Orac is the nom de blog of a humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
I had wanted to let this cup pass, but couldn't, not after several readers e-mailed it to me and I went and experienced its inanity first hand. As Michael Corleone said in The Godfather, Part III: "Just when I thought I was finally out, they drag me back in again!" In this case, it was Robert F. Kennedy, Jr. who did the dragging.
Yes, RFK Jr. has dropped one more steamy, stinky turd on the blogosphere. No, it's not nearly as big and stinky as the first one that he dropped back in June, but that's almost certainly only because it's a short blog piece, rather than a full feature article for Salon.com and Rolling Stone. I'm sure if RFK had expanded the article to the length of his infamous June Salon.com/Rolling Stone article, he'd have almost certainly matched or exceeded its foulness. (The man seldom disappoints in that respect.) I commented on the many distortions and examples of faulty reasoning in RFK Jr.'s article shortly after it came out. Several other skeptical bloggers ripped into the article's mendacity, including Skeptico (whose exposure of the utterly dishonest and deceptive manner in which RFK Jr. misrepresented the Simpsonwood Conference as a secret meeting in which dire conspiracies were discussed, not unlike the Cigarette Smoking Man would have thought up on the X-Files, was a classic in skeptical blogging, as was his later revelation about how RFK Jr. super-selectively quote-mined the Institute of Medicine report to make it appear as though there was a cover-up about thimerosal in vaccines when there wasn't); Majikthise, who came to pretty much the same conclusion about the Simpsonwood Meeting; and Autism Diva , who pointed out even more errors and distortions in the article.
Yes, on The Huffington Post, that repository of altie woo, ranging from the antivaxer who claims he isn't, pediatrician Dr. Jay Gordon, and that tireless purveyor of quantum physics pseudoscientific New Age nonsense Deepak Chopra, RFK Jr. has, after a several month absence, returned to resurrect his conspiracy-mongering regarding the CDC and vaccines.
Not unexpectedly, RFK Jr.'s article, Time for the CDC to come clean, starts poorly, with a blanket statement that is unsupported by science:
Thimerosal is the mercury-based vaccine preservative that has been linked to epidemics of neurological disorders, including autism, in American children born after 1989.
Yes, it's more of the same old assertions without evidence. (See the links at the end of this article for multiple discussions about why this assertion is unsupported and almost certainly incorrect.) The article then gets to the meat of RFK Jr.'s conspiracy-mongering, proceeding to an accusation that the CDC quietly turned down an offer by SmithKline Beecham Pharmaceuticals in 1999 to begin production of thimerosal-free vaccines immediately:
But the newly released documents show that behind the scenes CDC was quietly discouraging Thimerosal's removal. In a July 1999 letter, vaccine producer SmithKline Beecham tells CDC that it is ready to produce non-Thimerosal DTP (Diptheria/Tetanus/Pertussis) vaccines immediately and has sufficient inventories to supply the entire U.S. market during the remainder of 1999 and the first half of 2000, by which time other vaccine manufacturers would have their Thimerosal-free DTP vaccines on line.
It doesn't help that RFK Jr. links directly to an site touting the supposed link between thimerosal and autism, but let's look at the actual letters, shall we? The letter from SmithKline Beecham to me looks like a pitch for an exclusive contract to supply vaccines, stating early in the letter:
As a manufacturer, we agree that, despite the absence of any scientific data that thimerosal causes any adverse effects, whenever possible "thimerosal-containing vaccines should be removed as soon as possible," as is recommended in the July 7 Joint Statement of the AAP and the U.S. Public Health Service (PHS). For this reason we wish to inform you that SB is in a position to supply Infanrix (Diptheria and Tetanous Toxoids and Acellular Pertussis Vaccine Adsorbed), the only U.S. licensed DTPa vaccine that does not use thimerosal as a preservative, in enough quantities to supply the estimated U.S. market needs for at least the remainder of 1999 and the first half of 2000. By that time, other thimerosal-free DTPa products, including SB's pentavalent DTPa/HB/IPV, will likely be available, pending FDA approval.
Near the end of the letter, SB makes its intent explicit:
Several weeks ago, SmithKline Beecham was approached by the vaccine contracting department at the CDC inquiring about our ability to supply the entire U.S. DTPa market with Infanrix and the potential for an exclusive DTPa contract., until other nonthimerosal DTPa vaccines were licensed. In reviewing our inventory levels, SmithKline Beecham is now in the position to move forward with such a contract. We believe the exclusive availability of Infanrix DTPa moves the AAP, CDC, and PHS much closer to their stated objectives of thimerosal-free vaccines in the U.S.
So, basically, SmithKline Beecham had been approached about the possibility of providing thimerosal-free DTPa (which begs the question of why the CDC would have approached SB in the first place about thimerosal-free vaccines if it were so intent on promoting thimerosal, but I digress). Based on that contact, the company was now making a pitch that it could fulfill an exclusive contract, which no doubt would have been highly profitable. The reply letter, which RFK described as "rejecting SmithKline's offer," actually did nothing of the sort. Here's how it concluded:
The Centers for Disease Control and Prevention (CDC) National Immunization Program staff has communicated this updated information regarding your supply to the 64 immunization projects. CDC also plans to monitor DTaP ordering patterns and continue to provide the States with a choice among currently licensed brands of DTaP vaccine.
In essence, it sounds as though the CDC took the pitch under advisement and wanted to keep its options open for the 64 vaccination programs under its auspices. So upon what does RFK Jr. base his dire-sounding insinuations of conspiracy? Upon what appears to be a single anonymous "federal health official," who claims that the motivation was largely to protect the financial interests of the CDC's "vaccine industry friends." It may be true that anonymous sources are a time-honored technique in journalism, but they are also a risky one, mainly because it's impossible for the reader to evaluate their veracity, reliability, or potential conflict of interest. Given the way RFK Jr. has utterly destroyed his credibility on this issue by selectively quoting the Simpsonwood transcript and the Institute of Medicine report to the point that I have to wonder if he was outright lying, by cherry-picking all the dubious data that supposedly supports a link between mercury and autism and ignores the much better evidence that refutes such a link, and confuses correlation with causation again and again and again, I can no longer give him the benefit of the doubt on any assertion he makes, much less his use of a single anonymous source. Could there have been a big conspiracy by the CDC to promote thimerosal in order to protect the pharmaceutical industry? I suppose it's possible, but RFK Jr. certainly hasn't made the case that it's true, either last June or now. To me, the one assertion by this anonymous source that rings true is this:
"There was also concern," says the federal official, "that an immediate withdrawal might discredit the international vaccine programs for which CDC is an important partner." The World Health Organization has urged CDC against the banning of Thimerosal in U.S. vaccines since that prohibition might discredit WHO's third world inoculation programs.
Indeed, why should WHO remove thimerosal when there was no good evidence that it caused autism or any other neurological diseaese, particularly when doing so could deal a severe blow to efforts to vaccination programs in poor nations?
Near the end of the article, RFK Jr. makes this accusation:
CDC continues to exert muscular efforts to derail studies of American cohorts -- the Amish, Christian Scientists, and home-schooled children -- who were not exposed to Thimerosal vaccines. Preliminary studies of these groups indicate very low levels of the neurological disorders, including autism, that have been associated with Thimerosal in vaccinated populations.
Of course, RFK Jr. presents no evidence whatsoever that the CDC was or is trying to derail any vaccine studies in any population. (I guess we just have to take his word for it.) Indeed, his assertion that there are lower rates of autism and neurological disorders in these children is also flawed. In reality there is no credible evidence to support this contention, which has been popularized by UPI reporter Dan Olmstead. I addressed one such bit of credulity towards unsupported claims about unvaccinated patients in the suburbs of Chicago, and pointed out how this supposed finding was based solely on the undocumented and unsubstantiated recollection of a single practice of altie doctors. (Can you say confirmation bias? Sure, I knew your could.) Prometheus ably took on the claim that the Amish have a lower incidence of autism, pointing out that, even if that were the case, there are so many other factors, genetic and environmental, that could be just as plausible an explanation for such a difference that it is curious that antivaccination advocates would automatically zero in on vaccines without even acknowledging these other possibilities.
The bottom line is that at present there is no compelling epidemiological, scientific, or clinical trial evidence that mercury in thimerosal in vaccines causes autism, RFK Jr.'s conspiracy-mongering notwithstanding. Indeed, now that thimerosal has been removed from all routine pediatric vaccines except the flu vaccine since 2003, there is as yet no evidence of a decrease in the rate of autism. In other nations, such as Denmark, there has been no evidence of a decrease in the rate of new diagnoses of autism even 13 years after thimerosal was removed from vaccines. This is pretty strong epidemiological evidence that there is no link between the two. At best, one can postulate that a very small percentage of the population might be susceptible to mercury, a population that is such a small percentage of the overall populationthat it wasn't detected, but that's a far cry from the dogmatic statements of groups like Generation Rescue that "autism is a misdiagnosis for mercury poisoning." In addition, there isn't really any good evidence that such a population exists or that mercury causes autism in it. In fact, the symptoms of autism don't even resemble the symptoms of mercury poisoning. (Look up Pink Disease, if you don't believe me, particularly the skin changes associated with mercury poisoning in children.)
So why does this pseudoscience persist? Certainly it's not because of good science. The available evidence does not support a link between thimerosal in vaccines and autism, and the articles published by those claiming a link is usually published in journals that are either ideologically biased or not peer-reviewed. Articles in better journals that are touted as showing a link almost always, upon closer examination (such as reading the entire article rather than just the abstract) do not support a link or are very weak evidence at best. Kathleen Seidel correctly points out one reason:
It's time for RFK Jr. to come clean about the fact that he represents the interests of private litigants seeking compensation for supposed vaccine injury when in fact many of those litigants have no evidence that such injury occurred. Many never even suspected that their children were "damaged" until they were convinced after the fact that vaccines offered the only possible explanation for their children's autism. The sense of entitlement and certainty expressed by many autism=poisoning crusaders is not always based on a careful review of a wide range of information. The numerous studies exonerating vaccines as a cause of autism are often dismissed out of hand, simply because they do not support litigants' preconceptions.
I agree. For what they no doubt consider to be noble motives, people like RFK Jr. and David Kirby have foolishly hitched their names to a cause that is primarily at its heart not about finding the cause of or better treatments for autism, but rather about trial lawyers seeking to sue the National Vaccine Injury Compensation Program (VCIP). Indeed, as I wrote about recently, this litigation has tainted a major vaccine adverse events reporting database. Perhaps the chief driving force behind this movement are the father-and-son tag team of autism quacks and providers of "expert testimony" and legal services to parents seeking to sue the VCIP, Mark and David Geier. They publish highly speculative papers in non-peer-reviewed journals like Medical Hypotheses (which is dedicated to "radical ideas outside the mainstream) or poor quality articles in which they dumpster-dive this tainted database in really crappy woo-filled journals like The Journal of American Physicians and Surgeons, and then use these papers to support their litigation.
Far more harmful is how this widespread belief in an almost certainly nonexistent link between mercury and autism provides an opening to a wide variety of quack "therapies" purported to "cure" autism or greatly mitigate its symptoms, assisted by dubious labs hawking nonstandard "provoked" mercury testing. Chief among these quack therapies is chelation therapy, which, its supporters say to parents, will remove the mercury that is supposedly causing their children's autism. Sadly, it is an ineffective therapy that has led to at least one death, and the quacks don't do it cheaply. Worse, as I pointed out just last week, utterly speculative and even more scientifically implausible variants of chelation therapy have been proposed by the Geiers, the most bizarre of which is their claim that somehow testosterone potentiates the toxicity of mercury and prevents chelation therapy from properly removing mercury. This speculation (I won't dignify it by calling it a "hypothesis" or "theory") has led them to propose an even more bizarre and potentially dangerous solution to this nonexistent problem: the use of Lupron to chemically castrate autistic children in order to make chelation "more effective." I wonder if RFK Jr. knows what bizarre forms chelation for autism has evolved into in the eight months since his original article appeared in Rolling Stone.
Madness. A whole industry of quackery has sprouted up to prey on the desperation of these parents, who will do anything to help their autistic children.
But that's not all. There's still one last harmful effect from this "mercury=autism" hysteria, and it may be the worse effect of all. This intense focus on thimerosal as the "cause" of autism, as the Holy Grail that will lead to cures through chelation, driven by advocacy and pseudoscience rather than sound epidemiology and science, has diverted money, research time, and researchers' attention to rebutting the pseudoscience used to justify the "mercury-autism" link and away from more productive avenues of research into the true etiology and pathogenesis of autism.
That will be RFK Jr.'s legacy for coming down on the wrong side of this issue.
Some previous posts on this topic:
Comments
With all the links, I think this pretty well covers the whole nonsense. Consider this topic bookmarked.
Posted by: BronzeDog | March 2, 2006 8:51 AM
Rule 1: You do not fuck with vaccination (or other public health) programs.
Rule 2: If a vaccine is shown to be safe after it stops being used, then every single person who catches that disease after the vaccine as been stopped should sue those who stopped the vaccine - whether they would have been vaccinated or not (or even if they actually have been vaccinated). The effect of providing mass-immunity from a disease to the whole population is just that great.
Rule 3: Not having yourself or your kids vaccinated is free-loading and thieving from the general immunity of the population. This should be pointed out repeatedly. And cases such as the British MMR case (which probably gave Kennedy his ideas) leading to the return of Measles and Mumps in the general population should be pointed out.
Currently there are only three ways of getting me angry in under 10 seconds flat. Fucking with public health (in particular vaccinations and contraception), Creationism, and lying about your evidence...
Posted by: Francis | March 2, 2006 8:52 AM
RFK Jr. RFK. JFK Jr. is dead, isn't he?
...
...
No, I can't say it.
I subscribed to The Huffington Post after Phil Plait (badastronomy.com) announced his association with them. It lasted less than 48 hours. I don't have time for that crap. Thanks for jumping on this. I have friends who have an autistic son. Thankfully, his case is mild, and they have not fallen into any of these traps, but the issue hits home nonetheless.
Posted by: Paul | March 2, 2006 8:59 AM
Francis;
I had measles, mumps and rubella. They were no big deal Autism is a big deal. Wake Up!
Posted by: Fore Sam | March 2, 2006 12:06 PM
Thats right Fore Sam, you had Measles, Mumps and Rubella and are just fine so they offer no risk to anyone at all. But you haven't had Autism so how can you compare them to know huh? My logic > Fore Sam logic. pwned.
Posted by: Steve | March 2, 2006 12:23 PM
Kids die from measles, and it's "no big deal?"
Even in America, with good health care, measles can still be deadly. 1 in 2,000, or so?, versus an imaginary chance of autism?
Posted by: BronzeDog | March 2, 2006 12:26 PM
You know, by Fore Sam's apparent logic, diabetes isn't a big deal: My dad has it, and he controls it very well through diet and exercise (plus a minor drug help). Of course, my dad knew someone else who had diabetes and ended up dying from gangrene when the blood vessels in her foot broke down, so diabetes is a big deal... Wait, surprise, surprise, Fore Sam's apparent logic leads to a contradiction.
That's why we judge the danger of a disease by more than one individual. Like large population samples, while controlling for other factors. The virulence of measles, mumps, and rubella don't revolve around you, Fore Sam.
Posted by: BronzeDog | March 2, 2006 1:00 PM
Thanks, Orac.
Gee, how about diptheria, Fore Sam. Did you ever know someone who got diptheria and said, "no big deal"? There's a reason why there was an epidemic of diptheria in the former Soviet Union a few years ago, and why there wasn't an epidemic of diptheria here. They had let their vaccine program slip (or had to let it slip) and the US didn't let it slip.
Leave it to Fore Sam (who has taken steps to put himself in line for future money coming from a vaccine lawsuit) a his antivax friends and there will be outbreaks of diptheria here. There have already been deaths from whooping cough most likely caused by the drop in vaccinated kids in California. The parents didn't want their kids to get vaccinated out of an unreasoning and baseless fear of vaccines and their ingredients, so the herd immunity dropped and babies died of pertussis.
Fore Sam would like to see all vaccinations to end today, wouldn't you Fore Sam? Many of the supposedly "anti-mercury" parents are really totally antivaccine and only admit it privately that they will never allow any of their kids to be vaccinated for any reason, and they'll lie about having a religious reason for not vaccinating their kids, too. They talk about doing this on the mercury=autism Internet groups. Just like they talk about their lawsuits and how they intend to make the CDC and "big pharma" pay for their children's suffering which was not caused by the CDC or "big pharma". One thing about "big pharma" and the Dept. of Health and Human Services is that they seem to have very deep pockets, it makes them look like likely targets for the kind of people who suddenly "accidently fall" and hurt themselves in WalMart and even for parents who have been convinced that their kids were made autistic by vaccines by the hysteria.
Parents whose babies die of vaccine preventable diseases can thank people like Arianna Huffington and Bobby (I wish I was president) Kennedy Jr. for keeping the insanity going.
Posted by: Autism Diva | March 2, 2006 1:42 PM
Fore Sam appears to be falling victim to this kind of thinking.
Posted by: Orac | March 2, 2006 2:44 PM
Fixed.
"Fore Sam appears to [have willingly and exuberantly fallen] victim"...
Posted by: Bartholomew Cubbins | March 2, 2006 3:17 PM
Autism Diva said "There have already been deaths from whooping cough most likely caused by the drop in vaccinated kids in California."
Huh?? California DTaP rates for school age children are in the 96-97% range per the CDC. Pertussis is on the rise 1) because it is a cyclical disease 2) because it is largely undiagnosed in anyone older than age two and 3)the DTaP vax only lasts until you are about 10. That's why the adult vax was just licensed. You can't blame whooping cough on kids when most of the cases are in adolescents and adults.
Out of curiosity, do any of you have an infant right now? Just wondering if you really know what it is like to take your 8 week old baby to the doctor and have him injected with vaccines for seven different diseases (soon to be eight) in one day.
I am not worried about thimerosal. I am not worried about the number of needles. I am worried about Offit thinking that 10,000 vaccines in a day is just fine.
Posted by: Concerned Mom | March 2, 2006 3:27 PM
Nicely done, once again.
Folks, sadly there's no convincing Fore Sam. He's not here to inform, he is here to instigate. If you stop feeding the troll, he will wither and die.
Posted by: Ali | March 2, 2006 3:39 PM
Concerned Mom,
I am not worried about thimerosal. I am not worried about the number of needles. I am worried about Offit thinking that 10,000 vaccines in a day is just fine.
I'm kinda on the same page as you. To be honest, I didn't even know there were all these semi-organized "Anti-Vax" groups out there who generate hostile reactions from Orac and his minions.
I, too, am not worried about thimerosol. I'm sure somewhere some solid (non-lawyer) epidemiological studies have been undertaken comparing autism rates of 2 groups: those who took thimerosal and those who didn't. Whatever the results are, I'll abide by.
Also, I do think highly of vaccines, in general, or at least historically. I am persuaded that polio and small pox vaccines have virtually eliminated said diseases in US -- which obviously is a good thing.
You raise one excellent point that intrigues me:
...thinking that 10,000 vaccines in a day is just fine.
I guess the question is, Whether there is a region of diminishing rate of (health) return, the more vaccines one takes. There could be a "saturation factor" where more and more innoculations, counter-intuivitively, end up on the margins, hurting, not helping, the child.
That's a viable hypothesis -- I'm suspect it has been tested somewhere, but I don't know. I care about the health of kids, more so than debunking anybody or defending vaccines. So, I haven't formed concrete opinions on the matter, other than the general ones above.
Hank Barnes
Posted by: Hank Barnes | March 2, 2006 3:46 PM
Fore Sam seems to be sticking around for shorter periods of time, and I'm trying being more direct in disecting his stuff. I have a habit of getting into a subtle Socratic mode, which seems to be self-defeating when someone won't pay attention to what I'm saying.
I also don't want any fence-sitting lurkers to commit any arguments from silence.
Posted by: BronzeDog | March 2, 2006 3:51 PM
Dear Concerned Mom,
Unless you live in a hermetically sealed bubble, you and your child come into contact with more than enough microbes than would ever be in 10000 vaccines. That is what he meant... not that eventually what kids will be given that many vaccines.
Also, the number of "needles" is reduced with the combination vaccines. For instance, if your child had MMR vaccine twice as recommended (which has never had thimerosal), that would be two appointments instead of SIX!
Speaking of needles... which would you prefer: The old oral polio vaccine or the now recommended IPV? (an option now that polio is almost gone from the USA, unless some people decide to import it... which happened recently, Polio Outbreak in Minnesota
I've had babies... they've all been vaccinated. But then again they are old enough to get a couple of the actual diseases. Particularly chicken pox and a gastrointestinal ailment that may have been prevented with the new rotavirus vaccine. The latter caused my toddler to become dehydrated and caused a grand mal seizure. I'd much prefer to have avoided that trip to the ER by ambulance.
I've also noticed that vaccine requirements change with time. My kids have never had the smallpox vaccine offered... yet I still bear the scars from the several I had as a kid. They may be re-vaccinated with a new DTaP for adolesecents since pertussis protection does wane after time.
Posted by: HCN | March 2, 2006 3:54 PM
Hey, it looks like real scientists are also looking for the cause of autism!
Posted by: justawriter | March 2, 2006 4:02 PM
That is just one of many research programs on neurology and psychiatry that is going on globally. Here is a link to the efforts in the USA:
Autism Spectrum Disorders Research at NIMH
Posted by: HCN | March 2, 2006 4:13 PM
Any evidence that RFK Jr. is one of the lawyers representing private litigants? There's nothing in the link, and I didn't find anything in a quick scan of the Web.
Posted by: Brian S. | March 2, 2006 4:37 PM
Normally, I prefer to avoid appeals to motivation, but I'd certainly like to know, in case I need to do a Socratic tu quoque.
Posted by: BronzeDog | March 2, 2006 4:40 PM
That is not exactly what Kathleen is saying, nor is it what I'm saying. What Kathleen is saying is that RFK Jr. is representing the interests of the litigants and their lawyers, which is undoubtedly true. His articles support their cause. I have no idea what his motivation is, but it probably feeds into his apparent view of himself as a crusader for the little guy against power.
Posted by: Orac | March 2, 2006 4:43 PM
Orac,
The CDC has been deceitful and I have a hard time understanding why you fail to see that. They declared that mercury should be removed from vaccines. I think we will agree on that point. So why wouldn't they give a contract to a company that could supply the country with mercury free vaccines? If their primary goal was to eliminate mercury then there was no reason why they wouldn't have taken SKB up on their offer. But apparently the elimination of mercury from vaccines was not their primary goal. Do you agree with this statement?
In fact, now in 2006 and with mercury still not eliminated from vaccines I think it's quite obvious that the CDC does not want to eliminate mercury from vaccines. If you don't think this is true then how do you explain organizations like the AAP fighting to prevent states from banning mercury from vaccines? To me, that is madness.
You mention Pink Disease and seem to imply that because autistic children do not turn pink they cannot be mercury poisoned. Does the skin change color in all cases of mercury poisoning? Did that happen in Minamata?
Posted by: killerjabs | March 2, 2006 5:10 PM
The statement that RFK Jr. "represents the interests of private litigants seeking compensation for supposed vaccine injury" isn't very meaningful absent some kind of representation. So what if his articles support one side in litigation - is that a huge surprise? What exactly is there for him to come clean about?
FWIW, I think both sides of this debate are guilty of exaggeration and ad hominem attacks. I actually think RFK's side is worse, but Orac's side could stand to be more careful.
Posted by: Brian S. | March 2, 2006 5:38 PM
Brian:
Please state where I have "exaggerated." If anything, I've held my fire a bit. (My first draft was much harsher.) Also, it's obvious that Kathleen was simply turning the title of RFK, Jr.'s article back on him in a rather ironic way.
However, you may have a bit of a point. Perhaps Kathleen and I were suggesting that RFK Jr. should "come clean" about the wrong issue. In actuality, what RFK, Jr. should come clean about is the way he has systematically quote-mined at least two transcripts in most a most deceptive way, distorted evidence, used numerous logical fallacies (his favorite one to violate being the "correlation does not equal causation" fallacy, as I pointed out in my very first piece on the topic), all in the cause of promoting bad science, the worst kinds of autism quackery, and a dark "conspiracy" that almost certainly didn't and doesn't exist.
The bottom line is that RFK Jr. is on the wrong side on this issue. There are many reasons to criticize the CDC or pharmaceutical manufacturers, but the thimerosal issue is not one of them.
Posted by: Orac | March 2, 2006 5:53 PM
Concerned Mom,
As a practicing Pediatrician I deal with concerns such as yours every day. Our bodies are bombarded with foreign antigens from shortly after conception. Our immune system is a highly evolved, complex, and beautiful system that protects us against most invaders. The typical child becomes ill about 8-10 times per year. The typical healthy adult only becomes ill a couple of times per year. Why is this? Because our immune system is a dynamic system that is programmed to learn faster and better that mankinds best computer. Our current vaccines teach the immune system. They are not free of risk. But neither is driving with your children to the grocery store. The simple fact is that every vaccine being given today on balance, saves lives. I have been in practice for only 10 years but I can remember when spinal taps were extremely routine and admissions for H.flu meningitis happened on normal days. My last child admitted for meningitis was 18 months ago. For every anecdote presented by the antivaccine crazies, you could go in any Pediatricians office and hear 100 stories about the terrible diseases that are now virtually eliminated.
The story is not over. You mentioned the 8th vaccine which will be reintroduced this year. I admitted two children this week for Rotavirus and dehydration. In my small community, we lost a child to Rotavirus just last year.
I have two young children and I will continue to vaccinate them with any well studied future vaccines with no hesitation. My son is allergic to eggs and we invested an entire day in the allergists office so he could receive a gradually increasing dose of the measles vaccine.
Posted by: Jackdog | March 2, 2006 6:13 PM
By each "side" of the debate, I meant what proponents on each side are generally saying, not just what Orac is saying in this post and RFK in his post. Maybe I should've been clearer.
If there is an exaggeration in Orac's post, however, it might be the Denmark issue. According to this comment:
http://majikthise.typepad.com/majikthise_/2005/06/thimerosal_corr.html#comment-6378728
Denmark and Canada used little thimerosal before the phaseout, so the lack of response is understandable. I know, completely unsourced info. I don't trust it, but I don't dismiss it out of hand either.
My two cents are that I think Orac's side is 90% likely to be right. I also think RFK Jr. is using environmental lawyer language rather than responsible environmental leader language. And I think both sides should tone down their rhetoric and their claims of certainty.
Posted by: Brian S. | March 2, 2006 6:45 PM
May as well add that I think the record is 100% clear that thimerosal is not the primary cause of autism.
Posted by: Brian S. | March 2, 2006 6:50 PM
"I have two young children and I will continue to vaccinate them with any well studied future vaccines with no hesitation."
Jackdog, It's great to have a pediatrician on this board. The comment of yours that I quoted above is very interesting to me. Are you aware of a single safety study for thimerosal? If yes, please forward on the link. I'm not talking about studies for autism, just studies to prove that thimerosal is safe in vaccines. My understanding is that it was grandfathered into modern medicine since it was invented prior to the FDA.
As a pediatrician, I would also be interested to hear your thoughts regarding the AAP's position on mercury. They take a very strong stance against mercury from coal burning plants yet simultaneously fight against the ban of mercury in vaccines. This truly baffles my mind.
Posted by: killerjabs | March 2, 2006 7:26 PM
Also, the number of "needles" is reduced with the combination vaccines. For instance, if your child had MMR vaccine twice as recommended (which has never had thimerosal), that would be two appointments instead of SIX!
And yet that doesn't prevent some idiots on this side of the Atlantic from having fallen for the idea that MMR causes Autism based on extremely flimsy evidence and a corresponding drop in MMR uptake...
Posted by: Francis | March 2, 2006 7:31 PM
Francis,
There may not be evidence that the MMR causes autism, but there is a growing amount of clinical data showing that autistic children with bowel issues have the vaccine strain of the measles virus in their gut. This was tested via biopsy and I hear the results will be released this summer.
Posted by: killerjabs | March 2, 2006 8:21 PM
"...there is a growing amount of clinical data showing that autistic children with bowel issues have the vaccine strain of the measles virus in their gut."
Yes, and I'm sure there's also a "growing amount" of data showing that autistic children with bowel issues have breast milk in their gut. Does that mean that breast-feeding causes autism?
Posted by: Ebonmuse | March 2, 2006 9:01 PM
It is true that, as of 2001, there was not clear understanding of whether or not thimerosol played a role in autism and other neurodevelopmental problems. The concerns were based in the fact that mercury is often a toxin. That is why the decision was made to go ahead and move to thimersol free single dose vials. There was nothing deceitful about how this was done. The debate is in the public record. The changes were made in a controlled manner. The consequence of moving too quickly and disrupting the vaccine supply in this or other countries can not be minimized. There were infants in this country who contracted Hepatitis B as a result of the delay in administering this vaccine around that time. If anything, based on what I would consider to be flimsy evidence, the move was extremely rapid.
I think the AAP believes that state legislatures have no business getting into this debate. We don't have a perfect process for making these decisions in this country but I personally know my representative and I don't want him involved.
Posted by: Jackdog | March 2, 2006 9:11 PM
"Yes, and I'm sure there's also a "growing amount" of data showing that autistic children with bowel issues have breast milk in their gut. Does that mean that breast-feeding causes autism?"
I stated upfront that there is no evidence that the MMR causes autism. But to compare breast milk to the measles virus is silly. The measles virus is not supposed to lodge itself in the guts of children after vaccination.
Posted by: killerjabs | March 2, 2006 10:22 PM
"It is true that, as of 2001, there was not clear understanding of whether or not thimerosol played a role in autism and other neurodevelopmental problems. The concerns were based in the fact that mercury is often a toxin"
When would mercury not be a toxin?
"That is why the decision was made to go ahead and move to thimersol free single dose vials."
Exactly, so don't you find it odd that the CDC did not want to take advantage of the thimerosal free vials offered by GSK?
"There was nothing deceitful about how this was done. The debate is in the public record. The changes were made in a controlled manner. The consequence of moving too quickly and disrupting the vaccine supply in this or other countries can not be minimized."
It was extremely deceitful. After refusing to provide thimerosal free vaccines via GSK the CDC promised to require that all vaccines be thimerosal free as soon as "adequate supplies are available." The supplies were there. It was the CDC choosing not to use them. The vaccine supply did not have to be disrupted.
"If anything, based on what I would consider to be flimsy evidence, the move was extremely rapid."
Flimsy evidence? Mercury is a known neurotoxin. Do you really need evidence to realize it shouldn't be a vaccine ingredient? It has now been in vaccines for about 60 years. I would argue that the decision to start removing it was anything but rapid.
"I think the AAP believes that state legislatures have no business getting into this debate. We don't have a perfect process for making these decisions in this country but I personally know my representative and I don't want him involved."
If the CDC & AAP would put politics aside perhaps there would be no need for state legislatures to intervene. We're now at 7 years since the CDC made the initial announcement to remove mercury from vaccines. That should have been more than enough time. And not wanting state legislatures to intervene is not a very good reason for wanting to keep mercury in vaccines. You didn't answer my question regarding why the AAP is against mercury emissions from power plants but for mercury in vaccines.
Posted by: killerjabs | March 2, 2006 10:40 PM
Orac, thanks for quoting me. You're right; I was referring specifically to RFK Jr.'s advocacy for the interests of litigants, which is not the same thing as serving as plaintiffs' counsel. In fact, there are many different attorneys serving as counsel to plaintiffs in thimerosal cases. Many of them have snazzy websites with dramatic though unsubstantiated statements such as "Recent studies have confirmed that autism is often caused by these vaccines and in particular the ethyl-mercury preservative Thimerosal." Head over to Lawyers and Settlements for a spiffily-formatted conspiracy rant by Evelyn Pringle, then one click later you can find out how you, too, can get in on the opportunity to turn the difficult experience of diagnosis and disability into cold hard cash. I have been through it myself, so have members of my family and many friends, and I know that a person can come through to another place if they are willing to make peace with the fact that objectively troublesome and socially devalued characteristics can be genetically transmitted. Coming to terms with these experiences is likely to be considerably more difficult if a person devotes huge amounts of energy to laying blame and seeking revenge.
Posted by: Kathleen Seidel | March 2, 2006 11:04 PM
Wakefield is distancing himself from measles as far as his "research" goes. There's a new paper out by Ashwood and Wakefield, there's nary a mention of measles anywhere in the body of the paper.
He seems to be talking about his orginial kids (the ones who's parents' lawyer hired him to find a way to sue the vaccine makers?) Interestingly even with good old Andy Wakefield giving them advice on diet and antivirals or whatever he might have advised them on their imaginary measles in their guts, they are all still autistic. He says it right there in his paper. All the kids are still autistic, and this from a man who likes to portray autism as completely reversible like a bout of drunkeness is reversible.
He also admits that autistic kids might not have any more bowel problems than normal kids (both normal and autistic kids have fairly high incidence of constipation and diarrhea, it's just that the autistic kids who have bad gut problems are talked about ALL the time as if they are representative of all autistic kids. They are not.
What should be out this summer is a paper from Eric Fombonne showing what Wakefield did, what error he made in his lab tests that gave a false positive for measles in the guts of those kids. NO MEASLES, is the finding that other researchers have come up with when they tried to replicate Wakefield's work.
As has been pointed out once you allow a baby out of the womb (gasp) it is in a world full of bacteria and viruses. Ever notice how much of what a baby touches goes in it's mouth??? The number of dead and near dead germs in vaccines are pitiful next to what the kids are swimming in. The point in vaccinating is to control the exposure to germs that could take off and harm lots of people. Autism Diva doesn't have a baby, but if she were responsible for a baby right now, even a preemie she wouldn't freak out about the amount of thimerosal in vaccines. The fear of the amount of mercury and the form that mercury is in is grossly exaggerated by people who intend to rake in the bucks from lawsuits.
Maybe "killerjabs" has a case pending?? Not that he'd be likely to admit it. But this is a good place to keep the fear of mercury alive isn't it, Killerjabs?
The lawyers for the mercury parents have been on borrowed time for a year or more... they were supposed to have all their "proof" martialed by now to show to a judge, but because they have NOTHING vaguely like proof that autism could even possibly be caused by thimerosal hypothetically on a "good" day, they are scrambling with garbage like the latest stuff from the Geiers. Pure garbage. It's not going to convince any judge, but if they can get a jury that has heard stuff like what Kennedy is spewing, then they have a chance.
It's all about the money and the ambulance chasers and their stinking greed. Bobby Kennedy Jr. is probably not aware that he has been outright lied to by these folks. He's not bright enough to check out the facts himself so he's just blathering.
Posted by: Autism Diva | March 3, 2006 12:07 AM
Autism Diva,
Not sure where you are getting your info from but I don't think Wakefield is distancing himself from measles. Have you seen the presentation at Carnegie Mellon in November? Here is a link: http://www.chem.cmu.edu/wakefield/
The rest of your rant is a bit off topic. RFK Jr's blog focused on the CDC's decision to not secure thimerosal free vaccines which contradicts their public statements.
Posted by: killerjabs | March 3, 2006 12:17 AM
"But to compare breast milk to the measles virus is silly. The measles virus is not supposed to lodge itself in the guts of children after vaccination."
Why not? The measles vaccine uses a live virus, doesn't it? The point of live-virus vaccines is to create a virus strong enough to provoke an immune response, but too weak to make the child sick. I don't know what the attenuated virus is "supposed" to do, but I wouldn't be at all surprised if it replicated at least a little inside the body. The point is that it can't replicate enough to actually give you the measles.
Posted by: Ebonmuse | March 3, 2006 12:44 AM
Dear Killer
'Mercury is a neurotoxin' is about the only true statement that's ever been issued by the 'Evidence of Lunacy' Brigade. Notably absent are all the other equally true statements having equal validity - water is a toxin, nutmeg is a toxin. Point of fact you would be hard pressed to find any substance on this earth that's not capable of being a toxin. Some of those toxins - real nasties are produced by bacteria - Chlostridium Tetanii for instance - that toxin produces tetanus - not a nice way to die. Fortunately we don't have to watch our children die this way any more. Maybe Killer and cronies should have to watch one of those simulations showing what happens - kind of a techie version of the ads on cigarette packets. Watch Corynebacterium Diptheria in action - see your simulacrum choke to death - now there's a thrill.
To avoid getting a lethal dose of said toxin or some equally nasty disease - we vaccinate - with far far less exposure to antigens than 5 minutes playing in the dirt. Come to think of it - if we had the immune systems that the EOH lot like to believe we had - how long would we last ex-utero - 24 hours before we shuffled off this mortal alfoil with massive septicaemia? Nah - probably succumbed in utero - actually - no human race full stop.
Posted by: Alyric | March 3, 2006 1:00 AM
Proble with Friday afternoons - forgot half the post.
What the EOH crowd and I assume you too Killer, have failed to prove as in completely and utterly and abysmally failed to prove is that mercury IN THE FORM OF THIMEROSAL, AT THE DOSAGE GIVEN has ever harmed anyone, anywhere. Has not been done and is not likely to be done any time in the forseeable future. Rabbiting on robotically
mercury is a neurotoxin - exterminate - mercury is a neurotoxin - exterminate (repeat 50 times)
doesn't explain anything at all except possibily the critical thinking skills of the emitting robot.
Posted by: Alyric | March 3, 2006 1:09 AM
Exactly, so don't you find it odd that the CDC did not want to take advantage of the thimerosal free vials offered by GSK?
That depends on the terms and conditions GSK offered their vials at. If they were e.g. at three times the price then no I don't think it odd in the slightest.
Posted by: Francis | March 3, 2006 5:05 AM
As already mentioned Mercury is a neurotoxin. I also note that the Sun is hot, UV light can be dangerous and its generally a bad idea to eat unidentified funghi. What you "killerjabs" need to do is present evidence that mercury in the levels and form found in vaccines is actually dangerous. Try not to circular eh? Any less is well... fearmongering and i'm sure a moral person as youself does not intend that.
Posted by: Steve | March 3, 2006 7:18 AM
Alyric:
I like the Dalek reference. I'm a big Doctor Who fan.
Posted by: Orac | March 3, 2006 8:05 AM
Ebonmuse,
The measles virus is being found in the guts of children years after their vaccination. Also, the reason these children were scoped in the first place is because they have terrible bowel issues. So the contention is that the measles virus from the vaccine has caused bowel disease. There is a pediatrician on this board. I'd be willing to defer to his/her opinion regarding whether or not the measles virus should be alive & well in the gut of children years after vaccination.
Posted by: killerjabs | March 3, 2006 8:55 AM
Alyric, Steve,
The CDC requires children to be vaccinated with a mercury containing solution. It should not be the responsibility of concerned parents to test those vaccines for safety. That responsibility should rest with some combination of the drug manufacturers and the CDC. But there isn't a single safety study. How can you argue this with me? I'm not arguing that thimerosal causes autism. I'm arguing that mercury is a known neurotoxin that has no place in medicine. And if the CDC, AAP or anyone else wants to keep it in vaccines then they need to provide the long overdue safety studies to back up their argument.
Posted by: killerjabs | March 3, 2006 9:04 AM
"That depends on the terms and conditions GSK offered their vials at. If they were e.g. at three times the price then no I don't think it odd in the slightest."
Francis, If you read the CDC's response to GSK price was not a factor. They expressed a desire to provide options. Producing energy without fossil fuels comes with an increased cost but yet the AAP has no problem suing to attempt to stop mercury emissions from power plants.
Posted by: killerjabs | March 3, 2006 9:09 AM
killerjabs:
I'd like to see a reference for this.
Posted by: Ebonmuse | March 3, 2006 10:56 AM
Look -- each individual vaccine is studied for safety in multiple phases before it is approved for use, and the question of thimerosal toxicity has been extremely heavily studied. The scientific and medical communities take this subject very seriously, and have gone to extraordinary lengths actively looking for adverse effects before delivering a consensus opinion that no convincing evidence has been produced linking vaccines to autism or other neurological disorders.
To say that "there isn't a single safety study" evinces a lack of familiarity with the published literature, a strong desire to find support for a predetermined conclusion, or both.
Posted by: jre | March 3, 2006 12:16 PM
Ebonmuse,
The report is not published yet. You should view the presentation from Carnegie Mellon. Here is another link to it: http://www.chem.cmu.edu/wakefield/
Posted by: killerjabs | March 3, 2006 12:43 PM
Oh shit, I really stepped in it. I thought I had jumped over to another page on Pharyngula. I think I've fixed it now.
Mea maxima culpa. This isn't as bad as Dan Rather's goof, is it? http://revart.blogs.com/minister_of_rants/2006/03/skeptics_digest.html#trackback
Posted by: Rev. Art - Minister of Rants | March 3, 2006 1:30 PM
killerjabs,
The reason you will not see a "safety" study (I mean a dedicated clinical trial of thimerosal vs. placebo) is that thimerosal alone has no specific medicinal value (it does not, by itself, treat any disease). Therefore you would have trouble getting review-board approval to do a meaningful test (in infants).
Also, all new products including vaccines have to undergo extensive safety studies as mandated by the FDA. So, all thimerosal-containing vaccines have undergone said studies and can be found in the PDR.
As far as you "mercury is a toxin" contention. Well, Aspiring is certainly a toxin and kills many people every year. Other toxins used medicinally: Lithium, digitalis glycosides, colchicine. The golden rule of toxicology "A toxin is in the dose" - I'll drink a gallon of homeopathic cyanide and smile, but not so much as a drop of tetrodotoxin.
Posted by: drinkysr | March 3, 2006 1:32 PM
I read the correspondence, too. The CDC was willing to address public concerns about thimerosal, since these concerns have to be taken into consideration when developing public health programs that hinge on voluntary participation. With a double-edged letter that is a glorious subject for dissection, John Jabara, the head of SKB's Vaccine Business Unit, tried to turn that to his company's advantage. First he acknowledged SKB's agreement with the CDC that there was an absence of scientific data regarding adverse effects of thimerosal in vaccines. Then he emphasized the then-current DTaP's higher thimerosal content relative to other vaccines. Then he referred to the cumulative exposure to mercury via DTaP as "nearing the EPA threshold" -- slightly more dramatic than "below the EPA threshold" -- as preface to broaching the possibility of a sole-source contract for SKB to provide DTaP vaccine for the entire US! That was wily and businesslike of him, but hardly altruistic. Who knows whether SKB actually had the inventory or production capacity that Jabara claimed? His statement that SKB was "in a position to supply Infantrix... in enough quantities to supply the estimated US market needs for at least the remainder of 1999 and the first half of 2000" is followed by speculation that other sources of supply would "likely be available, pending FDA approval." FDA approval is not a predictable or always-speedy process. What if Dr. Koplan had taken him up on the offer to monopolize the DTaP supply, then the prediction that other companies would be able to pick up their slack soon enough were not to pan out? Dr. Koplan conveyed the information about the availability of Infantrix to all 64 immunization projects, ensuring that their administrators were aware that thimerosal-free formulations were available. Recognizing the need to respect state and local autonomy, he left the ultimate purchasing decisions to local authorities. He also kept open supply lines for brands that were already licensed -- that is, vaccines that had already met FDA approval. It would have been foolish of Dr. Koplan to make the entire U.S. DTaP immunization program vulnerable to the fate of a single manufacturer. If he didn't maintain diverse sources of supply, all it would take would be a single plant disaster and he and the DTaP component of the national immunization program would be totally hosed.
Posted by: Kathleen Seidel | March 3, 2006 1:55 PM
Drinkysr,
So what happens when a drug company wants to use a new preservative? Are there really no tests performed on the preservative because it has no medicinal value? Your point about the preservative being tested as part of the vaccine safety study is well taken.
But since we're talking