Respectful Insolence

I can just see what's next: autism as a "misdiagnosis" for ear infections.
Autism as a "misdiagnosis" for hot water burns.
Autism as a "misdiagnosis" for being punched in the face.
I wouldn't put it below these people.

Posted by: Laser Potato | March 6, 2008 11:51 AM

Or maybe they'll just find another condition to latch onto as the One True (Side-)Effect of Vaccines... Tense, nervous headache? Vaccines. Can't get laid? Vaccines. Incurably stupid? Vaccines.

Posted by: Dunc | March 6, 2008 12:17 PM

It would be nice if these people woke up and realized that their efforts and money would be better spent on actually helping people with autism, rather than running around like headless chickens searching for the cause.

Posted by: Jen | March 6, 2008 12:47 PM

On CNN they just said two things which maybe interesting:

1) The father of the girl who settled this case is a neurologist.

2) The family will be on Larry King Live tonight.

We shall see...

Posted by: Dan R. | March 6, 2008 1:12 PM

It is quite obvious from your ignorant commentaries that none of you idiots have had to speak with a doctor (who is subsidized by the pharmaceutical companies) and your "scientific" evidence of harm is purely based on "quackery", and there is no possible evidence that the worst nightmare of the drug companies, CDC, etc is to have actual proof of the harm caused by these injections containing heavy metals ... of course not, it would be the largest class action in the history of law. Parents of children with Autism are not in the business of reintroducing Polio, Mumps, Rubella, etc ... what we are heavily invested in is acknowledgement from the drug induced government of their stupidity in throwing levels of toxic materials into a baby that doesn't way 20 pounds. Do any of you "know it alls" have a child with Autism ... I thought not.

Posted by: Gary Myers | March 6, 2008 1:25 PM

Do any of you "know it alls" have a child with Autism ... I thought not.

Here we go again. I do have a classically autistic son.

The notion that all parents of autistic children would necessarily have to be pro-quackery and government conspiracy mongers boggles the mind. I'm not sure where people get these ideas. It's totally contrary to my experience. Many if not most parents online don't buy the anti-vax stuff.

Posted by: Joseph | March 6, 2008 1:35 PM

I have nothing but admiration for the overwhelming majority of parents who struggle to bring up a child with ASD. I know a couple of them myself, and what amazes me is their down-to-earth attitude and the fortitude with which they cope with the curve ball that life has thrown them, without resorting to hysterical delusional ramblings about vaccines and invoking big pharma conspiracies lurking in every corner of the doctor's surgery.

Posted by: DT | March 6, 2008 1:41 PM

I hope you guys enjoyed the press conference as much as I did. Now you can give up your obfuscation of the truth and engage in other pursuits. You put up a decent battle but the good guys just won!!!

Let us know if you ever want to engage in another battle of wits. We'll give you a bigger head start next time.

Posted by: John Best | March 6, 2008 2:12 PM

must proof tags

That should look like this

actual proof of the harm caused by these injections containing heavy metals

That's the rub isn't it. Show the actual proof of harm by the vaccinations.

Go ahead. Show us.

Posted by: Rev. BigDumbChimp | March 6, 2008 2:18 PM

First off, I agree with the scientific evidence against there being a link between autism and vaccines, I'm not certain that the comment by daedalus2u is correct about inheritance and mitochondrial disease.

I pulled the following discussion of the etiology of mito disease from this link:
http://www.umdf.org/site/c.dnJEKLNqFoG/b.3042179/

"Sporadic Cases -- Where There Are No Affected Relatives
In the "real world", in the majority (perhaps about 75%) of cases the patient is the only family member affected with mitochondrial disease. These cases are called "sporadic", and present much difficulty in answering the questions posed about regarding inheritance.

The first question is whether the problem is due to genetics, environment, or some combination of the two. Certainly, the genetic aspects of mitochondrial disease are well known and were briefly summarized above. However, not all mitochondrial disease is primarily genetic. For example, anti-retroviral medications used to treat HIV/AIDS can damage mitochondria and cause symptoms due to resultant energy failure. Removal of these drugs reverses the process and the symptoms resolve. There are other environmental causes of mitochondrial disease, and likely many that we do not know about.

In the opinion of this author, most mitochondrial diseases are probably both genetic AND environmental in origin. Even in the case of anti-retroviral medications, thousands of individuals have no problem on these drugs while only a handful do. Likely, there are genetic reasons for the high susceptibility to these drugs in an unlucky few - a genetic predisposition of an "environmental" disease. On the other hand, in MELAS, which clearly is primarily genetic in origin, neurological deterioration often occurs during a viral illness and/or fasting - an environmental trigger of a "genetic" disease.

The second question is: If genetic, was the mutation inherited? The answer is usually yes, but not always. New mutations do exist. In particular, deletions (missing areas) of mtDNA tend to be new mutations not present in the mother or siblings. However, deletions with duplications are often inherited, and some duplications are hard to detect.

What this all means is that there are very few answers in most cases where only one person in a family has mitochondrial disease. The condition probably is genetic, and it may or may not be inherited. Either the nuclear or mitochondrial DNA could be involved. Inheritance is probably autosomal recessive, maternal or sporadic (no inheritance), but not necessarily.

Based on many families, some groups give an estimated recurrence risk for mitochondrial disease (chance that each additional child of the same two parents will be somehow affected) of 10-15%. This is probably a reasonable rough estimate, but you should discuss the probability of recurrence for your family with a genetics counselor familiar with mitochondrial disease.

- Written by Richard Boles, M.D. and Terri Mason

I'd appreciate comment by those with medical expertise.

Posted by: b | March 6, 2008 3:05 PM

From what I've read, it appears that mitochondrial disease is genetic, but sometimes doesn't manifest until a few years after birth. It can manifest after some stress, like a fever or an infection. In that sense I guess there's an "environmental trigger" if you will, but not in the sense that it might be preventable.

I can see, though, why some people might hypothesize that *regressive* autism has some relationship with mitochondrial disease. The main reason I'd be skeptical is that autism is not fatal.

Posted by: Joseph | March 6, 2008 3:22 PM

The Poling dad thinks Hannah's vaccines created her mitochondrial disorder. That's a new one.

I listened to the CNN reports. That mom is quite the harpy.

Posted by: isles | March 6, 2008 3:43 PM

Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.

Posted by: Carlie | March 6, 2008 3:54 PM

This whole vaccine award is purely legal. And the award should not have been given when considering what has been admitted the facts of the case...this is a confusing and weird case.

From everything I've read, which has been on-line and in newspapers, the child showed "autistic" signs at three months old, far earlier than the supposed affects of the vaccine. The child is also described as being mildly affected, which if such is the case, where's my damn money?

How does the this fund work? What the parents have to say doesn't really illuminate this issue, and the fact Larry King is going to talk to this coupld only goes to show that whether you love her or not, Rosie O'Donnell was right and maybe he should hang up his microphone. I want to know the reasons, especially as what the child supposedly has is not considered autism.

And an example of another doc who has been emotionally manipulated, either by himself or his "handlers," into a state of denial.

Posted by: Rjaye | March 6, 2008 5:02 PM

Rjaye - I think the news report that said 3 months was in error. Nothing else I've seen has indicated she had problems before starting to get ear infections at about 6 months.

I do think it's important that, as you point out, she is apparently only mildly affected - which was borne out in the CNN video aired today. If that is a child who needs 24-hour one-on-one supervision (at least more so than any 9-year-old), I am Queen Elizabeth. The published case report says that she has not scored in the autism range on a standard metric since she started kindergarten. So, wtf?

Posted by: isles | March 6, 2008 6:14 PM

Do any of you "know it alls" have a child with Autism ... I thought not.

I do, you arrogant jackass. And if you and the rest of the mercury militia are not in the business of reintroducing polio, mumps, rubella, etc., you're sure doing a damn good job of pretending to be.

(By the way, dipshit, thimerosol's been removed from the vast majority of childhood vaccines. What was that about heavy metals? Do you even understand what the term means?)

Posted by: Azkyroth | March 6, 2008 6:34 PM

The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.

It's ALREADY clear there isn't a connection. It's as clear as the fact that there isn't a total absence of transitional fossils. The people who lead the movement denying one of these claims have the same basic motives and mindset as the people who lead the movement denying the other, and it is highly unlikely that any evidence up to and including the stars moving around to spell "It's Not the Vaccines, Stupid!" could possibly convince them otherwise.

Posted by: Azkyroth | March 6, 2008 6:39 PM

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.

And of course some studies end up suggesting this (one out of the UK, for example) just because the numbers work out that way. But I think it's just as mistaken as suggesting that because thimerosal exposure and autism diagnoses increased simultaneously in the first half of the 1990s, then there's a causation effect. We're clearly looking at coincidence. The California trends are very telling in this regard. They are completely unaffected by removal of thimerosal. There's no discernable change in the previous increasing trend, upward or downward.

Posted by: Joseph | March 6, 2008 7:04 PM

Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.
Posted by: Carlie

First, autism is diagnosed before these vaccines are given. Some very clever research was undertaken looking at the abundant videotapes of children's first birthday parties. Researchers identified behaviors that were diagnostic of autism. Prior to that, the diagnosis was most often made when toddlers reached a stage of more social interaction after 12 months of age. The original suggestion vaccines were related to autism had to do with the coincidence vaccines are given at the same age socialization increases. The original research has been discredited, by the way.

Now autism can be diagnosed even younger than one year. It's pretty apparent that the root of autism is either in utero, perinatal, or genetic. The medical community has been unable to get the news media as excited about those discoveries as they have been about the vaccine misinformation.

As for the ideal age for vaccinations and the reasoning and safety of administering them together, in the US that is determined after very careful review and continual monitoring undertaken by the public health service's Advisory Committee for Immunization Practices (ACIP). They meet twice a year to review the research and the Vaccine Adverse Event Reporting System (VAERS) data. Their findings are public as well as the documentation of their rationale and the hundreds of citations they based their decisions on.

They also alert providers to any problems with vaccines that show up in between the April and October meetings.

Criticism the ACIP is simply an extension of the pharmaceutical companies couldn't be more ignorant. Their decisions are completely transparent, and contrary to the big pharma conspiracy theorists, there is abundant research out there which is not funded by drug companies. There is also a very large and very diverse medical community out there who are capable of and do read the research for themselves, and who are capable of and do evaluate the bias of the source or funding of the research. In fact, it should be rather obvious the medical community is by far better at evaluating the bias and significance of medical research than any layperson conspiracy theorist.

Vaccine age recommendations are based on actual data as to the risk of the specific infections. The earliest given, hepatitis B vaccine, is given just after birth because there are cases of infants contracting hepatitis B at that age. Pertussis and tetanus are risks to infants. It would be dangerous to delay those vaccines. Herd immunity is irrelevant when it comes to tetanus, the bacteria come from dirt not other people. And you need both herd immunity and individual vaccinations to protect infants from pertussis because the vaccine is not good enough without both.

Also, you cannot usually achieve sufficient herd immunity in older populations to protect younger populations because the pool of unvaccinated younger kids would be too large.

Vaccines are given in combinations, one, to decrease the discomfort in giving a child numerous injections, and two, because the data shows if you can give them all together, kids are more likely to get them. If you spread vaccines out, they inevitably get delayed, duplicated (when records of past shots cannot be found) and sometimes missed altogether. Again, we know this from experience, not from guessing or assuming.

Other countries have similar public health systems to evaluate and make vaccine recommendations. There is more consistency in the recommendations between countries than there are discrepancies. Again, for vaccine recommendations to be a big pharma conspiracy it would have to involve the majority of researchers and scientists all over the world, the majority of health care providers all over the world, and all the world's public health systems. Either the entire medical community is in on the scheme or they are a bunch of dupes. You trust them to perform neurosurgery but not to figure out if a vaccine is safe?

There is one more typical antivaxer misinformation I haven't addressed here. That is the notion that 'herd immunity' is somehow the sole objective of the public health system. Nonsense! The objective of this country's public health system and the world's public health systems is to decrease disease burden. The idea herd immunity trumps individual risk is a contradiction in logic. If individuals were somehow sacrificed for herd immunity, you would have by simple analysis, a vaccine risk greater than vaccine benefit.

Posted by: skeptigirl | March 6, 2008 7:49 PM

"Science needs a voice that is as loud as a heartbroken and/or angry parent. We need a story that is as marketable as perseverance prevailing over the establishment. Until we find that voice or that story, it's going to be a long struggle with these issues."

Science (or at least the American Academy of Pediatrics) is looking for parents of children injured or killed by vaccine-preventable diseases to tell their stories. Similarly, it may be desirable for the parents of such children to sue the pants off the irresponsible and sociopathic antivaxers who assured them that vaccines were useless and gave them advice on how to dodge vaccination requirements. The antivaxers obviously don't have pockets as deep as those of vaccine makers or the government, but it's another place to start.

"This is the same Larry King who once famously asked why there (were) still monkeys if humans descended from monkeys"

Actually, the burning question is, if human descended from monkeys, why is John Best still around?

Posted by: Dangerous Bacon | March 6, 2008 8:21 PM

Well, it sounds like the press is far worse than I could imagine. I just watched the newscasts in Seattle, and Channel 5 just reported that the vaccine caused the child's autism. AAAAGH!

Thanks, Isles, on the vaccine fund info. I thought the ball was dropped, but reading the Academy of Pediatrics press showed that the fever the vaccine may've caused might've aggravated her mito, and not caused autism. It was a probability-not a certainty...I guess that fifty percent and a feather? Actually, the fund makes better sense now that I've read that, but wow! I can't believe how the press has bungled this one.

Ouch.

And kids do die from pertussis. I worked for several years in a NICU and it happened several times over that period. There would also be babies come in with whooping cough, and never go home. That was so heartbreaking. And it would only be a blurb or two in the paper, the usual "the signs and symptoms of," and that was it. On to the next story.

Posted by: Rjaye | March 6, 2008 8:46 PM

Thanks to people like Barabara Fisher, we now use the DTaP, rather than the DTP, a much safer vaccine, that has had far fewer adverse reactions.

Thanks to parents of immune deficient children who contracted polio from the vaccine, we now use a safer vaccine, an inactivated virus vaccine.

How is it we successfully eradicated polio, smallpox, etc, without vaccinating infants? These vaccines were given to older children, not infants.

To think we cannot strive to improve safety is ignorant.

I do ask you this, can anyone find a study that shows how many children produce antibodies to the vaccines they received in our current schedule?

I am very interested because my child's immunologist stated that it is NOT abnormal for a child to not respond to vaccines, as the immune system is not mature until age 2. If this were true, then our vaccination program would be faulty, correct?

My child suffered an adverse reaction to either the MMR, or Varicella vaccines. She had encephalitis, seizures, fever, bulls eye rash.

We also discovered she didn't create antibodies to these live virus vacines, and may have some sort of immunodeficiency. That is where it gets tricky, one immunologist said immunodeficiency, based on the lack of antibody response to vaccines. The other said that the lack of antibosy response is typical, but I just don't feel this is true...

Posted by: Monica | March 6, 2008 9:41 PM

So, instead of the "god in the gaps" of creationism, we have "autism in the gaps" from antivaxxers?

Posted by: Badger3k | March 6, 2008 10:40 PM

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.

And of course some studies end up suggesting this (one out of the UK, for example) just because the numbers work out that way. But I think it's just as mistaken as suggesting that because thimerosal exposure and autism diagnoses increased simultaneously in the first half of the 1990s, then there's a causation effect.

Yes, that's the point: it's as sound as the conclusions the Mercury Militia are drawing.

Posted by: Azkyroth | March 7, 2008 3:29 AM

Posted by: Monica Thanks to people like Barabara Fisher, ... Thanks to parents of immune deficient children who contracted polio from the vaccine, ...

Why would the medical community need a suffering child or parent to lobby those health care providers to evaluate risks and benefits of a vaccine and choose the safest most effective options? Why would we not act when safer vaccines became available? What makes you think the medical community only acts when some suffering person brings something to our attention?

I've spent 8 years at a university and 30 years in practice. Do you think people like me sit around on our asses not caring in the least about our patients or the care we provide? Why would I spend so much time learning my profession and providing health care and then need a suffering person to lobby me to act responsibly? Do you trust a neurosurgeon to cut into your brain yet think that same medical provider would not evaluate the research on the safety of vaccines?

Why do you, with no medical education from the sound of your comments, think you have looked at vaccine safety but the the medical community hasn't? Do you think that we want to cure cancer and heart disease but while we are at it make a few bucks on the side hawking vaccines which result in needless misery for children and parents? Are you serious?

Posted by: Monica How is it we successfully eradicated polio, smallpox, etc, without vaccinating infants? These vaccines were given to older children, not infants.

You could not be any more ignorant of the facts here than this.

Posted by: Monica To think we cannot strive to improve safety is ignorant.

No, Monica. To imagine the medical community has no interest in improving care and safety is where the ignorance lies.

Posted by: Monica I do ask you this, can anyone find a study that shows how many children produce antibodies to the vaccines they received in our current schedule?
I am very interested because my child's immunologist stated that it is NOT abnormal for a child to not respond to vaccines, as the immune system is not mature until age 2. If this were true, then our vaccination program would be faulty, correct?
My child suffered an adverse reaction to either the MMR, or Varicella vaccines. She had encephalitis, seizures, fever, bulls eye rash.
We also discovered she didn't create antibodies to these live virus vacines, and may have some sort of immunodeficiency. That is where it gets tricky, one immunologist said immunodeficiency, based on the lack of antibody response to vaccines. The other said that the lack of antibosy response is typical, but I just don't feel this is true...

So you've taken your personal experience, the failure of the medical community to provide answers or treatment for your child and decided that every one of us are to blame? You have no answers so we must all be at fault? They didn't help your child so we all must not have tried hard enough?

I'd like to offer you empathy for your tragedy, whatever it is. But I'm not in the mood to take the blame you want to heap on me and my 30 years of dedicated practice doing the best job I could. I am a nurse practitioner and I am not making tons of money by any stretch. But I take great pride in my work and I, like most of my colleagues, feel an obligation to providing the best care we can.

Medicine has only been in the business of serious evidence based practice for the last 100 years. Of course we can't cure every patient and of course we don't understand every disease process. But to accuse us of not giving a sh*t is as ignorant as it gets.

Posted by: skeptigirl | March 7, 2008 3:49 AM

Askyroth,
Thimerosal has not yet been removed so your conjecture is premature.

John Best Just Won,
Good job, insult my son's appearance when you have nothing intelligent to say.
Perhaps the Poling's child has not been cured yet because they have to deal with the mitochondrial thing that most of us aren't dealing with. Why don't you "scientists" figure out how to help her?

Posted by: John Best | March 7, 2008 7:52 AM

First and foremost, I am NOT here to blame anyone, I don't recall stating this was YOUR fault skeptigirl, perhaps you inferred that because you feel guilty? Have you administered vaccines to a child who had a severe reaction?
I am not sure what to make of your attack. I never accused anyone of not giving a "sh*t". In fact, quite the opposite is my experience. My daughter's pediatrician, and her entire team of doctors have been very compassionate, and determined to learn why my daughter had such a reaction. I have never once blamed them, as they could not have known the outcome. You could not be further from the truth.

Secondly, I am NOT antivaccine. I hate when people draw conclusions that are not valid.

We CAN create safer vaccines, we have in the past, and we need to continue to do so. The first step towards that is a more accurate, accessible and well known adverse reporting system.

I find it sad that the ARNP and 2 pediatricians that have been treating my daughter did not know of VAERS, or how to report a reaction. My congressman suggested I do such a thing, and I provided the practice with the correct information.

Thirdly, I have real skepticism with our current state of affairs at the FDA. Let us not forget Ketek, Zelnorm, Oxycontin, Heparin and Vioxx. Let us not forget who funds the FDA.

I would also like to remind everyone that for every congressman in the US, there are approximately 40 pharmaceutical lobbyists. Pharmaceutical companies have more lobbyists in the US than any other industry.

Currently, the only countries that allow direct to consumer advertising of pharmaceutical preperations is the US and New Zealand. Recently, congress asked these corporations to suspend such marketing, until a product has been available for 2 yrs, to allow for a smaller sample size and moniter adverse reactions more efficiently.

Last yr, $48 billion was spent on direct to consumer advertising in the US.

Pharma's lawyers said "no way, we have freedom of speech", which by laws of our constitution, trumps our safety.

Currently, members of our congress are asking that the commissioner of the FDA, Andrew von Eschenbach, resign. Congress has lost confidence in officials over the handling of investigations and oversight by the agency.

Former employees of the FDA often wondered who the client was, the American people, or the companies funding the studies. You can read about it in the NEJM.

The tides are turning, our congress is demanding answers from these corporations, and the FDA, not just about vaccines. I say it is about time.

Posted by: Monica | March 7, 2008 11:09 AM

skeptigirl, I would also like to add that when you speak for the entire medical community, as it seems you want to be their spokesperson, you are speaking for the medical community that treats patients.

That is not where the problem lies.

You see, most physicians truly care for the patients they treat, and want to see them healthy.

The individuals at the core of this issue never even see patients! They sit in a lab, or behind a desk, and are very profit driven.

Thankfully congress had ensured that I no longer have to see Dr Robert Jarvick hawking his pills on the air.

Skeptigirl, this is much different from what drives you to care for your patients. You see them, face to face. Corporations see them as dollar signs, and increased revenue.

Trust me, I am all for doctors, nurses, and practicing physicians who treat patients. They have a rough job these days. They are often fed even more b*llsh*t than us patients are.

Posted by: Monica | March 7, 2008 11:27 AM