Respectful Insolence

As if Jenny McCarthy weren’t enough stupidity in pushing the alleged “link” between vaccines and autism, it looks as though Donald Trump has joined the fray on the side of pseudoscience:

In an interview with Palm Beach Politics, Donald Trump offered a controversial opinion on a new topic: autism. The New York-Palm Beach real estate mogul is no doctor, but he said he thinks the rising prevalence of autism is related to vaccinations given to children at a young age.

Autism now affects 1 in 150 children, a sharp increase from a few decades ago.

But whether vaccinations have anything to do with it is passionately debated, and many dismiss the notion as a conspiracy theory.

“When I was growing up, autism wasn’t really a factor,” Trump said. “And now all of a sudden, it’s an epidemic. Everybody has their theory. My theory, and I study it because I have young children, my theory is the shots. We’ve giving these massive injections at one time, and I really think it does something to the children.”

He made the comments following a press conference at his Mar-A-Lago estate announcing a fundraising and lobbying push by Autism Speaks to get the brain disorder covered under private insurance policies.

“Trump is no doctor”? That’s certainly an understatement. He’s clearly clueless about science as well. As for a “strong” or “controversial” opinion, so what? The lie that 9/11 was an “inside job” or that it was done by the Bush Administration in cahoots with the Mossad is a “strong” and “controversial” opinion held by many conspiracy theorists. That doesn’t make it any less ridiculous, nor would it be any less ridiculous if Donald Trump decided he were a 9/11 Truther. It’s the same thing with vaccines and autism. Just because a rich, celebrity know-nothing like Donald Trump decides he thinks that vaccines cause autism doesn’t lend any credibility to the concept.

But here’s my favorite part:

Here’s more of what Trump had to say about autism and vaccinations:

“When a little baby that weighs 20 pounds and 30 pounds gets pumped with 10 and 20 shots at one time, with one injection that’s a giant injection, I personally think that has something to do with it. Now there’s a group that agrees with that and there’s a group that doesn’t agree with that.”

Arrrgh!

It’s the dreaded false equivalency ploy. Sure, Don, there are people who don’t agree with you. Those people represent virtually the entire medical and scientific community that studies vaccines. And, yes, there are people who agree with you. They’re virtually all pseudoscientists and cranks. Either that, or they’re lawyers looking to make a buck.

Worst, the “journalist” who wrote this puff piece is just as clueless. As Do’C at Autism Street says about the “sharp increase” in autism claim:

The implication here is clear. It’s implied that there has been a sharp increase in the actual proportion of people affected by autism. Sorry Josh Hafenbrack, until you understand and explain to your readers the effect that changes in diagnostic criteria, diagnositic practices, awareness, recognition, and the provision of services have had, you have no business of claiming a sharp increase in how many people are affected. If you can’t explain those things in sufficient detail, you should, at the very least, be able to provide some solid epidemiological evidence of an actual increase in the prevalence of autism.

There was a very convincing study about a year and a half ago that supported the generally accepted concept that the apparent “increase” in autism diagnoses is due to increased awareness and broadened diagnostic criteria since 1994. There almost certainly is no “epidemic.”

In other words, Donald Trump is a scientific ignoramus, who’s too clueless to realize that the “debate” over whether vaccines cause autism or not is not a scientific debate. It’s more an ideological or religious pseudodebate, akin to the “debate” between creationists and evolutionary biologists. The science is about as settled as it can be in medical science and epidemiology. Sure, there’s always a small chance that some new study will overturn this consensus, but, given the weight of previous studies, this chance is vanishingly small. It’s becoming smaller and smaller with each new study that fails to find a link between vaccines and autism.

Trump should stick with real estate, casinos (well, given his luck of late in the casino business, maybe not), and The Apprentice. He’s clearly totally unequipped to evaluate a medical or scientific question.

Comments

  1. #1 notmercury
    December 29, 2007

    The Donald: “My theory, and I study it because I have young children, my theory is the shots.”

    Doesn’t he mean that he dates young children?

  2. #2 Elissa
    December 29, 2007

    Between 10 and 20 shots at one time? Seriously?

    I think the most my kids have ever had at one time is 4, maybe, combined into 2-3 injections.

    Maybe Trump needs a new pediatrician / family practice doctor. Either that, or the kids’ mom (who looks about 20) needs to give him better versions of what actually happens, ’cause no way is he taking the kids in for their well-child visits. He’s said in interviews that he doesn’t even change diapers.

  3. #3 Freddy
    December 29, 2007

    Orac — you are an obnpxious twit!

  4. #4 SLC
    December 29, 2007

    Re Freddy

    Mr. Freddy is a poopy head who appears to have a spelling problem.

  5. #5 Kerry Maxwell
    December 29, 2007

    I’m watching a documentary about the 1918 flu epidemic, and it chills me to think about the wave of irrationality that will accompany the next real epidemic. My wife and I are the parents of two autistic teenage boys, and struggle to stop our heads from exploding each time some celebrity spews anti-vaccine idiocy.

  6. #6 Abel Pharmboy
    December 29, 2007

    What is it about the press giving bandwidth to celebrities pontificating about pseudoscience? I’ll defer to The Donald on business issues (with Orac’s exceptions above) but, please, give qualified scientists their due in reporting this nonsense.

  7. #7 Cuttlefish
    December 29, 2007

    When polio was something that
    Your friends and family got,
    Damn right you’d wait in line to get
    That magic-seeming shot.

    When infant graves were commonplace,
    Each parent knew the cost;
    A victim of our own success,
    Perspective has been lost.

    But now that science gives our lives
    More health and fewer pains,
    True geniuses like Salk give way
    To Trumps with shit for brains.

    I’d bet if Trump was suddenly
    Confronted with, say, cancer,
    He wouldn’t hesitate to look
    To science for an answer.

    But ignorance and affluence–
    A potent combination–
    Are threatening the future of
    A younger generation.

    With every anti-vaxxer voice they add
    Our children’s risk enlarges,
    And science must–for all our sakes–
    Defeat these Trumped-up charges.

    http://digitalcuttlefish.blogspot.com/2007/12/no-vaccine-for-arrogance.html

  8. #8 Regan
    December 29, 2007

    Is there a US equivalent to the UK campaign, “Science for Celebrities”, because I believe that we really NEED one.

    http://www.senseaboutscience.org.uk/index.php/site/project/132/

  9. #9 Ex-drone
    December 29, 2007

    The Donald may wish to rethink his theory. Doesn’t he realize that there is a positive correlation between increased autism diagnosis and global warming? Since apparently all “the The New York-Palm Beach real estate mogul [who] is no doctor” needs to satisfy him is a perceived correlation and a feeling that he is right, then maybe he should spend a couple of minutes going over this new finding.

  10. #10 notmercury
    December 29, 2007

    Say what you will, but that Freddy knows how to win an argument.

  11. #11 daedalus2u
    December 29, 2007

    So why doesn’t the media have real experts there to tell Donald Trump to his face on TV that he is a no-nothing idiot?

    Are they afraid that the contraversy won’t sell as entertainment?

  12. #12 Avekid
    December 29, 2007

    “My theory, and I study it because I have young children, my theory is the shots.”

    Wow! I’m convinced! Surely, Donald Trump, prompted by parenthood to “study” the supposed link between vaccines and autism, counts as an expert.

    (I wonder if he has yet been introduced to “correlation =/= causation”…)

  13. #13 Avekid
    December 29, 2007

    If, that is, there is even a correlation. I’ve yet to see conclusive – or even suggestive – evidence that there is one.

  14. #14 Schwartz
    December 29, 2007

    Elissa,

    I suspect he was referring to the total number of disease components across the 4 or so shots which in some cases can add up to close to 20 or so depending on which ones you get.

  15. #15 Schwartz
    December 29, 2007

    Orac,

    Unfortunately, the term “epidemic” is very subjective, as it means an “unexpected” rate of disease.

    If the current rate of Autism is unexpected (which it certainly seems to be), then it will be called epidemic regardless of why it’s unexpected (i.e. change in diagnostic criteria).

  16. #16 Mason
    December 29, 2007

    Schwartz: I disagreed with your definition so…..

    epidemic
    • noun 1 a widespread occurrence of an infectious disease in a community at a particular time. 2 a sudden, widespread occurrence of something undesirable.

  17. #17 DLC
    December 29, 2007

    Cluelessness Trumps Science ?
    Here I always thought it was the other way around.
    Of course, making a few bucks in the Real Estate market
    has granted Trump a sense of “rightness” that carries him through such little disturbances as preponderance of evidence.
    His arrogance has inoculated him against realizing he’s wrong.

  18. #18 Schwartz
    December 29, 2007

    Mason — just for fun…

    Autism certainly doesn’t qualify as noun 1 since it’s a disorder not an infectious disease.

    Here is a small sampling of definitions that I can quickly find from a variety of different sources:

    “In epidemiology, an epidemic (from Greek epi- upon + demos people) is a disease that appears as new cases in a given human population, during a given period, at a rate that substantially exceeds what is “expected”, based on recent experience…” — Autism can easily qualifies here.

    “affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time.” — Autism can easily qualify here

    “a disease that spreads rapidly through a demographic segment of the human population, such as everyone in a given geographic area, or a similar population segment; also refers to a disease whose incidence is beyond what is expected.” — Again, Autism can easily qualify here

    “The occurrence of cases of an illness in a region in excess of what is normally expected.” — Same here

    “The occurrence in a community or region of cases of an illness (or an outbreak) with a frequency clearly in excess of normal expectancy. …” — same here

    “Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other health-related event occurring in such outbreaks.” — same here

    I can go on and on. Your definition is certainly valid, but it is very limited and quoted far less frequently unless referring specifically to infectious diseases.

    Since there are a large number of official definitions (some sampled above) that include subjective terms like “expected” frequency I would thus conclude that the term epidemic applied to Autism is certainly valid.

  19. #19 bonni
    December 29, 2007

    I don’t understand the thing about getting Autism (the “brain disorder”) covered by private insurance. Aren’t therapies like speech therapy and occupational therapy covered by most comprehensive policies? (Seriously, I don’t know; I’ve been living in Australia since 1999 and our family’s private insurance does cover those things, and there are provisions in the public health care system here, as well).

    Or are these people working to get coverage for junk medicine procedures (like chelation and who knows what other woo)?

    Oh, and I fully, totally, and absolutely agree that if people understood history and knew the toll that childhood illness once took, they wouldn’t be bucking the vaccination now. Not only have I studied a lot of history, I have a bit of a thing for old cemeteries (I like the statuary and gravestone artwork, as well as finding them generally very peaceful). It doesn’t take long to find graves where a family has buried four or five or more of their children, all of whom died before the age of five, and the fact is, the majority of those deaths were things that could be prevented by simple vaccination.

    I fear that in order for these people to settle down and pay attention, there’s going to have to be a lot of severe illness and death from virulent disease.

  20. #20 Richard
    December 29, 2007

    Please help us find a cure for Celebrity Idiocy today. Give to the Celebrity Idiocy Fund to help us develop a vaccine.

  21. #21 Brendan S
    December 29, 2007

    Schwartz:

    The words you are saying are true. The problem is that most people don’t understand this to be the case. 99% of people think that we really are seeing more Autism then we used to. In reality we’re just catching what we didn’t catch before. That’s at least one of the problems in this debate. The semantics argument is valid, but doesn’t some the problem that people thin we’re seeing an explosion of cases when we’re really just diagnosing more of the ones we’ve already got.

  22. #22 Guy
    December 30, 2007

    Just because a rich, celebrity know-nothing like Donald Trump decides he thinks that vaccines cause autism doesn’t lend any credibility to the concept.

    Unfortunately, that is not so (at least not in the minds of John Q. Public). We live in an era where celebrity worship is commonplace, and your average individual tends to trust what they have to say. Advertisers have known this for years, which is why they go for celebrity endorsements of their products even if the celebrity has nothing to do with the product they are selling.

    To be clear, I agree that such an improper appeal to authority should be called-out – but bear in mind that it’s going to have far more weight than it should with your average individual.

  23. #23 HCN
    December 30, 2007

    bonni asked “Aren’t therapies like speech therapy and occupational therapy covered by most comprehensive policies? ”

    No, not necessarily. In my state neurodevlopmental therapies for children through age six was only covered started from the time my son was about three years old. Then it was a new law and not questioned so much. After a while the insurance companies set a $1000 limit on total therapy costs (that covers way less than half a year).

    So no, it is not always covered. We did get our son therapy through a charitable organization (that we send money too each year):
    http://www.scottishrite.org/what/phil/ritecare.html

    But we still paid for private speech therapy for a few years (driving three growing children around in a compact car, after oldest was dismissed from private speech we could afford a minivan).

    Anyway, my son’s first seizures occurred when he was 48 hours old. This was over 19 years ago, way before the newborn HepB vaccine (by the way, only my daughter got that, and she is the only child to not need speech or language therapy, so obviously that means the HepB vaccine PREVENTED those issues, ;-) right?)

  24. #24 Schwartz
    December 30, 2007

    BrendanS,

    I agree, that’s why I said unfortunately the first time. I’m sure that’s why the CDC justifies using the term epidemic.

    The reality is it was a suprise to them. So either it’s an epidemic in the sense that it is a large increase, or it’s gross incompetence on their part for taking decades to realize the actual prevalance.

    Either way it’s some form of incompetance, since they can’t even figure out if there’s an increase or not.

  25. #25 HCN
    December 30, 2007

    Schwartz wrote “The reality is it was a suprise to them. So either it’s an epidemic in the sense that it is a large increase, or it’s gross incompetence on their part for taking decades to realize the actual prevalance”

    Ummm, yeah… It depends on how it was defined. If the definition changes, does that cause a problem? How can you find a problem if you don’t know what it is?

    Let’s look at official defintions and the DSM, the Diagnostic and Statistical Manual for Mental Disorders. So if you look at the DSM before the mid-1970s you will learn that homosexuality is a disease. Is that the same situation in 1980?

    How much would you learn about autism in the DSM dated in the 1970s? Find an old copy and tell us.

    While you are at it, find the statistics for autism under the DSM definition prior to 1979, then 1980, then 1990 and finally 2000. Be sure to include what the definition is for the DSM.

    Then do the same for IDEA.

  26. #26 J
    December 30, 2007

    Mason: I agree with Schwartz’s definition.

    In epidemiology, “epidemic” is the occurrence of more cases of a disease than would normally be expected in a specific place or group of people over a given period of time.

    As such, a case series over 4 weeks of typhoid fever (say… 10 people) in a developed city (say… population 2 million) where the annual rate of the past few years is 0.5 per 1 million would be considered epidemic (a.k.a. outbreak) even though it’s not actually “widespread”.

    For interest’s sake, endemic means a high background rate of disease. Like “Hepatitis B is endemic in South-East Asia” or “Tuberculosis is endemic in India.”.

  27. #27 Samantha Vimes
    December 30, 2007

    Oh, no! Fibromylagia is a terrible epidemic which MUST be caused by something in our modern environment!!!! (I’m being sarcastic here).

    I mean, back in the old days, you had rhuematism. Or you were sort of pretending to be sick when there was nothing wrong with you, especially if you were female, because you just wanted attention.

    Then they discovered rhuematoid arthritis! Suddenly, you could *tell* which of the people who whined about joint pain with changing weather were honestly sick, and which ones were just pretending.

    And then doctors found out that the ones who had rhuematic pain complaints but no arthritis often had other disorders that tended to show up in conjunction. And they had something else, kind of unique, called tender points. If you touched a person with fibromyalgia in a few certain places, they would experience extreme pain.

    Suddenly, a lot of crazy attention seekers turned out to have a disorder that could be diagnosed by doctors and controlled by medicines.

    And, there are people who still want to call fibromyalgia sufferers crazy attention seekers, and fibromyalgia a made-up disease, but the consensus has been in favor of it being real and worth treating. Since fibromyalgia was something there wasn’t an independent word for until relatively recent decades, it wasn’t getting diagnoses as that, so there’s been a rising wave of diagnoses.

    Just like with autism, which was probably known as “There’s something wrong with the Johnson boy, he just sits there rocking” decades ago.

  28. #28 Schwartz
    December 30, 2007

    HCN,

    It is the job of the CDC to detect and analyze clusters of common illness. Something serious that has a prevalence of 1 in 150 children or even higher in some juridictions is a pretty large cluster. To identify such a cluster should not take decades. They were able to identify and successfully research far less prevalent diseases.

    Even more shocking is that Autism has such a large impact on educational services and families and still the prevalence went largely unnoticed by the CDC for decades?

    OK, maybe the American public school system has been so broken they couldn’t detect the problem. But not every country has a public school system problem, and they all missed these clusters?

    Either the prevalence grew, or they messed up in a big way. I certainly think they messed up, but I’m not fully convinced that diagnostic changes can account for all of the differences in numbers.

    But, we certainly don’t have reliable data to determine that answer conclusively yet, so we just have to wait longer for the real verdict.

  29. #29 Squillo
    December 30, 2007

    HCN wrote:

    “No, not necessarily. In my state neurodevlopmental therapies for children through age six was only covered started from the time my son was about three years old. Then it was a new law and not questioned so much. After a while the insurance companies set a $1000 limit on total therapy costs (that covers way less than half a year).”

    De-lurking to comment that, to me, this is the one issue for which celebrities could actually do some good. Especially Jenny McCarthy, who could afford not only the woo she claims cured her son, but also the conventional therapies that were more likely the cause of his improvement. Why not crusade to ensure ALL affected families have equal access to effective therapies, and leave the science to the scientists?

  30. #30 Ron Hager
    December 30, 2007

    Doctors should refuse to treat all of these “experts” including Trump and his family. Why treat someone that doubts your ability and knowledge?

  31. #31 Lucas McCarty
    December 30, 2007

    Or that the vast majority of Autistic children and adults are very able but eccentric. When parents are not fed doom-mongering nonsense about Autism, that also generally improves outcomes. It didn’t exist thirty years ago, so it wasn’t there to be a problem for Autistics.

    For others it’s a simple case that they were misdiagnosed and treated in a way that would not have made them easy to spot. The number of people qualified to make a diagnosis will also be a big issue and I reckon it’s the second biggest factor after the criteria change.

  32. #32 HCN
    December 30, 2007

    Schwartz said “It is the job of the CDC to detect and analyze clusters of common illness. Something serious that has a prevalence of 1 in 150 children or even higher in some juridictions is a pretty large cluster. ”

    The initials CDC stand for Centers for Disease Control. Are you calling autism a disease and illness?

    Anyway, answer the questions about the definitions in the DSM and IDEA. How do you find out the numbers of prevelence from the past when no one was looking for it?

    For intance, the CDC should have nice numbers for the prevelence of Hib before the vaccine was available in the 1990s. Unfortunately it was not a reportable disease until AFTER the vaccine was approved. The only real information on Hib levels are from studies done on its transmission in day care centers in a few cities.

    Squillo said “Why not crusade to ensure ALL affected families have equal access to effective therapies, and leave the science to the scientists?”

    I agree. I tried to lobby my state’s legislature, and even garnered a bit of support when I was paying several hundred dollars per months on speech therapy. Unfortunately it is very difficult, and when my son graduated from private speech therapy I had no more reason to lobby anymore. We were able to finally by a van when that happened.

  33. #33 HCN
    December 30, 2007

    Wait, Schwartz! Why are you going on about the CDC? You’re Canadian, how about bringing in Health Canada and their counting strategies?

  34. #34 Schwartz
    December 30, 2007

    HCN,

    Since you seem unable to get past the name of the organization (or do YOU think Autism is a disease?), here is an excerpt of their mandate. If you go to their home page, the first main area is Diseases and Conditions with Autism listed there.

    “CDC, as the sentinel for the health of people in the United States and throughout the world, strives to protect people’s health and safety, provide reliable health information, and improve health through strong partnerships.”

    “To promote health and quality of life by preventing and controlling disease, injury, and disability.

    CDC seeks to accomplish its mission by working with partners throughout the nation and the world to:

    * monitor health,
    * detect and investigate health problems,
    * conduct research to enhance prevention,
    * develop and advocate sound public health policies,
    * implement prevention strategies,
    * promote healthy behaviors,
    * foster safe and healthful environments,
    * provide leadership and training”

    Again, I maintain they failed their mission miserably in this case.

  35. #35 Schwartz
    December 30, 2007

    HCN,

    I agree there are huge diagnostic problems — considering that Autism was considered a parenting problem not that long ago.

    You’ve stated my point exactly: No one was looking for problems.

    The lack of detection or realization of a problem is a failure of the CDC. The fact that they’ve never even tracked children in health studies over a long term is pretty pathetic. From the perspective of safety drug trials it borders on professional misconduct to not track child populations longer than 30 days — what is the average followup for a childhood vaccine safety trial? Consider the number of changes to recommended vaccine schedules? How do they measure the efficacy of the actual schedule timing? Any type of longer term study (non vaccine even) would also have helped track down issues like SIDS etc.

    Maybe that’s why American public education is in such poor shape, no one has ever bothered to evaluate the health or education of children. If the 1 in 150 prevalance was really consistent over time, it most certainly would show up in some sort of educational statistics.

  36. #36 Do'C
    December 30, 2007

    If the 1 in 150 prevalance was really consistent over time, it most certainly would show up in some sort of educational statistics.

    It probably does. Look at the IDEA data for 1998-2005 for all disabilities across all 50 states. What you will see is a pretty flat line. It’s a pretty good indicator that diagnostic substitution has taken place. You can look at such a graph here:

    http://www.autismstreet.org/weblog/?p=138

    See graph #8.

  37. #37 Michael Ralston
    December 31, 2007

    Schwartz: I am one of the 1 in 150. (Since that’s everyone with an “autistic-spectrum disorder”.)
    I am also a Ph. D. candidate.

    I wasn’t diagnosed until age 16, and that only because my (much) younger sister was clearly autistic at that point, which lead some people to connect the dots about me.
    Was it because of a horrible failure of diagnosis?

    No, it’s because the factors that actually got my me diagnosis are relatively subtle, and their primary impact is to make people who don’t know me think me to be rude, and for social things to not always make sense.

    But … I’m a funded graduate student beginning my Ph. D. research, and I didn’t get any kind of treatment after my diagnosis. All I ever got as a result of the diagnosis was the ability to register for my courses early at my undergrad institution … and a bit of knowledge of HOW I’m different from neurotypical people. Was that a help? Oh yes. But … I’d probably be where I am now without it – An eccentric graduate student liable to become an eccentric professor.

    And yet I’m one of those horrible 1 in 150 people. The only conclusion I can come to is that the number of people for whom an ASD diagnosis is reflective of a drastic and serious problem is much smaller – that is, the people who were diagnosed as autistic under the old definitions, and who were diagnosed as schitzophrenic before Autism was first named.
    I don’t think they were missed, because the ones for whom being autistic is really a problem aren’t very missable. It’s the ones for whom it’s both an advantage and a minor disadvantage whom were missed – and we only need to know what we are and what that means to compensate for most of the disadvantages. But … it’s excusable that we were missed, because we’re not sick. We are different, and that’s not a purely bad thing.

  38. #38 Rjaye
    December 31, 2007

    Of course, the thing the experts aren’t also saying is that other diagnoses such as certain forms of retardation are down a similar amount as autism disorders are up. The number of people “afflicted” total nearly the same–what people are labeled is different.

    And while I am of the generation who didn’t have the label, in fact didn’t get the label until the last ten months, to say I didn’t have a problem would most definitely wrong, or any others of the tribe. A little help would have gone a ways, and acceptance much further. I think more studies need to be done on current treatments to determine if they are effective or not. The minimal studies are showing perhaps they are not what we hoped the therapies would be.

  39. #39 George
    December 31, 2007

    “We’ve giving these massive injections at one time, and I really think it does something to the children.”

    Good for Donald for speaking out about botox and it’s social impact on the younger generation.

  40. #40 Texture
    January 15, 2008

    I’m not on either side of the fence on this one. I’m not prepared to call anyone a moron for suggesting this is true, and I’m not prepared to claim that it’s true either. That’s because I’ve never seen any research in either direction. So, my question is: after an article and a few pages of comments, does anyone have links to studies which inconclusively point in either direction? And if not, then… ?

  41. #41 HCN
    January 15, 2008

    Texture, try reading more of the posts on this blog, like this one:
    http://scienceblogs.com/insolence/2008/01/another_very_bad_day_for_antivaccination.php

    Better yet, click on the links on the message above (points to several). Or you can check out http://www.pubmed.gov yourself.

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