This post has been hanging in my drafts for a bit – I’m still not happy with it, but I felt like sitting on it longer would make it just irrelevant. I might edit it significantly to make it more readable or understandable. Infact I’d like to make it a collaborative effort – feel free to post comments about how to improve this piece, and if it’s reasonable I may change it accordingly. Heck, feel free to post general suggestions to improve this blog. Everything from “Your grammar sucks, work on it”, “get a darn thesaurus, stop saying disappointing so much” to “you really need to get off of this topic, it’s no longer relevant to me”. Go wild with it!
This post is a reaction to Bernadine Healy’s recent post on US-News & World Report. Dr Healy’s post can be found here. Please also read Parts 1,2, and 3. Our resource to educate today is “Vaccines and Autism: A Tale of Shifting Hypotheses” published in Clinical Infectious Diseases, full citation at end of post.
I was planning on leaving Dr Healy for another day. Originally Part 4 was going to be my breakdown of the “mitochondrial disease” hypothesis of autism-vaccine connection! Unfortunately Dr Healy wrote a post that I found so profoundly incorrect it required immediate response. Age of Autism advocates have touted Dr Healy’s credentials and her seemingly ambiguous position on this issue as proof that they have a legitimate concern, and this can no longer be tolerated.
Let’s be clear, this post is not an ad hominem, but before discussing the content of her post we’ll start by talking about who she is. I have the utmost of respect for Dr Healy as a cardiologist. I don’t know enough, and don’t have enough time to learn about whether she was a competent head of the NIH. By all accounts she was a good dean at Ohio State University College of medicine. I will not in discuss her tenure as president and CEO of the American Red Cross. In passing I’d like to mention that Dr Healy was a member of the Advisory board of The Advancement of Sound Science Coalition (TASSC). TASSC is a lobby group funded initially by Philip Morris that promotes the idea that scientific research on issues such as smoking and global warming is “junk science”. It is operated by Steve Milloy and I encourage you to investigate that connection yourself. Dr Healy was also declared Age of Autism’s Person of the Year.
None of this immediately invalidates anything Dr Healy says. A shady connection does not discredit someone altogether. It’s important to look at the connections someone has, but it’s also important not to impugn someone’s reputation entirely on the basis of connections – I will not be committing a tobacco shill gambit here. One must look at, and weigh the evidence, then come to an appropriate conclusion. Note the difference between my position on this, and the position advocated by many of our anti-vaccine commenters, who ignore evidence if they can find even a passing conflict of interest in opposing viewpoints.
Here’s the problem: Dr Healy has neglected her responsibility to educate herself before she speaks from her pulpit. When you are not an expert on something yourself, you had darn well better do your homework before talking! I’m extremely disappointmed in Dr Healy for this article and for her position on this issue in general. Dr Healy is not an immunologist. Dr Healy is not a pediatrician. Dr Healy is not a scientist. Dr Healy does not express an understanding of the evidence in her article.
We’ll start at the beginning.
McCarthy and Carrey and two colleagues from the autism advocacy group she founded, Generation Rescue, took the AAP to task for its unwillingness to give at all in the controversy over vaccine safety and, while holding up a vaccine ad in its journal, accused the group of shilling for vaccine manufacturers.
Firstly, McCarthy and Carrey did not found Generation Rescue, J.B. Handley did. Secondly, complaining that the AAP won’t “give” is the Gray Fallacy, that we addressed in Part 1. Just because the AAP says “vaccinate” and someone else says “Don’t vaccinate” doesn’t mean that the appropriate response is in between. Generation Rescue is wrong. Terribly wrong. Disturbingly wrong. So wrong that no doctor should be advocating for them! Lastly, she reiterates McCarthy and Carrey’s pharma shill gambit. The pharma shill gambit does not a real argument make. Early on Dr Healy reveals a lack of understanding of the basic issues at hand.
Next Dr Healy brings up the “Vaccine overload hypothesis”, which we have discussed in part 3.
the United States now gives more vaccines to all its children, and earlier in life, than the rest of the developed world: some 36 doses before our little ones hit kindergarten, with most crammed into the first 18 months of life. If you look at the best-performing countries in terms of infant and early-childhood mortality, the average number of doses is 18, with most of the Scandinavian countries, Japan, and Israel mandating just 11 to 12.
To support her hypothesis she brings up a non peer reviewed “study” by Generation Rescue complaining that we give more vaccines than other countries . I will not discuss this study here at all, it doesn’t even pretend to be science, and has been thoroughly disassembled by Dr David Gorski here.
Next up she complains about specific vaccines: Hep B, Rotavirus, Hep A, and chicken pox.
The extras here include protection against the sexually transmitted hepatitis B virus, which many countries (and the United States in the past) recommend only for infants at high risk because of an infected mother; a vaccine against the rotavirus, which causes some cases of infant diarrhea…
Rotavirus is a group of viruses that cause lots of childhood diarrhea – actually they’re the single largest cause of childhood diarrhea. They also cause the less known, but more embarrassing med-student-on-pediatrics-rotation diarrhea. Per the CDC, rotavirus leads to the hospitalization of 55000 children in the US and the deaths of 600000 children worldwide each year. Yet another fact has been glibly ignored by the good doctor.
She also makes a mistake I thought no doctor would make “sexually transmitted hepatitis B”. Tsk tsk Dr Healy. Lest we forget our basic virology, Hep B is body fluid transmitted, not just sexually transmitted. This often chronic disease is regularly missed in patients before they do lots of liver damage, and if a child is infected young, they are far more likely to get chronic disease, that will lead to liver failure, and death.
She complains about loosening the vaccine schedule, I won’t paste her entire argument here, all I’ll say is this: There isn’t a study showing a good reason to loosen the vaccine schedule. If you were to loosen the schedule, what infectious disease would you decide to bring back first? Polio? Tetanus? Measles? Hepatitis?
Even more disappointing, she brings up the idea that many people are susceptible to side effects of vaccines – and brings up Hannah Poling and mitochondrial disease and implies a connection with autism. We’ll be discussing this in the next part.
Some have lobbied to keep vaccines out of the government’s autism research agenda, because they see the case as closed and fear further study will threaten confidence in vaccines. Doing so would be just plain wrong.
This is ridiculous, those lobbying to keep vaccines out of the government’s autism research agenda are doing so because further study won’t reveal any more evidence, and will be like flushing money down the toilet. Not because it will threaten confidence in vaccines. Doing so would be just plain right.
Finally there is this pearl, where Dr Healy really reveals that NIH director or not, she is no scientist.
so is a study comparing groups of vaccinated and unvaccinated children.
Now someone with much less education made the very same suggestion earlier on this blog, and I called it unethical. She suggests that this is completely reasonable. Bravo Dr Healy. Bravo. Not one immunologist thinks that we need that data. Not one expert in the field sees this as necessary. Only a thorough misunderstanding of science, and statistics, makes that sound like an OK idea. Of course, Dr Healy doesn’t actually believe in evidence based medicine, as she said here. It’s hard to imagine going from the thorough misunderstanding of EBM shown there to being able to suggest reasonable science.
Ref:Gerber, J., & Offit, P. (2009). Vaccines and Autism: A Tale of Shifting Hypotheses Clinical Infectious Diseases, 48 (4), 456-461 DOI: 10.1086/596476