Who are the denialists? (Part IV)

It’s time to talk about the anti-vaccine (or anti-vax) denialists. Considering the Autism Omnibus trial is underway to decide whether or not parents of autistic children can benefit from the vaccine-compensation program, a fund designed to compensate those who have had reactions to vaccines and shield vaccine makers from the civil suits which drove them out of the country in the early 1980s. I think it’s topical and necessary to set the record straight about vaccines, their risks, and many benefits. To do this though, we’ll have to talk about the history of and resistance to vaccination, the history of autism and the current alleged epidemic of autism, and the denialist arguments used by the anti-vaxxers to suggest that vaccines are linked to the disorder.


Since vaccination was discovered to confer immunity to individuals there has been resistance to vaccination.[1]

Widespread vaccination began in the early 1800s following Edward Jenner’s presentation of an article to the Royal Society of London in 1796 detailing his success in preventing smallpox in 13 people by inoculation with live infectious material from the pustules or scabs of people infected with cowpox. The process induced cowpox, a mild viral disease that conferred immunity to smallpox. Jenner called the cowpox material “vaccine” (from vacca, the Latin for cow) and the process vaccination. Although Jenner did not discover vaccination, the was the first person to confer scientific status on the procedure and was chiefly responsible for popularising it.

A large number of anti­vaccination tracts, books, and journals appeared in the 1870s and 1880s. The journals included the Anti­Vaccinator (founded 1869), the National Anti­Compulsory Vaccination Reporter (1874), and the Vaccination Inquirer (1879). Similar movements flourished elsewhere in Europe. In Stockholm, the majority of the population began to refuse vaccination, so that by 1872 vaccination rates in Stockholm had fallen to just over 40%, whereas they approached 90% in the rest of Sweden. Fearing a serious epidemic, the chief city physician, Dr C A Grähs, demanded stricter measures. A major epidemic in 1874 shocked the city and led to widespread vaccination and an end to further epidemics.

At the time, the anti-vaccination movement did have some legitimate arguments. This was, after all, before the germ theory of disease was understood, and vaccination was not done in a nice sterile fashion as it is now. As medical science has improved, so has the science of vaccination, and there are few public health measures that rival the success of vaccines in preventing disease. Smallpox has been eradicated. Polio, which used to sicken and paralyze thousands a year is largely eradicated. Tetanus, which still kills hundreds of thousands a year worldwide – particularly in neonates – is exceedingly rare in countries with routine vaccination – like the United States since the 1940s.
i-ce4aefbe9c54574a62af2c5bfe60c50f-tetanus.jpg

This is a terrible disease, and one that the first-world prevents (since the spores are everywhere and cannot be eradicated) through immunization.

i-a281249ac7f137ea92c718de7257be19-lockjaw.jpg
Muscular spasms in a patient suffering from tetanus. Painting by Sir Charles Bell, 1809. From the tetanus wiki

Diptheria, pertussis, measles, mumps, rubella (which caused blindness in thousands yearly), and numerous other diseases can be prevented, and morbidity and mortality decreased through immunization. Each of these diseases still kill many hundreds of thousands a year worldwide. Vaccination programs could prevent and in some cases eradicate them if vaccination were properly invested in and pursued.

The benefits of vaccination are clear. But there is a pervasive distrust among some people of medicine, of pharmaceutical companies, and when something needs to be blamed for a child’s illness, vaccines seem to be an easy target. Especially since their benefits these days seem more abstract – people don’t see tetanus and diptheria any more, so why risk a vaccine to prevent it? And man will people blame vaccines for some crazy stuff. For instance, people who have killed their infants by shaking them have gotten anti-vaxxers to blame vaccines for their crime. It’s also not too surprising to see, when one peruses the various anti-vax sites (there are too many for me to list and the Millenium project’s list here is very thorough), the overlap with other anti-medicine movements, including HIV/AIDS denialists like Mohammed A. Al-Bayati, and various types of woo-promoters.

What is universal about the anti-vaccination sites is that they overestimate the risks of vaccination, while underestimating the benefits – or denying they are responsible for preventing disease at all. Often they will suggest a disease disappeared because of other public health measures, better hygiene etc., despite the fact that the drop off in each of these illnesses occurred immediately after the introduction of the vaccine, and these vaccines were rolled out at different times – often decades apart. They also like to point out how rare the diseases are that are being vaccinated against, and how compared to the risk of adverse events the vaccines are therefore not worth it. People may think that now that these diseases are rare that immunization might now be unnecessary. However the evidence is that when vaccines are attacked and immunizations decrease, these now-rare diseases are quite capable of making a comeback. [2] Further the other denialist tactics are always present. From conspiracy theories about the medical establishment hiding the truth, to cherry picking a few studies about mercury and thimerosal out of context (and ignoring the IOM reports and systematic reviews), fake experts like Mark and David Geier , to some outstanding examples of moving goalposts (like not letting go after thimerosal was removed from vaccines), to the classic logical fallacies.

But why does autism get special attention as having a link with vaccination? Specifically, why does thimerosal, the mercury-containing preservative that allows vaccines to be stored in multi-dose vials, get so much blame?

To understand this, I think a brief history of autism is also warranted. Autism was first described by Leo Kanner in 1943, then underwent the classic progression of psychiatric blame. It only took about 10 years or so for psychiatrists to start blaming the parents – specifically “refridgerator mothers” for causing the disorder. Hey, they were Freudians. They have to blame the mother first. By the 70s though, people were realizing how stupid this was and started looking for environmental and genetic causes. As parents were blamed less the disorder lost much of it’s stigma – as a diagnosis of autism essentially meant you were a bad parent in the eyes of the Freudian quacks. It kind of reminds me of the Simpson’s episode Hurricane Neddy and Dr Foster’s great line “Get down from that bookshelf, please. Most of those books haven’t been discredited yet!”

This is where the problem starts. As the disorder was recognized separately from other learning disabilities and developmental delays, parents were more interested in having the appropriate diagnosis and getting help specific to the disorder. Then critically, in the 1990s, it was added as a separate category of disability for special education. The result was far more diagnoses of autism and a decrease in diagnoses of other disabilities.

The notion that the prevalence of autism is increasing would seem to be borne out by the increasing rate seen in special education programs in the US, but that’s a fallacy according to Dr. Paul T. Shattuck.
He found that the administrative prevalence of autism rose from 0.6 cases per 1,000 students in 1994 to 3.1 cases per 1,000 students in 2003. Seventeen states reported increases in autism rates that would qualify as an epidemic.

During the same time period, the prevalence of mental retardation fell by 2.8 cases per 1,000 students and the prevalence of learning disabilities fell by 8.3 cases per 1,000 students. The increase in autism prevalence was significantly associated with declines in mental retardation and learning disabilities.

“Autism was not added as a separate category until the early 1990′s, and all newly introduced categories experience explosive growth. No one is claiming there’s an epidemic of brain injury, for instance,” Dr. Shattuck commented.

He also notes in his paper that prevalence findings from special education counts are well below epidemiological estimates for most states, and so do not support the claim of an autism epidemic.

In the broader context of widespread public concern that autism rates have been increasing sharply, and that childhood vaccinations are to be blame, Dr. Shattuck said, “I hope the article creates more informed consumers of prevalence claims. Many bright people, including doctors, have turned to the special education counts hoping to find meaningful information…in the absence of good quality surveillance data.”

Additionally the diagnosis of autism was expanded from a more limited set of criteria to a spectrum, hence the current designation of autism spectrum disorder rather than merely “autism” to describe everything from severe autism to milder versions of the disorder such as Asperger’s syndrome.

Well, the problem should now be obvious. The disease emerges from a dark period of psychological misunderstanding, and barbaric treatments, and parents, no longer stigmatized by the diagnosis, want treatments, help and education specific to their child’s disorder. Special education funding opens up, and autism diagnoses increase with concurrent decreases in other mental disorders. But outside of this context all people see is a massive increase in the rate of autism diagnosis. They naturally ask, what is causing this apparent epidemic of autism?

The anti-vaxxers, always keen to blame something new on vaccines, come to their rescue, helped along by one particular small and unreplicated study by Andrew Wakefield who has subsequently been shown to be on on the payroll of the anti-vax lawyers. Mostly, thimerosal and/or the MMR gets blamed. Then repeatedly vindicated. Thimerosal was even removed from vaccines in the United States (all but flu – thus reducing the dose about 10-fold – although there is a thimerosal-free flu shot approved for kids under 4) with no concurrent decrease in autism diagnoses – if anything they continue to increase.

Despite all of this evidence that thimerosal wasn’t the cause, the anti-vaxxers still pursue vaccines and thimerosal as a cause of autism. In the current Autism Omnibus hearings, a panel of three judges (or Special Masters) are reviewing the “expert” evidence for a link. I’ve been following the trial from the transcripts and recordings and the link still simply has no evidence. The testimony is telling. First of all, the witnesses can’t decide on the cause – thimerosal or the attenuated measles virus or both together or genetic mercury hypersensitivity etc. Day one starts with an expert who goes into all sorts of mercury poisoning with different varieties of the chemical – organic, elemental and inorganic – and completely fails to connect the disparate forms of poisoning from excess doses to anything resembling autism – especially based upon the type of mercury in thimerosal. Instead the best he can come up with is an essentially unprovable hypothesis about “brain retention” of mercuric mercury. The next couple of witnesses provide similar scant evidence, with no solid links (and some nice CV inflation along the way), and eventually jump to blaming attenuated measles virus for autism – not based on anything measles virus has ever done in humans but based on canine dystemper since it happens to be in the same family! This is the best they’ve got, and it ain’t much. No proof of causality, no isolation of mercury or measles from brain or CSF, just conjecture, speculation and circumstantial nonsense. See Autism Diva with some great coverage and Orac’s coverage of the quacks’ coverage.

The evidence is mounting that autism is primarily a genetic disorder. One obvious flaw with environmental exposure is the high predominance of autism among males vs. females. An environmental cause would likely effect both sexes equally in prepubescent children. Further it is linked to a specific genetic cause in about 10-20% of cases and this number is likely to be revised upwards. The most recent and powerful study into the genetics of autism suggests a strong correlation between copy number variation of various genes and sporadic autism spectrum disorders. While our knowledge of the cause is by no means complete, an environmental cause doesn’t fit with the basic facts.

I’ll add as a final note, one of the saddest aspects of the anti-vax intrusion into autism, aside from the usual problem of attacking such a beneficial public health measure, is the encouragement by the anti-vax quacks of human experimentation on children. Between the Defeat Autism Now doctors and quack treatments like the Geier’s bogus Lupron protocol (Lupron is a drug usually given to kids to prevent precocious puberty), the approach the anti-vaxxers advocate is usually based on the faulty premise of mercury being present in the kids. The kids are then subjected to chelation treatments meant to remove the mercury from the bloodstream – a dangerous and occasionally lethal procedure – for no good medical reason. The kids are essentially getting stuck with needles constantly, put on whatever diet the fake experts can come up with based on some tenuous hypothesis about the cause of autism, and with confirmation bias rampant – the testimonials of these unmonitored and poorly-designed experiments on children pull in more parents desperate to find anything that will make their kid normal. If it wasn’t for the parents’ active involvement in experimenting on the kids, this would be a Nuremberg violation (and should be anyway in my opinion).

Summary
Ratbag’s full list of anti-vax quacks
Robert Kennedy Jr.’s “deadly immunity” at salon.
I also include the The Huffington Post as an anti-vax denialism site. While not 100% denialist, it has an entrenched anti-vaccination element including Robert Kennedy Jr.’s BS articles and David Kirby railing against the evil mercury (should we be surprised when they give Deepak Chopra a loudspeaker?). Although it should be noted they’ve made a positive step in publishing Arthur Allen’s work recently instead.
And don’t forget to experiment on your kids with the help of DAN!

1. Robert M Wolfe, Lisa K Sharp Anti-vaccinationists past and present BMJ 2002;325:430-432.
2. EJ Gangarosa, AM Galazka, CR Wolfe, LM Phillips, RE Gangarosa, E Miller, and RT Chen Impact of anti-vaccine movements on pertussis control: the untold story The Lancet 1998; 351:356-361

Comments

  1. #1 Paul Schleifer
    June 18, 2007

    Until recently, I was visiting a chiropractic who, despite the obvious hocus pocus that abounds in this area, seemed to be benefitting my neck pain.

    In his waiting room, he would show DVDs produced by some US chiropractic organisation, one of which asserted that vaccinations have no benefits and cause many harms.

    When I challenged him about this, pointing out the eradication of smallpox and the near-eradication of polio, he shrugged and replied that there is “a lot of debate” about the efficacy of vaccination.

    Utter bollox! I have not returned.

  2. #2 Rozagy
    June 18, 2007

    Dear Mark,

    what a great article!
    One comment though that I’d really like to make: Asperger’s is NOT a milder form of Autism. It IS AUTISM in pure form, without mental retardation. It is also a type of brain (extreme male brain) that represents a next step on evolutionary ladder. Autism in pure form is necessary for any advanced learning to take place. One cannot possibly be a good musician, a good artist or a good scientist (like you) without having Autism in pure form.

    When all meaningful learning stops for a “normal” person’s brain at the age of 6, on the contrary, the neuroimagery of the frontal lobe in Autistic persons’ brain for example, i.e. in the frontal lobe – shows to look like that of a 6 year-old and stays that way. Which allows for continued learning of a person with Autism in pure form to be possible well into their advanced years (Einstein was still working on his theory of Everything just before he died at a ripe old age).

    It’s the tenacity and capacity for long periods of concentration on one particular subject – sometime for years, together with the “open” brain that is willing and able to learn is what makes Autistic brain better equipped at dealing with solving problems beyond that of NeuroTypical (“normal”) person.

    There’s nothing “MILDER” about Asperger’s because Asperger’s is AUTISM in it’s pure form and in all its’ glory. Sensory and motor issues are still present and perhaps there’s a reason for those (which may not be always a negative trait. Because until we know its’ true reasons for being there we can’t possibly know if it’s “useful” or not). Logic is a strength for people with Autism in pure form. And truth and justice seem to be high on the agenda (because those are logical – lies and propaganda are not).

    All the best and have a terrific Summer.

    Roza,
    Artist name Rozagy,
    Artistic Autistic,
    English is my 3rd language.

    http://www.myspace.com/rozagy

  3. #3 Abe G.
    June 18, 2007

    Of course this debate is heavily influenced by the emotional aspects involved. When it was time to get my daughters vaccinated, I couldn’t help but feel a certain fear that one of them might be the 1 in 10 million to have a lethal reaction.
    So this is part of the resistance to vaccines. Even intelligent people can have irrational fear because of the nature of the perceived threat. You may realize that driving to and form the store is a much bigger risk than vaccination. But you have to get to the store. eradication of a disease–no matter how dread–seems light years away.
    Still it is no excuse for ignorance. Good post.

  4. #4 Ashamed of you
    June 18, 2007

    This is a science blog? Where is the science?

    In a few paragraphs – utterly devoid of scientific citations – you can just sum it all up for us!! Wow!

    Have you had even an introductory course in immunology? It seems pretty clear you are just reciting information you do not understand. Virtually every vaccine ever released carries a risk of neurological consequences, especially for those with a porous BBB like an infant. Perhaps deleterious effects are transient, perhaps they are not.

    How about addressing the toxicology of mercury? Where are the safety data studies for ethylmercury?

    I mean after all, you are asserting that there is no way that injecting a neurotoxin into infants could cause neurodevelopmental disorders right? Show me the money! Show your science, and that means no epidemiological masturbation.

    Everything has a genetic basis. Only 85% of identical twins both have an ASD diagnosis. Your gender comment is laughable. Ever crack an endocrinology text? The sexes are different physiologically.

    Really your article does not even merit a smack down. This is truly pathetic.

    You condescendingly preach about denialism and post non-scientific drivel filled with unsupported speculation? You expect anyone to take this seriously?

    Try again please and make a *scientific* argument that vaccines can not cause neurodevelopmental disorders.

  5. #5 MarkH
    June 18, 2007

    Try again please and make a *scientific* argument that vaccines can not cause neurodevelopmental disorders.

    Isn’t it funny how the cranks always put asterisks around *scientific*?

    Anyway, the obvious problem with your requirement is that you’re asking me to prove a negative. Something science doesn’t do so well. Now, science can show, through epidemiology which you dismiss with a cranky wave of the hand, that vaccines do not increase the risk of autism. And there are known risks to vaccination which the compensation fund routinely compensates parents for, it is clear though, that autism is not one of them.

    I also love this:

    Everything has a genetic basis. Only 85% of identical twins both have an ASD diagnosis. Your gender comment is laughable. Ever crack an endocrinology text? The sexes are different physiologically.

    Only 85%? That’s pretty good evidence for linkage. Yeah it doesn’t have 100% penetrance, but most genetic disorders have less than 100%.

    The burden, given the absence of evidence for a risk based on the available data, is for the anti-vaxxers to show that mercury can cause autism. Considering the removal of thimerosal had no effect on rates they’ve had to move on to the classic attack on vaccines themselves – showing the problem is with vaccination period, not just thimerosal.

    In a few paragraphs – utterly devoid of scientific citations – you can just sum it all up for us!! Wow!

    I have extensive citations throughout the document, as well as two on the history of vaccination and anti-vaccination movements. I linked the IOM study and the systematic review from the APA, as well as the CDC pink book for pretty much every single available vaccination. I have citations to the journal Science on copy number variations, as well as various sources of information on the alleged epidemic. As usual, the crank has no reading comprehension skill and only sees what they want to see

    Finally, each of the links above for the named diseases goes to the CDC pink book on the disease and facts about the vaccine if people want to know about known side-effects of vaccines – which can include neurological side-effects. Just not autism.

  6. #6 Ms. Clark
    June 18, 2007

    Hi,

    Autism Diva is my blog. Thank you for the kind words and the link.

    There are several reasons that people came to believe in the autism epidemic. One is that until recently, doctors and parents both saw “autism” as a curse and there is still (worldwide) a belief system that says autism is the fault of the mother (she’s not engaged enough with the child, or she subconsciously wants to kill the child- if you go with Freud).

    But at some point, the way people looked at autism was that “there was a real child inside there” “there is hope for a cure, a way to get that kid OUT of the shell of autism” at that point, parents of mentally retarded kids would prefer to have the label “autistic” because they could get 40 hours a week of ABA or whatever, that might promise a normal child at the end of the process. At any rate, the indictment of the mother (and father) in autism has faded, and this increases the likelihood that parents will allow their child to bear that label.

    Then there is the whole thing that parents never used to think in terms of their children having disorders, they’d see a slow child or a stubborn child or a dumb child or a spoiled child… they wouldn’t see a child with a brain disorder. Everything has become more medicalized over the years including parenting.

    In some ethnic groups an sub-cultures, in the US, ones that aren’t like us white folks who love the medicalization of stuff (usually, here in the US anyway) the parents in those minority groups are less likely to see brain disorders in their kids and more likely to see something else, even seeing autism symptoms as a blessing or a curse from their god(s). At any rate, they aren’t likely to go running to “the man” to get their child “fixed.”

    Part of what drives the antivaxers is a subset of psychotic individuals who fear anything that the gov’t would inject into anyone. They see it as a way to make black people into white ones (Dr. Rebecca Carley says this) and a way to implant tracking chips into people. About 1% of the world’s population has schizophrenia, some of them are paranoid psychotics, and some of that group have access to the internet. Some of that group seems to belong to the mercury parent group or are allied with them. That’s not a joke, it’s what a few of them seem to be. They make comments about tracking devices being implanted in vaccines on the EoHarm Yahoo! group, for instance.

  7. #7 Brian
    June 18, 2007

    “In a few paragraphs – utterly devoid of scientific citations – you can just sum it all up for us!! Wow!”

    This post is filled with references, both to the CDC and to other sources. The science is right there, if you’d like to take the time to look at it.

    Hint:
    1) The blue text with the underlines
    2) The citations at the bottom of the page

    Please provide a citation that would clarify your position regarding the neurological consequences of vaccines via the BBB.

  8. #8 daedalus2u
    June 18, 2007

    Good post. I am doing research on NO physiology, and in particular how ASDs are influenced by it. It is my hypothesis that all the ASDs are perfectly �natural�, and that ASDs are in fact an evolved trait, expressed (most severely) in response to exposure to maternal stress in utero. The ASD phenotype is the tool making and tool using phenotype. It is a fundamentally human characteristic. The most important �feature� is the social isolation which allows ASD individuals to abandon cultural and scientific practices which may need to be abandoned.

    Essentially all symptoms of ASDs can be completely explained by low NO.

    The �mercury causes autism� idea is false and is completely inconsistent with much that is well known in the scientific literature. There is nothing to support it. It should have been abandoned years ago.

    There is potentially a mechanism by which an acute infection could �trigger� something that exacerbates the symptoms of ASDs. When an infection occurs, there is expression of iNOS, inducible nitric oxide synthase. This produces quite large amounts of NO, for about a day or so. This NO is what causes the hypotension of septic shock. If this high NO state persists, it can affect the feedback inhibition of expression of eNOS and nNOS, and so lower basal NO levels. The transcription factor that regulates iNOS expression is NFkB, which is inhibited by NO. Under conditions of low basal NO (as in chronic inflammation), NFkB is less inhibited, so when it gets triggered, more iNOS is expressed than if there was a higher basal NO level. So if one has low NO, then more iNOS gets made, and transient levels of NO are higher, leading to lower expression of eNOS and nNOS. I call this the �low NO ratchet�. Each case of immune system stimulation can causes basal NO to �ratchet� a little bit lower. A vaccination could do this, as could any of the zillions of colds, flues, fevers, diarrhea, etc, etc that children go through in their early life.

    The focus of my work is how to supply and regulate the basal level of NO during normal physiology. My hypothesis is that certain commensal bacteria, autotrophic ammonia oxidizing bacteria are responsible for this by oxidizing the ammonia in sweat into NO and nitrite which is absorbed into the skin. I think that the profuse sweating that sometimes occurs when a fever �breaks� is to supply the body with NO and nitrite from these bacteria.

  9. #9 HCN
    June 18, 2007

    Brian, it is a common tactic with the anti-vaccine folks to claim that there is “science” showing a definite link between vaccines and autism… and yet fail to show the actual cites.

    Usually the papers they cite are from such less than illustrious sources such as the “American Association of Surgeons and Physicians” (which is not indexed at http://www.pubmed.gov for a very good reason, it is more of a political publication than a scientific one), “Medical Hypothesis” (all one has to do is look up the word “hypothesis”), or from a researcher who is either being paid by a lawyer for specific results (Wakefield and the Geiers), or is trying to make money providing expensive cures (Buttar, Yasko, Bradstreet… and oh, look it also includes the Geiers with their unique solution of chemical castration of kids!).

    To illustrate how this kind of information is being played in the present Omnibus Autism trial I present testimony from Kinsbourne on Day 5, starting at page 1201 (you can download it at ftp://autism.uscfc.uscourts.gov/autism/index.html ):

    8 Q Doctor, do you know Dr. Bradstreet?
    9 A I’ve met him. I don’t know him.
    10 Q Do you know — and this is the part of your
    11 report that’s coming up now. Now, he’s not a
    12 neurologist, is he?
    13 A No, no. Not at all.
    14 Q He’s not a virologist, is he?
    15 A I don’t think that he has a particular
    16 specialty. I’m not totally sure of that, but I’m not
    17 aware of him being a specialist in the domains that
    18 we’re discussing.
    19 Q Do you know how he recovered measles vaccine
    20 virus material from cerebrospinal fluid?
    21 A Well, he didn’t recover it. I mean, he sent
    22 it to Ireland.
    23 Q So it was sent to the same lab?
    24 A Yes.
    25 Q Unigenetics?
    1 A Correct.
    2 Q Do you know if the journal that he published
    3 these results in is indexed?
    4 A Which journal was it in?
    5 Q You cited it, Doctor.
    6 A Yeah. Okay. I think it was probably the
    7 Journal of American Physicians and Surgeons or some
    8 such title.
    9 Q That’s what it was.
    10 A Okay. I don’t know much about the Journal.
    11 Q So you don’t know whether it was indexed?
    12 A Whether it’s?
    13 Q It’s indexed?
    14 A I have no idea.
    15 Q Do you know what the term indexed means?
    16 A Sorry. Could you say it again?
    17 Q Do you know what the term indexed means in
    18 relation to a journal?
    19 A In the indexed medicals? Maybe I should
    20 know something. I don’t.
    21 Q Do you publish important work in nonindexed
    22 journals?
    23 A Apparently not. When I’ve sent an article
    24 for publication I’ve never first tried to determine
    25 whether the journal was indexed mostly because I don’t
    1 know what that means.
    2 Q That’s fine, Doctor. So Dr. Bradstreet is
    3 not a neurologist, he’s not a virologist. He’s
    4 reporting on a neurologic and virologic finding. Is
    5 that right?
    6 A Correct.
    7 Q Do you know anything else about him? I
    8 mean, you know of him?
    9 A I know of him. I know he has a practice in
    10 Florida someplace, and he sees a lot of autistic
    11 children. That’s pretty much what I know.
    12 Q And he sells them medication?
    13 A He does what with them?
    14 Q He has a mail order business to sell them
    15 medication?
    16 A I’m not aware of that. I don’t know.
    ….

  10. #10 b. sharp
    June 18, 2007

    I’ll try to be polite here-Roza, there is no proof that autism is due to having an extreme male brain, and if women with it had it I’d suspect most of us would have something like what is called Gender Dysmorphic Disorder (I invite any neurologist to correct me if I’m wrong here, I’m honestly curious if I’m not that up to date about that matter, and I’m willing to change my mind about it should there be enough convincing evidence). Systemizing and empathizing are false dichotomies, most people have both regardless of sex. I’m sure there are a few differences between male and female brains, but not to the extreme this person likes to allege. Until Baron-Cohen can provide a few peer-reviewed studies confirming his hypothesis I remain skeptical about that truth claim.

    that represents a next step on evolutionary ladder.

    Uh, no, we all share the same amount of genes with the rest of the population. We have not speciated. And the human race for all we know has had autistic individuals since time began. I urge you to look into books about evolution and biology before making these kinds of claims. As for the rest of what you said here, I admit ignorance, but considering the fact that you seem to also believe what else you said here about autism and evolution, I remain exteremly skeptical.

    Logic is a strength for people with Autism in pure form.

    Ah, but everyone can apply it goodly or badly, with or without autism. I think you have a romantasized view here. :)

    And truth and justice seem to be high on the agenda (because those are logical – lies and propaganda are not).

    The desire for truth and justice is emotionally-driven. I’m not knocking it, and I think it’s a pretty good thing to have if you are a member of an oppressed group. Oppression aside, those ideals tend to be good idea, at least for survival strategies. Certainly, there is probably an evolutionary rational to care about ethics, justice, and so forth, particularly since we’re members of a very social species. But let’s not confuse the idea and desire for it with logical arguments themselves.

    (Apologies for any mistakes or errors I may of made here in this response, I’m still suffering from a hangover).

  11. #11 Joseph
    June 18, 2007

    Autistic individuals have unique strengths. There are mountains of research in this area and there’s no point in pretending it doesn’t exist. I’d refer readers to the work of Michelle Dawson and to her blog (autismcrisis.blogspot.com).

    But to suggest that these unique strengths indicate that autism is the “next evolutionary step” or something of the sort is not only inappropriate, bigotted to an extent, badly perceived, and damaging to many autistics needing supports, but it also does not make sense scientifically. For one, reproduction is a key part of evolutionary fitness (much more than any form of intelligence I imagine). And as a previous commenter indicated, there is no evidence of speciation in humans as of yet.

  12. #12 Arthur Allen
    June 18, 2007

    Yours is a very concise evaluation of the history and role of the anti-vaccination movement. There is obviously a lot more to be said (half of my 520 page book Vaccine: the Controversial Story of Medicine’s Greatest Lifesaver deals with this and related subjects).

    As you note, vaccines did a lot of harm in the early days. Jenner’s vaccine was one of the first medications to actually work, but (I detail this exhaustively in my book) it was far from perfect. No one really knew what vaccine was (nor do they know to this day — ‘vaccinia’ is not related to what is now known as cowpox) or where it came from. So if you happened to have some potent vaccine, it worked but you didn’t know what it was. Chances were, it would NOT be potent, because it had to be shipped across the country as a scab in an envelope, or something on the end of an ivory stick. Or it would be contaminated with (or even supplanted by) TB or tetanus or half a dozen other pathogens, and the result would be a hugely swollen arm or worse — with or without immunity to smallpox! (We’re talking up to maybe 1920). One of the parts of my book I’m most proud of is my (completely original, if somewhat obscure) reconstruction of the smallpox epidemic/vaccine crisis of 1901-3. During those years, variola minor, a less deadly form of smallpox, became the dominant strain in the US, which further complicated the risk/benefit equation of using a crappy vaccine.

    There are a number of basic issues with the way vaccination operates on the psyche that make it harder for people to accept. One is the fact that it is given to a healthy child. There is something particularly horrible about the idea of giving a healthy child something that has a chance of making it sick. You can find expressions of this horror even in the literature of 1721, when Cotton Mather was introducing smallpox variolation into colonial Boston. I have a quote in my book from one of the Salem hanging judges in which he beseeches his college-aged son not to get variolated, saying that he’d much rather he be taken by God than by his own hand. There’s some of that there. Then too, vaccination is something out of our control (unlike driving a car at high speed on the freeway), its benefits are virtually invisible, except in the middle of an epidemic, and vaccines seem insidious because they represent a kind of reprogramming of the immune system, rather than the apparently straightforward chemical response to a malady that you get in a pill.

    The vaccines-cause-autism fiesta represents a kind of perfect storm for the anti-vaccinists, a mixture of novel and historical causes converging to give it continuous momentum. There are so many elements that it may be simpler for me to just list them arbitrarily:
    –the growing ability of science to detect small things that may or may not have significance (through PCR, genotyping, refined chemical analyses) and to communicate them over the Internet, so that the most obscure paper immediately finds “its” audience;
    –the obsession with healthy living and the concern about toxics;
    –ancillary factor: the environmental movement’s concern with toxic waste and the environmental movement’s powerful influence. When leading environmentalists (RFK Jr, Environemntal Working Group) bought into the theory, this represented a tipping point of sorts;
    –the fact that many parents of autistic chidlren who have fallen into this Wonderland for one reason or another are well-heeled and perseverating;
    –the Internet, which, in terms of first impressions, removes the denominator (If 1 in 150 children is autistic, you might perceive it as quite rare if you lived in a town of 5,000 people. But it’s easy to “meet” autistics on the Intenet, no matter how small a town you live in);
    –the clout and immense wealth of the supplements industry, which feeds off of autistic parents, just as patent medicine peddlers were in league with the anti-vaccinists a century ago;
    –the fact that �where there is no cure there are thousands of treatments,� as Eric Fombonne said in Vaccine Court today;
    –the fact that people get screwed by their HMOs and resent them;
    –the fact that people get screwed by their local Boards of Education and are angry;
    –the fact that Baby Boomers expect their lives to be perfect;
    –the fact that people mistrust the Bush administration, and with good reason.

  13. #13 Chris Noble
    June 18, 2007

    It’s also not too surprising to see, when one peruses the various anti-vax sites (there are too many for me to list and the Millenium project’s list here is very thorough), the overlap with other anti-medicine movements, including HIV/AIDS denialists like Mohammed A. Al-Bayati,…

    The overlap with HIV/AIDS Denial is quite strong.

    Andrew Maniotis appears to be a rabid anti-vaccination loon as does David Crowe.

    Then again there are some anti-vaccination loons that maintain that HIV was deliberately or accidentally introduced into US homosexuals via the Hepatitis B vaccination program in the 70s.

    Consistency isn’t a strong point of Denialism.

  14. #14 Obdulantist
    June 19, 2007

    HCN. I think you dismiss the journal Medical Hypotheses a little too quickly. It is entirely appropriate to have a journal that discusses novel theoretical ideas that have not yet been properly experimentally evaluated. The key words here are ‘have not yet’. I also point out that the journal does not in any way misrepresent itself.

    I have seen some quite interesting stuff in Medical Hypotheses that I wouldn’t dismiss out of hand until experimentally evaluated, (though neither would I base clinical judgments on it).

    Disclaimer: I have never published in Medical Hypotheses, or even submitted to it, and am unlikely to ever do so.

  15. #15 daedalus2u
    June 19, 2007

    My perspective on ASDs is that all humans have them, and that ASDs are an evolved feature, a response to stress in utero that programs the developing brain to have a (more) extreme “stress response”. In humans, that means greater facility at making and using tools.

    When did ASD individuals first appear in the human family?

    When tool use became important.

    It is not a “next” step in evolution (which is a fundamentally wrong concept), humans have already evolved it. It is a stress response, like the many other stress responses we have, many of which can be programmed in utero.

  16. #16 HCN
    June 19, 2007

    Obdulantist: Keyword you use about “Medical Hypothesis” is “novel theoretical ideas”.

    This does not apply to the thimerosal in vaccines which has been shown over, and over and over again to have no casual relationship with autism.

    I did not dismiss the whole journal out of hand, but I am actually referring to a specific article written by certain individuals including a nurse, a financial advisor, a chemical engineer and others with that type of medical expertise.

  17. #17 Chris Noble
    June 19, 2007

    I also point out that the journal does not in any way misrepresent itself.

    The journal is upfront with its editorial policy. Unfortunately, many of the people who publish in Medical Hypotheses are not. Nor are their supporters.

    Various flavours of Denialism point to articles in the “peer reviewed” Medical Hypotheses as evidence that their pseudoscience is valid.

    HIV/AIDS and vaccination denialist Andrew Maniotis recently claimed that many major scientific breakthroughs were first published in Medical Hypotheses. However, he never answered when he was asked to name them.

    Perhaps Medical Hypotheses does catch some wheat but most if not all is chaff.

  18. #18 dean0
    June 21, 2007

    Once upon a time, everyone got sick – just bad luck – and died.

    Then Jenner came along and invented vaccination.

    Diseases went away and everyone lived happily ever after.

    It’s a lovely fairy story.

    The only people who object to it seem to be pesky medical historians, Drs,Epidemiologist and journalists etc who have taken a long hard look at the facts.

    See, for example, the experience of England which saw smallpox vaccination utterly fail to wipe out the disease.

    Sanitation proved to be the saviour, as historians have repaetdly stated and can be easily checked by abnyone with internet access who is prepared to look past wikipedia.

    http://www.counterpunch.org/dachel06202007.html

  19. #19 deano
    June 21, 2007

    Oh, and the attempt to smear Andrew Wakefield was pathetic.

    Like, “don’t worry about him, he’s on THEIR payroll.”

    (Tired conspiracy theories, anyone?)

    Gee, I wonder if it’s ever happened that pro-vaccine scientists and pundits are on anyone’s payroll? Like a pharamceutical company, for instance? Nah! Scientists get their money by farming gold in World of Warcraft, obviously, leaving them free to be the honest and trustworthy independent free thinkers the public knows and loves.

    And as for pharmaceutical companies…well, a more honest and sincere lot it would be harder to meet.

    Is it a conspiracy theory that big pharma knowingly kills and injures users of it’s products while hiring the best pr and lawyers money can buy and using dirty tricks to subvert the sytem, delay justice and gain the upper hand?

    No – it’s a simple fact, established in courts of law by juries and judges.

  20. #20 MarkH
    June 21, 2007

    DeanO, how do you explain how each disease disappeared following the advent of the vaccine – with rollouts occuring over several decades?

    The history of vaccines is full of examples of vaccines causing harm. There have been examples of contamination with HepB, of non-sterile conditions etc. But to deny their benefit or their role in disease eradication is denialism of the highest order.

  21. #21 HCN
    June 21, 2007

    Yes, but sanitation is also what delayed babies getting polio, and then when they got it as older children it was more dangerous. Sanitation made polio worse:
    http://www.scq.ubc.ca/polio.pdf (also see _Polio, An American Story_ by David Oshinsky)

    Also, measles does not care about sanitation too much. Just ask the church group in Indiana that had over 30 members come down with measles in 2005. Japan is now experiencing an outbreak in measles to the extent some colleges had to cancel classes. Is there some kind of sanitation problem in Japan?

    If smallpox vaccination failed to wipe out the disease, why did they stop vaccinating the general population against smallpox over 30 years ago? Are there still people getting smallpox? Where? Who?

    The article you listed had this quote: “Dan Olmsted has already shown us that it’s possible. He found unvaccinated Amish and he found unvaccinated kids in a medical group in Chicago. He also found no autism in those groups and that may be why the Centers for Disease Control and Prevention hasn’t jumped at the chance to settle this heated issue once and for all.”

    The problem is that it is a false statement. The Amish will vaccinate their kids when reminded or when there is an outbreak of a disease, and they do have other genetic disabilities that make them a prime population for genetic disease studies. Just look up the Clinic for Special Children in Pennsylvania.

    A very good history of vaccination which details quite nicely the sometimes horrible history of smallpox vaccination and other terrible things in a more balanced manner is this:
    http://www.amazon.com/Vaccine-Controversial-Medicines-Greatest-Lifesaver/dp/0393059111/

  22. #22 deano
    June 21, 2007

    Who are the denialists?

    It’s the pro-vaccinators who consistently pretend that reports like this never happen:

    http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/10/27/nflu27.xml

    “In infants up to two, vaccination was no better than placebo and in older children there was little evidence of benefit.

    Nor could he find enough evidence of benefit among people with chronic chest problems, asthma and cystic fibrosis.

    In healthy adults the best evidence was that, on average, flu vaccination of a population would prevent 0.1 per cent of a working day lost.”

    Wow! and his research had a big effect on government policy didn’t it? nope!

    And you pro-vaccinators will happily link to it and quote it in your future writings, wont you?
    Instead of writing about nutters and micro-chip conspiracy theories.

    With Gardasil and the like, I’m already seeing the same old pattern:” Get your child vaccinated. You’ll be fine. Sideffects? Everyone agrees it’s fine and effective.”

    Everyone?

    Well, if you’ve got internet access you’ll be able to find dissenting voices but we don’t encourage our viewers to turn off the telly and go and do some reading. Trust us, this press release we’re reading says it’s safe and effective.

  23. #23 MarkH
    June 21, 2007

    Wow Dean0, you’re a pretty expert crank there. I love how you manage avoid all the criticisms of your stupid claim based on the genetic fallacy, and the absence of real proof that vaccines cause autism. You link another article which claims that the IOM, the pediatricians, the CDC and others are involved in a global conspiracy to hide evidence of a link. Then, when challenged, you just jump to the next attack – the flu vaccine.

    But that wasn’t your assertion was it? It was that sanitation removed these problems, not vaccines. It’s interesting, did we invent sanitation in 1947? Because that’s when tetanus dropped off (as shown in the graph above), and MMR – they dropped off after the invention in the 60s of a vaccine – maybe in the 60s we discovered sanitation? Oh, wait, no, we invented sanitation in the 50s, just in time for the polio vaccine. That’s it.

    Your arguments are a joke, when it’s pointed out, it’s onto the next foolish talking point. Classic crankery.

  24. #24 HCN
    June 21, 2007

    Hey, I still want to know how the sanitation argument works with the Japanese measles outbreak! Come on, DeanO… tell me, tell me!

    You may want to read this first:
    http://www.theage.com.au/news/world/measles-epidemic-strikes-japan/2007/05/25/1179601669854.html

  25. #25 Rozagy
    December 29, 2007

    Andrew Wakefield is a fraudster. Everybody knows that. If you don’t – look it up, read, compare facts – they speak for themselves!

    Anyway, people do all sorts of despicable stuff to make money. It’s a very “normal” thing to do in this society obsessed with drive for amassing material possessions determining levels of “success” and money-fueled wars for power (to appease fragile egos needing to be fed. It’s often linked with sexual impotence and inferiority-ridden psyche).

    Many great minds who influenced society are on the Autism spectrum. They are also reported to have lower sexual drive or at least don’t see it as “priority”. Nor are they money-driven (Einstein wasn’t. Steven Spielberg can’t help being successful financial, because that’s how movie industry is set up. He’s just brilliant at what he does, but he doesn’t do it “for money”. Steven Spielberg has Asperger’s.)

    Autistics abandoned social “niceties” and mindless socialising in favour of spending as much time as possible on their areas of interest, be it science, art, music, film or writing. Social game-playing serves only one purpose: to appease ego! Sleeping around, smoking, drinking, e.t.c. are base needs that are too low even for animals. Scientific discovery, art, music and other acts of creativity are the next level of human evolution because those are the food for the Soul.

    Hence, Autistics ARE the next step in human evolution by their own choice – they don’t care about what society chooses they should choose!

    anyone who disagrees is just jealous of us! LOL :-))))))))

    STOP DUMBING DOWN OUR AUTISTIC GENIUS KIDS!

    You can’t control Autistic minds because we’re all individual, we don’t follow crowds or trends – we create them! I wouldn’t be surprised if governments were complicit in the rise of anti-mercury and “curist” groups to help them “silence” the rise of Autistic intelligence because they simply can’t control us!!!! But I’m not into any conspiracy theories – only into facts! and I don’t care anyway! NOBODY can keep us down! Try and you will fail!!!!!

    They used to kill us of by placing us into asylums, torturing us, isolating us from the world. Now we’re free to marry whom we want – mostly other Autistics – and have our Autistic kids, do our jobs that are best suited Autistic minds and multiply (hence the rise in Autism diagnosis). Assortative mating theory is correct. And so is Extreme male brain theory of Autism (by brilliant prof. Simon Baron-Cohen).

    I’m an Autistic female, I have higher IQ than most “normal” males (never mind “normal” females … which proves theory perfectly as it’s a well-known fact that females have lower IQ but higher capacity for empathising and socialising – and gossiping!!!)

    Autistic is a different kind of human, absolutely, because we evolved out of emerging differently needs of society as a whole (even though majority can kick and scream – they need us in this increasingly technologically advancing world we live in. Guess who invented all the technology??? LOL :-)))

    it has nothing to do with biological MALE OR FEMALE sex! Somebody is barking up the wrong tree there suggesting body dysmorphia or being born in the wrong body syndrome…

    Being of extreme male intelligence does not interfere with my mothering skills – in fact, I’m more efficient than some “normal” females because I don’t spend hours on the phone talking crap – I pay attention to my kids! I’m clean, precise and efficient, I plan ahead and give my children my undivided attention – I can’t be any other way! I ALWAYS give 100 per cent to whatever it is I am doing at a time.

    I’m strong emotionally and psychologically because my Autistic father (who was very successful in his career) taught me to respect myself, believe in my abilities. He dismissed the societal notion of what girls are expected to do in life and taught me to reach for the stars and choose any profession I wanted. My education was excellent and I still find it easy to learn new things. My career is on the up which gives me even more confidence that I pass onto my children.

    At nearly 37, I’m not going to make any excuses for my “difference” and I don’t even ant to change, never mind be “cured”, because I accept myself as I am, with my epilepsy, with my stimming (rocking), my desire to work alone, my strong views about wrong and right, my high morals. I don’t care if you call me arrogant – males would be called strong in that same position. Especially middle-class white males. Why can’t a female be strong? I also don’t have hidden weaknesses that having a penis brings: I lack animal urges which gives me a clear mind at all times (many Autistic males, by the way, do not have the same animal urges as neurotypical males seem to be lumbered with or at least they are overridden by Autistic’s intellectual desires to pursue their areas of interest, i.e. Autistic “obsessions”, like math or science or art and music….)

    You can fume about what I’m saying but it doesn’t make it any less true, no matter how unpalatable.

    That’s how it is! DEAL WITH IT!

    lol :-))))

    Roza,
    Artistic Autistic and proud!

    http://www.myspace.com/rozagy
    http://www.autismart.org

  26. #26 Anonymous
    April 16, 2008

    blah

  27. #27 David McKenzie
    October 27, 2008

    I found your article enlightening, especially as one who was once suspicious of vaccines myself. Luckily I decided to vaccinate my children anyway despite the “information” out there about the dire risks of vaccines and the possible autism link. Thank you for a thorough and convincing analysis of the situation, as it has allayed my fears. A couple of comments on the critical side, however: don’t be too hard on people who are sometimes rightfully suspicious of the medical profession. Have there not been genuine cases of medical malpractice and real harm done in the centuries that this field of study and application has been practiced? Second: Why the crack against Deepak Chopra at the end of your article? Was it really necessary in an article that really had nothing to do with him? To me it smacked of a kind of political or otherwise unscientific bias against people who do not necessarily see the world the same as you. It momentarily made me re-evaluate your article for the same kind of unthinking bias that you accuse others of. After re-reading it, however, I still find your article convincing. I just find it unhelpful for you to crack on someone unrelated to the topic at hand without any follow-up as to what you mean or any evidence that this person is as shallow and stupid as you seem to think he is based on your comment. Although Mr. Chopra presents alternative ways of thinking about well-being, I am fairly certain that many people have benefitted from his views and his perspectives. Just my thoughts. Still, my thanks to you for an otherwise well written and convincing article. A summary of my criticism: Step back a little bit from your sarcasm and mockery of the other side and perhaps your thoughts will be even more objective seeming and hence “undeniable.”

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