    • Jenny McCarthy’s opinions aside, its not necessarily a bad thing that many of these children are being classified as autistic rather than MRDD (For the uninitiated, MRDD=mentally retarded or developmentally disabled).
      Autistic children need different resources to reach their academic, and really life capacities, making sure we diagnose them correctly means they’ll get appropriate access all of the specific therapies that will help them succeed.

      • Mu Says:

        I completely agree, unfortunately some of them get only access to different therapies, not appropriate different therapies.

  9. trrll Says:

    “The relativity of wrong” makes the important point that while we may not be confident that any of our medical or scientific beliefs are entirely correct, that does not make all beliefs equally valid, or more importantly, equally useful for practical purposes.

    If you believe the world is perfectly round, you are wrong, but for most practical purposes you are close enough, you may have some small navigational errors from not taking into account the oblate nature of the earth, but you will end up close enough to get to where you are trying to get to. If you believe the world is flat, you will make massive navigational errors, and are likely to get lost. It is not merely wrong, but dangerously wrong.

    Believing that vaccines cause autism is dangerously wrong, because people who decline to vaccinate because of that belief place their children, and everybody else’s children at risk of things that are as bad or worse than autism, and they do so to no benefit, because vaccines simply do not cause autism.

    Now one frequently hears for vaccine phobics something like the following, “But how do you know that vaccines never cause autism? Couldn’t there be some very small number of children who have something wrong with them that doesn’t cause any harm unless they get vaccinated? Maybe kids like that Hannah Poling girl, who developed an illness after vaccination that, while it wasn’t at all like typical autism, had some features of autism?

    And the scientific answer, which tends to be unsatisfying, is, “No, we can’t prove, that getting vaccinated, or riding in cars, or watching TV, or drinking Coca-Cola, or anything else, never causes autism. What we can tell you is that the risk, if it exists at all, is so small compared to the risk of the diseases that vaccination protects against.”

    It is much the same as seat belts. Nobody can ever prove that you won’t ever get into some kind of weird crash where you are more likely to survive if you are thrown through your windshield and out of you car. All we can say is that the odds of survival are very much better if you wear your seatbelt.

    • John H. Says:

      It is much the same as seat belts. Nobody can ever prove that you won’t ever get into some kind of weird crash where you are more likely to survive if you are thrown through your windshield and out of you car. All we can say is that the odds of survival are very much better if you wear your seatbelt.

      I know a woman who survived a serious crash in her BMW convertible precisely because she was ejected from the car. Anecdotally one could argue (and she now eschews seatbelts completely) that not wearing your seatbelt will save your life, but no matter how you look at it, your odds of survival are much, MUCH better if you’re strapped in.

      If you doubt, look at the experts: the race drivers. What kind of restraints do they wear? Hmm? They’d much rather risk a devastating fire while strapped in their burning car, than being smashed, bug-like, against another car (or the wall).

      Ms. McCarthy’s irrational denial of the value of vaccines is extremely dangerous, arguably more than either seatbelt or helmet laws, because it’s not just her family that’s at risk: it’s everyone else’s.[/captainobvious]


    • Thanks Trrl, that was far clearer than my gibberish on the relativity of wrong – really, that and gray fallacy could be entire posts or more on their own.

  10. Dawn Says:

    Hi!

    Thank you for the invitation to comment on your writings. I do understand that there is no scientific evidence linking vaccines to Autism. However, I also understand that the studies that have been done to date were missing critical pieces of evidence. The latest study that was done in Italy cannot be acceptable as viable either because it is a different country with a different lifestyle. They may/may not be exposed to the same chemicals that we are in the U.S. For example, are they exposed to the same amount of MSG in their diet as Americans? Do they have fluoridated water? Are their vaccines manufactured by U.S. manufacturers? Are they comprised of the same ingredients? Are they given in the same schedule as the U.S.? There are definitely many other factors to consider in this epidemic too. It is not just about vaccines. Yes, vaccines are the toxic tipping point for far too many people.

    I find it appalling that the CDC claims that mercury was taken out. That is a lie! Many vaccines do still contain mercury – in trace amounts though. If a manufacturer uses mercury in any of their vaccines, then more than likely the mercury will still be present in their so-called mercury-free vaccines. Do I believe that mercury is the sole cause of Autism? No? Again, it is just one factor.

    Why are we relying on the CDC’s reported statistics for cases of Autism anyways? Why aren’t we relying on statistics from say Easter Seals (Early Intervention) and the U.S. Dept of Education? Those statistics are more accurate.

    I had to play detective with my own son. His story is found on my blog. Some very big clues were his serious vaccine reactions, his regression in milestones, his developmental delays, and his sensitivity to chemicals. Last summer he was exposed to a PVC kiddie swimming pool. His eyes were inflamed for 2 weeks. He was then left with “purple shiners” until I removed gluten and casein from his diet. A chemical that he was exposed to caused a serious reaction in him. Children with mitochondrial disorders cannot tolerate chemicals or viruses well. They are extremely sensitive to both.

    If tens of thousands of parents in the U.S. alone are claiming that their children are recovering from Autism, why isn’t the CDC looking at this? I just don’t understand. If numerous doctors and scientists are also claiming the same thing with documented proof of this, why isn’t anyone investigating this? Why isn’t the media all over this?

    I believe that my son may very well have a Mitochondrial Disorder. If you look at this disorder and compare it to Autism, they are one in the same. Based on my own personal experience, I can honestly say that very few neurologists in the U.S. even know about this disorder and how to test for it. So, why is the CDC stating that 20% of Autistics are suffering from this disorder? Where did they get these statistics? I had to be the one to make the phone calls to find someone skilled enough to make the diagnosis. We are still in the process of finding out. The neurlogist did tell me though, that with the supplements that my son is taking and the diet that he is on will make it extremely difficult to prove that he has it. Why? Because if he does have it, I am assisting his mitochondria. My son is currently on the DAN protocol that Jenny McCarthy used for her own son, Evan. My child is recovering also. It is hard to believe that not too long ago he was walking on his toes, flapping his hands, spinning in circles, and so much more. Much of that behavior has disappeared too.

    Why is it so hard for a learning disabled child to qualify for an IEP in the U.S.(Special Education)? If 1 in 6 children are currently in an IEP for their neurological deficits, what are the real numbers? My own teenage son was in schools all across the country, went through the IEP evaluation process 5x and was told repeatedly that his scores are average. Yet, he cannot perform simple math equations (addition and subtraction!) or comprehend more than a paragraph of reading material! This alone tells me how enormous this problem really is. Apparently, he is doing just as well as his peers! That is scary!


    • Dawn I’d like to thank you for coming to this potentially hostile forum and sharing with us.

      I’d like to address everything you’ve written here, but its a pretty diverse set of complaints. I’ll be addressing some of them in Part 2. Note that I will not be discussing the Italian study, but American studies.

      I encourage you to get other people with your opinions involved in the discussion here. I want an open dialogue, and I’d like you guys to look critically at both the information I’m giving you, and the information that you’ve been handed by others.

      A reminder to everyone: Keep it respectful, no name calling, no All caps posts (I WILL REMOVE ANY POST THAT LOOKS LIKE THIS), and remember that we are talking about peoples children, and their lives, not merely statistics – we’re all bound to get emotional on the subject.

  11. Michael Says:

    Dawn, your missive is interesting, though filled with inaccuracies. MSG simply does not have any scientific effect on the body. It is a salt of glutamic acid, an amino acid required for building of proteins. Vaccines are essentially the same for all countries, manufactured by one or two companies. In fact, to keep supply stable, manufacturing is consistent. Tens of thousands of children with autism? Mercury has been taken out of vaccines, and you might want to look at your can of tuna fish or sushi for larger quantities of mercury.

    I don’t want to argue with you point by point, since a long refutation of every one of your points will end up being quite snarky.

    • Laura Says:

      Michael, as a neuroscientist I have to rebut your point about MSG. I don’t believe that American MSG consumption has a significant effect on autism rates, but it’s also not true that MSG “does not have any scientific effect on the body.” Glutamate is the primary excitatory neurotransmitter, and when present at abnormally high concentrations it can kill cells through a process known as excitotoxicity — too many ion channels open in response to the glutamate, too much calcium gets into the cell, and many important cellular processes are disrupted. While glutamate does not normally cross the blood-brain barrier (special pumps transport appropriate amounts of glutamate into the brain, probably to avoid neuronal damage caused by systemic fluctuations in glutamate concentration), there are parts of the brain that are not protected by the blood-brain barrier, and other cells in the body besides neurons are also subject to glutamate excitotoxicity.

      Of course, too much of anything can be hazardous, even water. How much MSG is too much? Experimenters commonly use single 4 mg/g doses of MSG to induce robust excitotoxicity in lab animals. For a 75 lb child, the equivalent dose would be almost 5 ounces of pure MSG at once, which is nigh impossible to ingest through normal foods. Other studies (work by John Olney at Washington University of St. Louis covers lots of research on this topic) suggest that lower levels of MSG sometimes found in food can cause neuroendocrine disorders in juvenile animals, and possibly human children as well. (The hypothalamus, which regulates most neuroendocrine function, is not protected by the blood-brain barrier. It could conceivably be harmed by high glutamate levels in the blood after eating too much MSG.)

  12. Dawn Says:

    More on this – we need to stop looking at whether or not vaccines cause Autism. If the CDC wants to play the “new label game” then we need to start looking at whether or not they cause Mitochondrial Disorders. It makes perfect sense that so many parents claim their child regressed after the MMR vaccine. This is the first live-virus vaccine that most children receive. The other is the flu and I have heard of many children regressing after this vaccine also. Again, children with Mitochondrial Disorders cannot tolerate viruses well – to include the weakened versions found in vaccines. How prevalent are these Disorders? How do we know who will/will not be affected? We don’t as of yet.

    So, do vaccines cause Mitochondrial Disorders or aggravate them or both? My son does NOT have any genetic disorders commonly associated with this particular type of disorder. So, either science hasn’t caught up yet or it was a condition that occurred after his birth….again, we are waiting for the “official diagnosis”, but that may never happen.


    • Dawn I appreciate your posting, But start posting references, so far you’ve made alot of sweeping comments, I’ve asked for references from everyone, I can’t check what information I’m not given access to.

      The flu vaccine is not normally a live vaccine – the shot is a killed vaccine, the nasal spray is a live vaccine, I have not seen a single study showing “regression” in relation to the live or killed flu vaccine

  13. Dawn Says:

    Michael,

    Mercury has NOT been taken out…..it has been “phased out”. There is a difference. They are not the same. Any chemist will tell you that if the manufacturer uses mercury in any vaccines, it will be found in trace amounts in the others. You simply cannot remove mercury 100% because it binds with other agents during the filtration process. So, what you are left with is “trace” amounts – meaning .3 mcg or less. However, some vaccines have had up to .5 mcg. How many vaccines does a 2 month old receive? Just a few “trace” amount shots would exceed even the FDA’s and EPA own guidelines…based on consumption not injection. Even then, the type of mercury used in vaccines cannot be studied on humans because it is “unethical”. Whatever.

    • Michael Says:

      Dawn,

      Once again, I have no idea how to reply to a reliance on testimony rather than scientific evidence. Also, ad hominem arguments bear no weight with me. In reply to your comments about mercury, several comments have already dismissed you arguments.

      If you would like to discuss the science of autism and of vaccines, I’m most willing to do so. But I won’t discuss pseudoscience, since those ideas are based on non-scientific, non-testable hypotheses.

      Scientific and clinical studies have shown over and over again that vaccines are not linked to autism in any way. Now, I’m willing to critique the methodologies of those studies, but not with an appeal to emotion or appeal to some other authority.

    • trrll Says:

      Mercury has NOT been taken out…..it has been “phased out”. There is a difference. They are not the same. Any chemist will tell you that if the manufacturer uses mercury in any vaccines, it will be found in trace amounts in the others. You simply cannot remove mercury 100% because it binds with other agents during the filtration process. So, what you are left with is “trace” amounts – meaning .3 mcg or less. However, some vaccines have had up to .5 mcg.

      Some vaccine phobics are desperately hanging onto this “trace amount” argument, because they are so emotionally invested in the mercury-autism notion. In some respects, they are encouraged in this fallacy by frequent media hysteria over the discovery of trace amounts of some drug or toxin in water or in people’s bodies, without clarification of the crucial role of dose in determining biological effects.

      It is virtually certain that every molecule in nature, natural as well as all of the synthetic chemicals used by man, exists in air, water, food, and yes, the human body, at some “trace” level. As our methods of measuring small numbers of molecules improve, we detect more and more examples of the trace levels that have been their all along. For the most part, they are harmless. Here’s why:

      Paracelsus is famously credited for the insight that (paraphrased) “the dose makes the poison.” Today, we understand the molecular basis of this medical homily. For the vast majority of toxins, a single molecule is unable to do any harm at all to the body–the damaging effect is the outcome of a very large number of molecules acting simultaneously in different places. Below some threshold dose, the toxin becomes utterly harmless. The rare exceptions are mostly substances that chemically react with DNA to cause mutations in the cell. For these, there is some finite probability of harm from a single molecule–but that probability is infinitesimally small. Thus, even for those compounds that react with DNA, as the number of molecules (the dose) decreases, the risk also decreases.

      What that means in terms of mercury is that as mercury has been removed from vaccines, fewer and fewer people are being exposed to less and less mercury. No, mercury will never be gone entirely from food, or water, or vaccines, but if there were anything to the mercury/autism notion, the incidence of autism should have dropped as mercury exposure decreased, rather than continuing to increase as actually happened.

      Vaccine phobics want to have it both ways–they argue that the increased incidence of autism is due to increased exposure to mercury, but they refuse to confront the logically unavoidable corollary: that decreased exposure to mercury should have reduced autism incidence.

  14. Joseph Says:

    “The latest study that was done in Italy cannot be acceptable as viable either because it is a different country with a different lifestyle.”

    Irrelevant, Dawn, considering that a much bigger, more detailed and methodologically more sophisticated study was done in the US prior to that one.

  15. Joseph Says:

    “Mercury has NOT been taken out…..it has been “phased out”. There is a difference. They are not the same. ”

    There’s documentation that shows thimerosal could only be found in less that 3% of vaccines by early 2002. It was phased out rather quickly. It’s silly to suggest that pediatricians routinely keep vaccines manufactured in the 1990s around.

  16. John H. Says:

    We’ve been having a debate about very small levels of mercury that used to be in some vaccines. Can newborns get mercury via mother’s milk? Surely they’re exposed to other “toxins” as well. The real answer is that the benefit of mother’s milk far outweighs its dangers. All of life is a risk and there are no guarantees.

    I feel for Dawn and her child. I wouldn’t wish that on anyone. It’s natural to want to find someone to blame, even if no one is culpable (or even if everyone is culpable). Life is risky. To expect vaccines to be entirely risk free … that’s not a reasonable expectation. It simply isn’t.


  17. One last quick hit from me before I go try to get Part 2 out this evening!

    A huuuuuge thanks to Orac for linking here, I never expected this big a response. Thanks to everyone for posting.

    I appreciate everyone keeping the tone respectful so far, just one thing I forgot – whenever possible please provide references for any claims you make!

    Thanks again guys!

    -Whitecoat Tales

  18. Dawn Says:

    As of right now, it is not a law that vaccines be mercury-free – at least there is no law that I am aware of. There is also quite a bit of flexibility for manufacturers on behalf of the FDA with regard to labeling products. So, who exactly has tested these vaccines to be sure that they are in fact, mercury-free? There has only been one organization by the name of Hapi (see http://www.hapihealth.com for vaccine testing). While some may claim that a can of tuna fish has more mercury than some vaccines containing “trace” amounts, again, children with Mitochondrial Disorders are extremely sensitive to mercury and vaccine ingredients in any amount. A standard can of tuna fish by the way has roughly 17.5 mcg of mercury. Even then, it is not the same mercury that is found in vaccines.

    John H., a study was done on breast milk (I cannot recall where I read it), but breast milk was found to contain roughly 20% toxins. The benefits of breastfeeding far outweigh the risks. There are more risks with giving your child formula these days – melamine being one of those lovely risks.

    Yes, it is about weighing the risks and benefits. My child’s risks outweigh his benefits for vaccinating – this straight out of his pediatrician’s mouth. After researching vaccines and diseases for over a year now, I have found that the risks outweigh the benefits for everyone – infant, children, and adults. The CDC’s “risks” associated with disease outlined are based on statistics dervived mainly from 3rd world countries. If you want to know the real “risks” associated with disease, take a look at the U.S. statistics on each disease 1-5 years before each vaccine came on the market. You will find your answer when you do that.


    • A few points on this one before I move on to part 2.
      – I’m not sure what 20% toxins means.
      – I’m also not sure what you mean when you say it’s “not the same mercury” found in vaccines, all they taught us in med school infact said that mercury found in canned tuna was exactly the kind of mercury to be of note.
      – You are entirely incorrect when you say we should look at the U.S. statistics on each disease 1-5 years before each vaccine came on the market. The reality is that the medical system today is strained to breaking point. My institution has literally not had a free bed since november (and I go to school at a large tertiary care center in a metropolitan area).

      Increasing the thoroughput on a full hospital system would NOT result in the same mortality seen in the 1-5 years before vaccines came on the market, when the hospitals were prepared for rushes of Measles and the other childhood diseases. Infact, many institutions don’t have units set up for epidemic infectious disease anymore. It’s rare tofind a complete “isolation unit” even in big hospitals for example.


    • Additionally you have mentioned Mitochondrial disease a very large number of times throughout this series of posts.

      While I know you want to help your child, you haven’t told us anything that would make a doctor thing “now this child has a mitochondrial disease!”.

      The statistics say that mitochondrial disease is infact quite rare, I’ll be addressing that in a later post as well. This is one of several reasons why the Hannah Poling case doesn’t prove vaccine’s cause autism, and isn’t particularly applicable to the discussion we’re having.

  19. Dawn Says:

    Joseph, you had stated that there was a much larger study done in the U.S. before the Italian study? Which one was that? Could you reference it for me? I was only aware of a study done shortly before Italy and it only contained 30 something children. That’s hardly a study.

  20. leigh Says:

    bang-up job on hitting the hard issues! you are off to a great start blogging! i think one of the most important skills you can convey as a physician is how to evaluate the quality/credibility of a source. the general public is quite open to a wide variety of definitions of “expert” while we in the scientific community are far more particular. this makes for a big discrepancy when we interact.

  21. Laura Says:

    Great post. The “Gray fallacy” is an important point that comes into play with so many issues related to science in the public sphere, e.g. “teaching the controversy” of evolution vs. intelligent design. Anyone can espouse a theory; not all theories are equally valid.

  22. skepticat1 Says:

    Very nice and very sensitively written post, thanks.

  23. blackwaterwolf Says:

    Welcome Dawn,

    I’d just like to point out to you that your comment

    “Children with mitochondrial disorders cannot tolerate chemicals or viruses well”

    suggests you may be victim to the “chemicals bad, natural good” fallacy. First of all it is important to understand that ALL matter is chemical in nature. Water is a chemical. Air is a chemical. Dirt is a chemical. Further, the artificiality or otherwise of a chemical does not inherently determine whether or not a substance is “good” or “bad”. Consider, if you will, botulin toxin, the deadliest substance none to humanity, which is entirely natural. Also consider the tropane alkaloids that come from the plant belladonna, very toxic, and entirely natural. Equally, there are a great many artificially created chemicals that are utterly benign or even beneficial to humans, not least being artificially created hormones like insulin, or even artificial water, salt, or atmospheric gases.

    • Robert S. Says:

      Water is a chemical, air is a small handfull of chemicals, dirt is a whole tanker full of chemicals. Oh, and the tetanus toxin is even more toxic then botulin iirc.

      Remember folks, nothing is quite as “natural” as decomp.

  24. DrBadger Says:

    Nice start with the “Gray fallacy.” It’s a universal problem in the media, not just with medical reporting, but with almost anything. They love making a big fight out of everything. Anyway, I look forward to the series. Hopefully you get a more civilized discussion about it here.

  25. Dawn Says:

    It really doesn’t surprise me that the people that shout “Vaccines don’t cause Autism” are the ones who also shout “Mitochondrial Disease is rare”. These two statements couldn’t be farther from the truth.

    I suggest you read “The Management of Mitochondrial Disease” by Mark Korson, M.D. – Tufts-New England Medical Center, Boston, MA

    (much of the treatment outlined in the paper above involves supplementation of CoQ10, Vitamin B1, B2, C and E)

    and read “The Spectrum of Mitochondrial Disease” by Robert K. Naviaux, M.D., PH.D. and Angie Longenecker, R.N.

    http://biochemgen.ucsd.edu/mmdc/ep-3-10.pdf

    After you’ve read those two, then attend a DAN conference – there is one actually scheduled in May

    http://www.autismone.org/?goto=chicago

    After you have accomplished all three, you will then begin to understand that recovery is possible and Mitochondrial Disease is not rare – it is more prevalent than you could ever imagine possible. Much of the treatment recommended by DAN doctors address treating an underlying Mitochondrial Disorder (not for all patients, but many).

  26. DLC Says:

    You’re right, it is a hard conversation.
    But then, I was there when my mom and dad had the
    “Your son has hepatitis ” conversation.
    That too was a hard conversation. One Doctors and Parents should be spared as much as possible.

  27. John H. Says:

    I just now got back to this thread. Just one final comment:

    After researching vaccines and diseases for over a year now, I have found that the risks outweigh the benefits for everyone – infant, children, and adults.

    I am sorry, Dawn, but that is categorically incorrect. You are entitled to your opinion, but the small–some might say infinitesimal–risk posed by vaccines is nowhere near equal to the toll once wrought by these diseases. That, too, can be googled–I did. (Just polio alone should convince you.) In order for vaccines to pose a commensurate risk, there would have to be a significant death rate (name your percentage) from people receiving vaccinations. There is no such death rate. If there were, could you really believe doctors would recommend them to their patients? (Doctors are people, too.) Do you think I would get a flu shot if there was even a 1% chance that I could DIE?

  28. Dawn Says:

    The risk with any vaccine is death. SIDS is just one of the many manifestations of an underlying Mitochondrial Disorder. I would hardly call 10,000 deaths each year in the U.S. “a small risk” of vaccinating, not to mention unexplained heart failure, kidney failure, liver failure and on and on. Many of the mitochondrial disorders have been discovered so recently that they have not yet made it into medical textbooks or, in some cases, the medical literature.


    • I have asked multiple times for references to be given with extraordinary claims.
      Never have I seen reputable evidence saying SIDS is a manifestation of mitochondrial disease.
      Additionally, the CDC has set up a page explicitly pointing out the evidence that SIDS and vaccines are unrelated
      http://www.cdc.gov/vaccinesafety/concerns/sids_faq.htm

      The cause of SIDS is not yet known, lots of mechanisms have been proposed. The best preventative action known to prevent SIDS is to place your baby to sleep on his/her back.


    • Many of the mitochondrial disorders have been discovered so recently that they have not yet made it into medical textbooks or, in some cases, the medical literature.

      Doctors who discover diseases, are doctors whose names I need to learn in school.
      Any realistic proposition of new diseases or disorders would be in the medical literature. that is where they would be proposed to be potentially a new disease, let alone accepted as a new disease.

  29. Jen Phillips Says:

    Many of the mitochondrial disorders have been discovered so recently that they have not yet made it into medical textbooks or, in some cases, the medical literature.

    Well if they haven’t hit the primary scientific literature yet, I have to wonder how you know about them. And, once again, your sweeping claims need references, please.

    Very nice post, whitecoattails! Welcome to the fray :)

  30. Michael Says:

    Whitecoattails, really, welcome. And please note that one of the key tenets of pseudoscience is “assertion of claims of secrecy or proprietary knowledge in response to requests for review of data or methodology.” You just can’t win.


    • Thanks kindly, both for the posts and the warning.
      But I’m not posting here to change Dawn’s mind, I know I’m not going too.
      I’m posting here so that some other parent stumbling across us will read this as part of their Google U education. My hope is that I can warn some people before they’ve comitted themselves to pseudoscience.

  31. passionlessDrone Says:

    Hi Whitecoat Tails –

    You seem to have decided to take a decidely cordial tact in discussing this issue. You are most definitely to be applauded for this. Thank you.

    After researching what I can, I’ve come to taking the position that we just haven’t really studied the process of vaccination in terms of long term neurological consequences in small subsets of children. Evaluating mercury contents is well and good, and made sense, but it gives us precious little information as to the effects of artificially generating an immune response at earlier and earlier stages in a child’s life, when the immune system is still developing. As we learn more about autism, this seems (to me) to be a large void in our knowledge if our population of interest has been shown to have an immune system drastically different than their undiagnosed peers. Please understand that I’m not arguing that vaccines cause autism so much as that the assurances that they cannot be having an impact are vastly overstated; and indeed, are largely based on studies that were designed before we understood how profoundly disturbed the immune system appears to be in the autism population. My biggest concern is, what if we haven’t been asking the right questions?

    A large amount of scientific literature tells us that the immune system of children with autism are highly dysregulated; in many cases indicating problems regulating immune responses. We also have signs of an ongoing inflammatory immune process in the brain and CNS of children with autism.

    The true list of references is very voluminous, so I’ll post some of the more recent findings here.

    (I’m hoping this particular flavor of software supports links)

    We hae three studies showing an active immune process in the brains or CNS of children with autism.

    Elevated immune response in the brain of autistic patients

    Elevation of tumor necrosis factor-alpha in cerebrospinal fluid of autistic children

    Neuroglial activation and neuroinflammation in the brain of patients with autism

    Peripheral to the CNS, we also have several studies showing dysregulated immune responses; again indicating a predisposition towards a proinflammatory state.

    Elevated cytokine levels in children with autism spectrum disorder

    Pro-inflammatory cytokines in autistic children in central Saudi Arabia

    Activation of the inflammatory response system in autism

    It turns out, we also have some indications of why we might be seeing such a skew towards an imbalance of cytokines towards an inflammatory state; several key regulatory components of the immune system have been shown to be dysregulated in autism; and again, in a fashion predisposing towards ongoing inflammation.

    Macrophage migration inhibitory factor and autism spectrum disorders [Of particular interest here, (to me), is that genetic promoter regions were associated, allowing us to cast doubt on a dual causation possibility.]

    Decreased transforming growth factor beta1 in autism: a potential link between immune dysregulation and impairment in clinical behavioral outcomes.

    Decreased serum levels of transforming growth factor-beta1 in patients with autism

    The first two studies showed correlation between circulating values and autism behavior severity. The Molloy paper referenced previously also showed decreased levels of IL-10.

    Unfortunately for our children, it doesn’t stop there. It turns out, when tested in vitro, children with autism have been shown to generate much more robust immune responses to a variety of stimulants including environmental pollutants, bacteria and / or viral proteins or agonists, and common boogeyman food proteins.

    Preliminary evidence of the in vitro effects of BDE-47 on innate immune responses in children with autism spectrum disorders

    Proinflammatory and regulatory cytokine production associated with innate and adaptive immune responses in children with autism spectrum disorders and developmental regression

    Dysregulated innate immune responses in young children with autism spectrum disorders: their relationship to gastrointestinal symptoms and dietary intervention

    So, it seems we have several lines of evidence of immune dysfunction in autism, including:

    1) An ongoing inflammatory process in the brain and CNS. I’ve had it proposed that this could be benificial, or at least have benificial components. While technically possible, I think that any intellectually honest evaluation of our knowledge of chronic neurological conditions and immune activation tells us that, in general, you are better off without an ongoing immune response than with one.

    2) Outside of the CNS, again we have several studies showing increased rates of inflammation. Again, considering what we know about other diseases with similar immunological profiles, I think it becomes safer and safer to say that this is a bad thing, as opposed to potentially a good one.

    3) When we measure known immune modulators, again we find wild discrepancies between autism and non diagnosed children. Considering what we have found as far as end states, finding disturbances in some of the underlying regulatory mechanisms hardly seems surprizing. Here, we have at least two studies showing correlations between values and autism severity.

    4) When we stimulate blood cells from chidren from autism, they generate pro inflammatory cytokines at rates far outpacing their undiagnosed peers. This appears to be consistent with a variety of stimulating factors.

    (Please note: there are many other studies, including those indicating auto antibodies to brain tissue, cerebral folate transporters, reduced cd4+ counts, and others. The above list is by no means exhaustive.)

    All of these effects are invisible to thimerosal related studies. MMR studies, which comprise the remainder of studies involving autism and vaccines measure only a fraction of the immune schedule, and indeed, one that follows much later in life than the end of the vaccine schedule that has increased so drastically in the past twenty years. This, in itself, is sufficient to cause me to evaluate statements that the vaccine schedule has been exhonerated by quality science with great, great skepticism. We only learn about what we evaluate, and the truth is, we just haven’t evaluated the effect of artificially generating immune responses at earlier and earlier ages in infants. By way of example, you cannot show me a vaccine / autism study that involves anything other than the MMR or thimerosal; they just don’t exist. Of all the canards in this debate, the notion that ‘vaccines in general’ have been studied in autism is a big one; and one you’ll find repeated ad naseum in places that seem to take great glee in disputing psuedoscience.

    But we do know that the act of vaccination can cause modifications to cytokine profiles up and above measurements of seriopositivity. For example, in Modulation of the infant immune responses by the first pertussis vaccine administrations researchers found distinct differences in the TH1/TH2 shift between infants who got DTP versus those that got DTAP, and those changes were persistent for several months. This study wasn’t initiated until eight years after we started adopting DTAP! If you go hunting for studies on other very early childhood vaccines, like Hib, Hep B, or Polio and resultant measurements on cytokine changes other than antibody generation, you won’t find anything. I’d be happy to be proven wrong on this.

    It seems that because we cannot imagine a way that the generation of immune responses early in life could create physiological profiles consistent with autism, it must not be the reality; even though we have not analyzed it.

    Even still, all this proves is that the immune system is abberant in autism, and that we haven’t bothered to evaluate if the act of vaccination could set in process a cascade of events eventually resulting in a behavior set consistent with autism. However, what we are learning very recently is that early life immune insults, including those that are comprised of nothing more than LPS, or tnf alpha, are capable of generating lifelong behavioral and physiological traits with parallels to autism. Unfortunately, we primarily reliant on animal models that have some big hurdles mapping across to humans; but in the absence of studies on humans at all, some knowledge is no doubt better than none at all.

    Postnatal Inflammation Increases Seizure Susceptibility in Adult Rats Here researchers showed that initiating an immune response in rats resulted in permenant increased succeptibiilty to seizures. You could block this effect by administering tnf-alpha antibodies; and indeed, you could generate the result by administering straight tnf-alpha; i.e., no actual bacterial protein was necessary. Further, the effect was only present during very specific developmental timeframes. It just so happens, children with autism go on to develop epilepsy at highly increased rates than their non diagnosed peers. What’s more, in some instances, having seizures during the first year of life has been shown to highly increase risk of autism in some groups. Risk of autism spectrum disorders after infantile spasms: a population-based study nested in a cohort with seizures in the first year of life.
    So, we know that children with autism generate tnf alpha at rates far outpacing children with autism in response to a variety of factors. In animals, we know that tnf exposure in critical windows can result in increased succeptibility to seizures. It also seems likely that having a seizure early in life greatly increases your risk of developing autism. Evaluating thimerosal or the MMR gives us precious little insight into this interplay.

    Other recent studies indicating that an early life immune response can cause long term behavioral and physiological outcomes include:

    Long-term disorders of behavior in rats induced by administration of tumor necrosis factor during early postnatal ontogenesis

    Neonatal inflammation produces selective behavioural deficits and alters N-methyl-D-aspartate receptor subunit mRNA in the adult rat brain

    Long term alterations in neuroimmune responses of female rats after neonatal exposure to lipopolysaccharide

    There are many others that show similar findings; but most alarming (to me) is that we are just beginning to begin testing on rats the effect of stimulating the immune system in early life; a decade after aggressively decreasing the age at which our children began receiving similar stimulations. If we don’t even understand the implications in rats, one wonders where all the certainty comes from in human infants?

    Finally, I’m not arguing that vaccines could cause all autism, or anything like it; in fact, if anything, I’d tend to believe they may exhibit a small risk factor for some kids. No doubt there are a large number of genetic, epigenetic, and environmental causes intersecting to create a physiology consistent with what is seen in autism. But the notion that parents questioning autism haven’t read the science, or are reliant on Jenny for knowledge isn’t always accurate. Likewise, just because it is shouted from the tops of buildings that vaccines have been studied, doesn’t mean they have been.

    Thanks again for your tone and for listening.

    – pD

  32. John H. Says:

    … We just haven’t evaluated the effect of artificially generating immune responses at earlier and earlier ages in infants.

    I’m ignorant, here. What’s the salient difference between “natural” immune responses (i.e., totally uncontrolled and uncoordinated–essentially random) and “artificially generated” immune responses (specific). What is “too early”? Why does one seem “good” while the other is characterized as “bad”? Why is it better to get (and potentially die from) measles, for example, than to be vaccinated against it? Because, whether early vaccination is good or bad depends wholly on the nature of the diseases being prevented. Unless I’m completely wrong.

    Even if some children were predisposed to developing autism and somehow vaccines are contributing to it, would this be an argument for throwing out vaccines? No. It would be an argument for 1) identifying the specific autism indicators, and 2) modifying the schedule for those children, as appropriate. Right?

    To my point, Ms. McCarthy’s recent commentary that exposing everyone’s children to polio was preferable to “sh*t vaccines” (her comments were in response to that very question) is way out of line. Do not sacrifice my grandchildren to your irrational fears!

  33. passionlessDrone Says:

    Hi John H –

    What’s the salient difference between “natural” immune responses (i.e., totally uncontrolled and uncoordinated–essentially random) and “artificially generated” immune responses (specific).

    Well, the biggest difference to my mind is that is that we have control over one and not the other; specifically the timing of administration.

    Also, there may be subtle to detect differences in small numbers of children as a result in the way in which vaccines work; remember, they have still poorly understood ingredients that are used to insure an appropriate level of immune response is generated. This is a big difference than a natural infection; and in fact, is critical to how vaccines generate an immunological memory without really making you sick.

    What is “too early”?

    Good question. I only wish we had some reliable science on which to start forming an answer. The overwhelming bulk of vaccine safety studies in regards to timing of vaccines involves measurements of very obvious things that occur within a narrow timeframe; i.e., fevers, seizures, and dying. Then, a few months later, perhaps, you are tested for immunity; i.e., did it work in making you immune? But what you cannot show me is a study wherein one group of children was vaccinated at two months, the other at six, and neurological outcomes visible at three years were evaluated for. Considering some animal studies show that the timing of an immune challenge makes all the difference in the world, the fact that we haven’t really evaluated this in humans leaves me pretty unsure.

    For example, specific to autism, these researchers found that administration of an agent shown to increase autism in twins caused behavioral and physiological changes in animal models; but only if administered during critical timeframes

    Neuroinflammation and behavioral abnormalities after neonatal terbutaline treatment in rats: implications for autism

    Why does one seem “good” while the other is characterized as “bad”?

    Well, I’d rather characterize them as both inadequately studied if our objective is to understand subtle and/or long term changes. The difference, again, is we have control over one.

    Why is it better to get (and potentially die from) measles, for example, than to be vaccinated against it?

    I never said that it was. Further, if you’d read my post, you’d see that my concern lies in large part in the vaccine schedule components that come far, far before the MMR, and for which, we have essentially no evaluations in terms of behavioral outcomes. Your argument is a false dichotomy in any case.

    Because, whether early vaccination is good or bad depends wholly on the nature of the diseases being prevented.

    I’m not arguing that vaccines don’t save lives. Nor am I arguing that earlier vaccination, therefore, doesn’t potentially save more lives. But if you only know half the equation, it makes it difficult to truly discern the cost / benefit ratio.

    Even if some children were predisposed to developing autism and somehow vaccines are contributing to it, would this be an argument for throwing out vaccines? No.

    I have not made such an argument.

    It would be an argument for 1) identifying the specific autism indicators, and 2) modifying the schedule for those children, as appropriate. Right?

    We are in complete agreement! Unfortunately, the conventional wisdom is that such a process is unecessary; and indeed, even proferring such a suggestion is likely to get you labeled as an ‘anti vaxer’. Unfortunately, at this time, such a course would be very expensive, and we aren’t really sure ‘which’ biomarkers might serve as warning signs, if any at all.

    Do not sacrifice my grandchildren to your irrational fears!

    I’m sorry that you feel my arguments are not rational. I guess I’ll have to work on my presentation even further.

    – pD


    • I don’t feel that you are being irrational, rather even the original post appears to directly say he’s referncing Jennifer McCarthy, regardless of your opinions, hers are irrational.

  34. trrll Says:

    There are many others that show similar findings; but most alarming (to me) is that we are just beginning to begin testing on rats the effect of stimulating the immune system in early life

    The immune system is going to be stimulated early in life whether you vaccinate or not. We all exist from birth in a sea of antigens, to which the few additional antigen exposure provided by immunization are very much a drop in the ocean. Even with the use of adjuvants, the immune response provoked by immunization is less than that produced by actual infection. So the rational conclusion from the data you present is that immunization may be even more important for the protection children predisposed to autism. It is worth keeping in mind <a href=”http://autismnaturalvariation.blogspot.com/2007/09/simple-selection-bias-model-explains.html” Generation Rescue survey that found that autistic spectrum disorders were 3 times more common in unvaccinated girls than vaccinated girls (boys showed no significant difference either way).

  35. passionlessDrone Says:

    Hi Trrl –

    We all exist from birth in a sea of antigens, to which the few additional antigen exposure provided by immunization are very much a drop in the ocean.

    Technically true, but very few of these antigens are provided a bypass through our bodies natural defenses, the skin, mucuous, and gastric acid. You are comparing apples to oranges.

    By way of example, rates of fever in the days after common childhood vaccinations are along the rates of 20 to 30%. Yet, in the days not following common vaccination, children do not have fevers anywhere close to 30% of the days. What are we to make of this, if the ocean of antigens our children are swimming in are equivalent to the antigens they are exposed to in a vaccine? Do you have an explanation for this apparent paradox?

    Further complicating our ability to reach such conclusions based on such gross oversimplifications are many of the papers I posted above. For example:

    Modulation of the infant immune responses by the first pertussis vaccine administrations

    Here we see that the infants had different immunological profiles months afterwards depending on which version of the vaccine they got. I’m open to an explanation as to why you believe the multitudes of everyday exposures over the course of two months did not deter our ability to make a distinction between which type of vaccine the infants received. Shouldn’t this be impossible if the responses generated from vaccination were ‘a drop in the ocean’?

    Or in this study:

    Postnatal Inflammation Increases Seizure Susceptibility in Adult Rats

    Presumably the rats in this study were also existing in the same sea of antigens as our children, and yet, only those rats who were injected with LPS developed increased succeptibility to seizures, and only if it happened during specific timeframes. Why would this be the case, if everyday exposure was the same as what comes from a syringe? Why do you suppose there was such a large difference in the outcomes between the two groups?

    Even with the use of adjuvants, the immune response provoked by immunization is less than that produced by actual infection.

    I’ve seen this argument made many times, and I’ve seen it backed up by empirical evidence exactly zero times. Do you have any references for this claim?

    You have also subtly substituted everyday exposure to antigens with infection. Why? A two month old is very, very, amazingly unlikely to be infected with pertussis, diptheria, tetanus, meningitis, and polio simultaneously, but we initiate an immune response to all of them at once at the two month well visit check up.

    I’d love to see you provide a reference that showed us what the immune resopnse looked like in a two month old who was infected all of those diseases simultaneously versus one who was immunized. Do you have any such references to back your claim?

    So the rational conclusion from the data you present is that immunization may be even more important for the protection children predisposed to autism.

    But if the timing of an immune challenge is important, our ability to determine the cost benefit ratio is highly suspect if we have performed no evaluations. Many animal models seem to indicate this is the case; as far as human models go, we just haven’t studied it well if our objective measures move into neurological outcomes that are only diagnosable several years after administration.

    Generation Rescue survey that found that autistic spectrum disorders were 3 times more common in unvaccinated girls than vaccinated girls (boys showed no significant difference either way).

    Your reliance on blogged responses to a very poorly constructed phone survey is telling, though not in the way you’d like it to be.

    – pD


    • By way of example, rates of fever in the days after common childhood vaccinations are along the rates of 20 to 30%. Yet, in the days not following common vaccination, children do not have fevers anywhere close to 30% of the days. What are we to make of this, if the ocean of antigens our children are swimming in are equivalent to the antigens they are exposed to in a vaccine? Do you have an explanation for this apparent paradox?

      You have also subtly substituted everyday exposure to antigens with infection

      There is no paradox.
      Firstly, you have faileed to provide a reference for your number, so I have provided my own. Per the WHO only DTP has a fever rate >10%. There is no paradox becuase of your mistake in the next portion. Exposure and immunization are equivalent, we develop immunity to many of those antigens we have been exposed to, whether or not we are noticeably (and a fever is noticeable) infected by them.

      Additionally, in both of your posts, you do post alot of science, I will do my best to take a look through all of it, but much of it may not be address until further on in the series if it all. Theres a good reason for this.

      You have presented alot of “devil is in the details” ideas on why vaccination might be a risk factor for ASD or other issues, or whether timing of vaccination might be important.

      I’m not denying that those are valid research topics, some day, some grad student will slave away on them.

      The problem is that you’ve lost the forest for the trees. If you form any sort of hypothesis about vaccinations being important to a diagnosis in this way, this would leave a characteristic epidemiologic pattern. We see no such epidemiologic pattern.

      While I agree that using a generation rescue phone survery is suspect as references go, the point trrll makes is that the references that do exist, fail to see any such pattern.

      Please do not reply by commenting the studies are of insufficient elegance to determine such a correlation. We have seen a supposed “epidemic” of ASD diagnoses, if you DO attribute it to vaccination (which I understand, is not really your contention) than the gross epidemiologic data would support that.

      Much of the research involving autoimmunity in Autism is exceedingly interesting. Whenever they find whatever the cause/causes of autism are, I’m sure immune response will play a role. I’m also sure genetics will play a role, and luckily, immune response and genetics are closely linked.

      However to make a convincing argument using all those studies, you need to provide me a good reason to doubt the data I’ve given you the other way.

      And from your posts, it appears you have not read my references from the initial post.

      Thank you for posting, I really do want to have an open dialogue on this subject, but I want it to at least start with the known, directly applicable evidence. If you feel that this evidence is inadequate, than please post your refutation of the studies I’ve already provided

      Ref:
      Supplementary information on vaccine safety. Part 2: Background rates of adverse events following immunization
      http://www.who.int/vaccines-documents/DocsPDF00/www562.pdf

  36. passionlessDrone Says:

    Hi whitecoattails –

    Firstly, you have faileed to provide a reference for your number, so I have provided my own. Per the WHO only DTP has a fever rate >10%.

    The DTP hasn’t been routine administered in this country for almost a decade. According to the CDC, fever rates for its replacement, DTaP are 1 in 4.

    http://www.cdc.gov/vaccines/vac-gen/side-effects.htm

    From the same document, pneumococcal conjugate vaccine shows fever side effects at 1 in 3.

    Or, check out the fact sheet for a combination vaccine, Pediarix:

    http://www.pediarix.com/hcp/why-combination-vaccines.html

    Administration of PEDIARIX was associated with higher rates of fever relative to separately administered vaccines (see Adverse Reactions section of the package insert).

    It turns out, getting a different vaccine for the same diseases results in differential immune responses. They aren’t even the same amongst themselves, how can they be no different to what we are exposed to everyday? Would you argue that there is no difference in robustness of the immune response between vaccination and everyday exposure?

    In order for the everyday exposure is the same as vaccine exposure to have validity, we shouldn’t be able to detect differences in fevers. But our observations are the opposite.

    Please do not reply by commenting the studies are of insufficient elegance to determine such a correlation. We have seen a supposed “epidemic” of ASD diagnoses, if you DO attribute it to vaccination (which I understand, is not really your contention) than the gross epidemiologic data would support that.

    How would the gross epidemiologic data possibly hope to show a relationship it was never designed to evaluate? If a study evaluated smokers who took cigarettes with tar, and those who took tar free cigarettes failed to find a relationship with cancer, this wouldn’t be a situation of relative lack of elegance, but rather, inappropriate design. The fact that we have run the same test a dozen times woudl have no impact on as far as making the result any more reliable.

    I really do want to have an open dialogue on this subject, but I want it to at least start with the known, directly applicable evidence. If you feel that this evidence is inadequate, than please post your refutation of the studies I’ve already provided.

    The first reference, “Autistic spectrum disorder: No causal relationship with vaccines” contains only references to the MMR and thimerosal.

    Your second reference, “Vaccines and autism: evidence does not support a causal association ” makes it clear that the entirity of our research is either thimerosal based, or MMR based.

    Despite compelling scientific evidence against a causal association, many parents and parent advocacy groups continue to suspect that vaccines, particularly measles-mumps-rubella (MMR) vaccine and thimerosal-containing vaccines (TCVs), can cause autism.

    And here, again, we see the sublte attempt to push all vaccines into this extremely narrow subset. If your thread was titled, ‘MMR vaccine, thimerosal containing vaccines, and Autism, Part 1′, these would be great supporting references.

    Our available evidence concerning the MMR and thimerosal are OK and good. I suppose we differ in how much we believe we can safely extrapolate those findings to other factors of vaccination as quality ‘directly applicable evidence’.

    – pD

    – pD

  37. trrll Says:

    Technically true, but very few of these antigens are provided a bypass through our bodies natural defenses, the skin, mucuous, and gastric acid. You are comparing apples to oranges.

    On the contrary, microorganisms bypass our body’s natural defenses systems all the time. Most of the time, the consequences are not particularly severe, because the immune system clears them out. The skin and mucous membranes are not the perfect impregnable barriers that you seem to imagine. Lesions in the mouth, a hotbed of bacteria, are not at all uncommon. Teething begins as early as 3 months. As kids begin to toddle around, scratches and scrapes are common, and bacteria are on virtually every surface. And many viruses move quite readily across mucous membranes; that’s why some of them are so contagious.

    I’ve seen this argument made many times, and I’ve seen it backed up by empirical evidence exactly zero times. Do you have any references for this claim?

    Immunization often does not produce as long-lasting immunity as a full-blown infection, and the symptoms of immune activation, such as fever, are generally far more severe and protracted with infection than with immunization for the same disease.

    By way of example, rates of fever in the days after common childhood vaccinations are along the rates of 20 to 30%. Yet, in the days not following common vaccination, children do not have fevers anywhere close to 30% of the days.

    Nobody is saying that every single day brings an infection with comparable immune activation to a vaccination, so it is ridiculous to expect children to show fever 20-30% of the days in a year. But fevers are very common in children. A more informative ratio is: what fraction of occurrences of fever in a typical year are vaccine related? Many children do not show any febrile response at all to vaccination, yet almost all children have several instances of fever in a year.

    Here we see that the infants had different immunological profiles months afterwards depending on which version of the vaccine they got.

    And this is remarkable why? Different formulations will likely be more effective in present some antigens than others. I expect that children infected with different strains of a virus will also show different immunological profiles. The immune response is a type of cellular memory.

    I’d love to see you provide a reference that showed us what the immune resopnse looked like in a two month old who was infected all of those diseases simultaneously versus one who was immunized.

    Don’t you think that this is kind of a silly demand? I’m sure that it must have happened occasionally before vaccination, but I doubt if anybody knows what the immune response would have been. The likely outcome would be death rather than immunity. Fortunately, immunization is a far more mile experience than infection–that is, after all, the point. Even symptoms of immune activation, such as fever, are mild, yet protection is provided to diseases that produce very intense immune activation, often with fevers that provoke seizures (and sometimes death).

    Presumably the rats in this study were also existing in the same sea of antigens as our children, and yet, only those rats who were injected with LPS developed increased succeptibility to seizures, and only if it happened during specific timeframes.

    Injection with LPS simulates a very severe infection, with far more severe symptoms of immune activation than with immunization, or with most exposures to environmental microorganisms in which the immune response develops fast enough to keep the infection in check. One difficulty in doing this sort of experiment is that it is not uncommon for rats injected with LPS to die. So I think this highlights why immunization is so important.

    But if the timing of an immune challenge is important, our ability to determine the cost benefit ratio is highly suspect if we have performed no evaluations. Many animal models seem to indicate this is the case

    Really? Give me just one example of an animal model in which a standard vaccination produces severe neurological complications at one age and not at another.

    Your reliance on blogged responses to a very poorly constructed phone survey is telling, though not in the way you’d like it to be.

    I do find it telling that a survey, conducted by an organization with an anti-vaccine bias, and whose weaknesses in construction were of a sort that would be expected to exaggerate any autism-causing effect of vaccines, found exactly the opposite. Surely if vaccines constituted any substantial risk factor for development of autism, then even a poorly- constructed survey ought to be able to pick it up, don’t you think?

    The numbers are available on the web site I referred you to. Run them yourself if you don’t like the blog analysis.

  38. passionlessDrone Says:

    Hi Trrl –

    Nobody is saying that every single day brings an infection with comparable immune activation to a vaccination, so it is ridiculous to expect children to show fever 20-30% of the days in a year.

    Whew! I didn’t think we’d ever get to this point. Doesn’t this make a straight equivalency between everyday exposure and vaccines also ridiculous? If vaccines are just a drop in the ocean, why do they seem to be having such a disproportiate effect?

    A more informative ratio is: what fraction of occurrences of fever in a typical year are vaccine related? Many children do not show any febrile response at all to vaccination, yet almost all children have several instances of fever in a year.

    Technically true, but again, there are things we control, and things we don’t. If the CDC rates of fever are accurate for DTAP and pneumococcal, we have undertaken a path to insure that one third of our two months old infants develop a febrile response. Sure, actually catching one of those diseases would have far worse complications, but the chances of that are very, very remote.

    And this is remarkable why? Different formulations will likely be more effective in present some antigens than others. I expect that children infected with different strains of a virus will also show different immunological profiles. The immune response is a type of cellular memory.

    It is remarkable because it is additional evidence against the claim that vaccine exposure is a drop in an ocean. The immunological profiles found didn’t have anything to do with cellular memory, but rather, broad shifts in the arms of the immune system. I’d expect that rates of immunity (how memory is measured) to the diseases targeted were likely very similar.

    Your claim that you expect children with different strains of a virus to have different profiles prevents a problem for your underlying argument. Lets assume that your analogy of a drop in the ocean is correct, and also we will assume that exposure is the same thing as infection.

    By your reasoning these children ought to each have their own, personalized little immunological profile; after all, they all were exposed/infected by a unique mix of bacteria and viruses with the exception of which vaccine recipe they received. Yet, we still were able to observe the effects of this single event, months afterwar. If vaccine exposure is so insignificant, how was the difference between vaccines able to create a detectable pattern between the children, considering each was exposed to thousands, or hundreds of thousands of different bacteria and viruses in the intervening months? Shouldn’t they each have had their own unique profile?

    Don’t you think that this is kind of a silly demand?

    I’d agree that it is. The point I was trying to make there is that it seems that reliance on common sense seems OK in one instance (the immune response generated by a vaccine is smaller than actual infection), but not OK in another, (because children experience fevers at differential rates on days following vaccines and other days, our ability to meaningfully comnpare the two is impaired). You seem to have agreed with me on this, in a roundabout way. (I think).

    Injection with LPS simulates a very severe infection, with far more severe symptoms of immune activation than with immunization, or with most exposures to environmental microorganisms in which the immune response develops fast enough to keep the infection in check.

    Can you provide some references on this point, that LPS injection creates a far more robust immune activation than immunization?

    The important point, however, is that the studies I have posted above found that it wasn’t the LPS that was the problem, but rather, the resultant immune response. Use of tnf alpha antibodies provided the same effect as the control group.

    Don’t forget that our specific subset of children have been observed to generate far more robust immune responses to a variety of factors than their undiagnosed peers, including increased generation of tnf alpha. The assumption that they will respond in the same way as other children is a poor one.

    Surely if vaccines constituted any substantial risk factor for development of autism, then even a poorly- constructed survey ought to be able to pick it up, don’t you think?

    But there are any number of other poorly constructed studies that I could post that show exactly such a relationship. Do you really believe that initiating a duel of poorly constructed studies contributes to the discussion?

    – pD

  39. John H. Says:

    At this point the educated layman calls this thread officially off topic. The discussion, while fascinating, has become almost incomprehensible to the non-science members of the audience. I know–I’m one of them.

    For passionlessDrone, I was misunderstood. I was responding to Jenny McCarthy’s statements, not yours. In fact, most of my commentary (in that comment) wasn’t specifically directed to you. Anyone could help clarify my concerns. I’m pretty sure I’m not alone in that regard. It was my error for not making that clear. I wanted to see if a layman could stay in the discussion past the first couple rounds. The jury is still out on that.

    I have a dozen points throughout these last few long comments where I have questions. But I’m not sure it would be fruitful to keep going.

    I’m only here because I’m passionate about this, and want to help improve the quality of the Google U education everyday moms and dads are getting. Those are the ones that need to be reached.

    OK.[/soapbox]

  40. Pete Says:

    “Technically true, but again, there are things we control, and things we don’t. If the CDC rates of fever are accurate for DTAP and pneumococcal, we have undertaken a path to insure that one third of our two months old infants develop a febrile response.”

    According to the CDC, fever rates are “up to” 1 in 4.

    Many of the related studies and prescribing information show that low grade fevers (100.4) have an incidence of about 25%. Those same studies also show that moderate (or sometimes acute) fevers (above 103F), have an incidence of 1% or less. So while “febrile response” is technically correct, it is not necessarily meaningful (especially not in terms of autism).

    “Sure, actually catching one of those diseases would have far worse complications, but the chances of that are very, very remote.”

    31% incidence in an unvaccinated (Pertussis) population doesn’t seem remote.

    http://www.springerlink.com/content/p622251x75550n6p/

    Not that this really has any relevance to autism, but…

    How about actual shot at some on first year of life fevers data; common colds, other viral infections, gastroenteritis, and meningitis, etc. How do those stack up against first year of life fevers from vaccines pD?

    How do morality rates compare between the DTaP vaccine and the diseases it helps prevent?

  41. trrll Says:

    Whew! I didn’t think we’d ever get to this point. Doesn’t this make a straight equivalency between everyday exposure and vaccines also ridiculous?

    Well, it certainly disposes of your straw man argument that every single day’s exposure to antigen is equivalent to a vaccination. So congratulations on disproving an argument that nobody but you made. I presume that you continue to belabor this straw man to avoid addressing the actual point, which is that the level of immune activation produced by a vaccination is not different from that which every child experiences from environmental antigens, not every day, but several times a year.

    Whew! I didn’t think we’d ever get to this point. Doesn’t this make a straight equivalency between everyday exposure and vaccines also ridiculous? If vaccines are just a drop in the ocean, why do they seem to be having such a disproportiate effect?

    You seem to be assuming your conclusion. What is the evidence that the effects of vaccines are disproportionate? Certainly not a minor fever in a minority of children, not discernibly different from the multitude of fevers that a typical child experiences several times a year.

    It is of course true that exposure to any antigen, whether environmental or by vaccination, produces a long-lasting, often permanent, immunological change. In principle, it would doubtless be possible to generate a unique personal immunological “fingerprint” of each individual, reflecting his own personal history of antigen exposure, but our ability to detect that speaks more to the sensitivity of our assays than to any “disproportionate” effect.

    Technically true, but again, there are things we control, and things we don’t. If the CDC rates of fever are accurate for DTAP and pneumococcal, we have undertaken a path to insure that one third of our two months old infants develop a febrile response.

    Which they do on a regular basis anyway, even if they are not vaccinated. Once again, what is your evidence for a “disproportionate” effect for a vaccination that produces no more evidence of immune activation than an unvaccinated child exhibits several times a year?

    I’d agree that it is. The point I was trying to make there is that it seems that reliance on common sense seems OK in one instance (the immune response generated by a vaccine is smaller than actual infection), but not OK in another, (because children experience fevers at differential rates on days following vaccines and other days, our ability to meaningfully comnpare the two is impaired).

    Once again, we are comparing the fevers that children only occasionally exhibit on days following vaccination to the fevers that children almost invariably exhibit on several days throughout each year. And yes, I’d agree that this is “common sense.” If you want to argue that the immune activation produced by vaccination has a disproportionate effect compared to that reflected by all of those other fever, you need to provide stronger evidence than the truism that each individual has a different antigenic history and is therefor immunologically unique.

    Can you provide some references on this point, that LPS injection creates a far more robust immune activation than immunization?

    We don’t inject LPS into children. But the immune reaction of rodents to LPS injection is so intense that it is not uncommonly fatal. This is not the case with immunization.

    Don’t forget that our specific subset of children have been observed to generate far more robust immune responses to a variety of factors than their undiagnosed peers, including increased generation of tnf alpha. The assumption that they will respond in the same way as other children is a poor one.

    But like other children, they will be exposed to a large number of antigens continuously, sufficient to provoke a robust immune reaction several times a year. So what is your evidence for your hypothesized disproportionate effect?

    But there are any number of other poorly constructed studies that I could post that show exactly such a relationship.

    One can always cherry-pick flaws in a study if one is looking for an excuse to discount it, but this is rationalizing, not science. A scientist will consider what the impact of the supposed flaws would be on the result. Does the investigator have a bias that might lead him to cherry-pick his data to produce this result? Well, no, not in this case–in fact it is contrary to the claims of Generation Rescue. Would the methodology tend to produce a bias in the direction of the result? Well, no–in this case the methodology would tend to bias the result toward overestimation of the frequency of autism in vaccinated children. Is the result contrary to other studies? No, it is in agreement with other studies that have found no correlation of autism with vaccination.

  42. Heraclides Says:

    John writes:

    At this point the educated layman calls this thread officially off topic. The discussion, while fascinating, has become almost incomprehensible to the non-science members of the audience. I know–I’m one of them.

    I agree (I’m a scientist not a layman, although my specialist interests lie elsewhere). The discussion has moved to focus on vaccines in general, not autism.

    My own impression is that most of the interesting correlates (interesting in the sense of potentially leading somewhere) are to neural activity, not immune system activity. In particular, these correlates are prenatal, before the child is borne or vaccines are administered.

    For example, several lines of research point to mutations in proteins involved in ion channels; these proteins are involved in regulating neuron activity and Ca2+ signaling. This has a much clearer connection to a neurological disorder and with several lines of evidence supporting it, would more justify looking at.

    I don’t think that the discussion is being helped by some of passionlessDrone’s statements comparing things that aren’t actually related.

    I prefer to focus on those who are trying to learn, too, rather than those that have already “made up their mind”, as in my experience the latter generally are focused on justifying what they want to be true, rather than learning.

    From a research point of view, I think it’s better to focus on autism itself and let whatever things fall into the context of the research as they naturally do or don’t. Starting with one thing, e.g. vaccines, then fitting it to the disease has the obvious danger of “fitting evidence to a preset conclusion”, rather like the cliché of hammers and nails. Vaccines don’t naturally fall into the context of autism from what I have read: all the interesting correlates for causing autism I’ve seen are prenatal and point at neurological issues.

  43. Heraclides Says:

    Excuse my not replying with a “nested” reply! (Spotted that your blog support this after I posted…)

  44. MtGuy Says:

    It seems to me that Jenny McCarthy has grasped something that not many here have. If you want to reach the layman, you have to speak in his/her terms. If I wanted to inform the public about the relationship or lack of between Autism and vaccines I’d perhaps create a story with metaphors that is easily understandable rather that a long list of scientific journal and text references. Create images in my mind to explain the numbers and stir emotions in my heart to help me make that truth mine.

    On a tangent, it occurs to me that time would be better spent by Dawn explaining what she is doing that is helping her child. Then perhaps the collective knowledge of the scientific minds present could bend towards figuring out why those activities are working. A little focus on the solution rather than the problem.

    Just my two cents as a non-scientist/medical student reading this blog.

    • A Noid Says:

      It’s generally not that they haven’t grasped it, it’s that they find dishonesty and misdirection repugnant, and low syllable count storytelling patronizing.

      Getting into a story telling contest with someone whose interest is only to tell the best story, regardless of accuracy, is a losing proposition. Look at product marketing, it’s full of deception and misdirection. Why? Because it works better.

      If they have trouble grasping anything, it’s that all too many people will put more trust in a smooth talking snake oil salesman, than someone who spent 10 years stunting their social skills because they were busy actually learning things.

      The details matter. Ignore them and you are setting yourself up to be nothing more than fodder for the slickest spin artist around.

      • MtGuy Says:

        I was trying to communicate that while the details are important, unless you reach a person’s heart you aren’t as likely to change their mind. I was just suggesting a different way of communicating that might be more effective for reaching those who haven’t spent 10 years learning from a book or a classroom. If science cannot be communicated effectively, is becomes less useful. I was trying to focus on solutions rather than the problems.

        I do believe it was Einstein that said “If you can’t explain it simply, you don’t understand it well enough.”


    • I’m an optimist. I think america is smarter than Jenny McCarthy. I believe laypeople can read about evidence and understand it. I try to make my posts accessible, admittedly the comments get overly scientific.

      But I think we run a fine ethical line making up stories to tell people things. You can’t believe in patient autonomy and then come back and say “but they’ll make their autonomous decision based on this story I tell them instead of the actual truth”.

      • MtGuy Says:

        I won’t comment on Ms. McCarthy’s intelligence as I have never met the woman and think that personal attacks are not an effective communication strategy. I do however hope that America is smart.

        Are there research articles to support Ms. McCarthy’s point of view? I’m sure there are. Are they current and factual? I’m not qualified to say, having never read them myself.

        Something to remember though is: the world was once flat, the sun rotated around the earth, smoking wasn’t harmful to your health nor was asbestos, it was a fact to the people who lived in that time.

        A story does not have to be fictional to be used to better explain science. Metaphors and analogies can help someone without comprehensive scientific knowledge relate to scientific facts.

        I find it useful to keep my mind open as fact does often become fiction and fiction often becomes fact.

  45. John H. Says:

    The details matter. Ignore them and you are setting yourself up to be nothing more than fodder for the slickest spin artist around.

    I think the ability to delve into the details is important, so that skeptics can have their legitimate questions answered. The only ones who should be worried about being “fodder” for the spin-meisters are the ones who aren’t very smart to begin with.

    • A Noid Says:

      That’s closer to what I was trying to say that what I managed to write.

      What I’m trying to say is that understanding that the details matter, matters. I’m not saying that you have to dig through the references of the references of every single reference. But rather, understanding that there is an important difference between seeing that a reference is presented to support a claim, and verifying that it actually does. Even if you don’t exercise that validation every time.

      The short version is “Evidence Based Reasoning”, but I’m trying to codify that a little.

      When presented with claims that are not reconcilable, the right thing to do is to look at the details.

      If you are not familiar enough with the subject to personally judge the truth value of claims made, examine the details of syntactic structure used to convey them, and the rhetorical tricks used to present them.

      Who’s claims are internally consistent? Who is addressing the points made, and who is just waving their arms and raising more points? Who flits from luxury speaking engagements to cushy talk shows, like the insipid social parasite that they are; and who busts their ass to the exclusion of sleep and social life for the better part of a decade actually trying to understand why people get sick and how to make them better?

      As an aside: Claiming that the only people who can be systematically deceived are those that weren’t very bright to start with, seems to either set an unreasonably high bar for ‘not very bright’, or ignores both innumerable possibilities in upbringing, and a large body of psychological research. Critical thinking is an educable skill, and as long as you live in a democracy, you’d better hope that not everyone is willing to give up on those who don’t manage to figure it out on their own.

      • MtGuy Says:

        First of all, I want to say that I appreciate most of your comments A Noid. I am, however, offended by your consistent attacking of those of us who haven’t excluded sleep and social life for almost 10 years to study. I don’t know if that was your intent but, that is how it makes me feel.

      • A Noid Says:

        MtGuy,

        Not my intent. I’m not a medical student, have never been a medical student, and do not plan to be a medical student. I am however deeply grateful to those who are, they put up with a lot of shit (sometimes literally) to help people in need.

        The anger is entirely directed towards those who would equate all of that education, experience, and dedication. With an afternoon spent at the University of Google, and making macaroni pictures with their kid.

        Look at the arguments that they make. Many of them make as much sense as saying that 1 + 1 = 1 x 1, because + and x have the same structure, just rotated. (See discussion of B12 in another thread)

        If it weren’t so infuriating it would be embarrassing.

        This is not restricted to medicine. You see the same thing in nearly every field in which complex, nuanced subjects, that are not trivial to understand, exist. Climate science deniers, P=NP kooks, plate tectonics skeptics, creationists, special relativity questioners.

        The argumentative form is nearly identical in all instances. Superficial understanding, argument by rhetoric rather than evidence, and the implication that: medical students spends all their time alternately being brainwashed by the establishment and playing with the nitrous inhalers, or physicists nothing better to do than use N2(L) to make ice cream, and that education is in general is a waste of time.

  46. Curtis Maybin Says:

    Great stuff on autism looking forward to more.

    Thanks
    Curtis Maybin


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