I don’t always blog about stories or studies that interest me right away. Part of the reason is something I’ve learned over the last eight years of blogging, namely that, while it’s great to be the firstest with the mostest, I’d rather be the blogger with the mostest than the firstest. I’ve learned this from occasionally painful experience, although I’d be lying if I didn’t admit that in part this is a rationalization for the fact that I have a demanding day job that keeps me from jumping all over stories and studies of interest in the way that some bloggers can. There’s also the simple fact that blogging is a global phenomenon, and even if blogging were my full time activity there would always be bloggers in time zones many hours ahead of me who can pounce all over science and skepticism stories that I want to pontificate about. (I’m talking about mainly you, U.K. bloggers. Damn you for being awake while I’m snoozing the night away.)

It’s also sometimes good to let a story percolate a day or two, anyway. It can let me put it into context and, just as importantly for purposes of entertainment value, survey the reaction of the quacks, cranks, and pseudoscientists when appropriate, not to mention give me time to look up the actual study. So it was that I didn’t leap all over the stories that began peppering the media yesterday about how the prevalence of autism is now estimated to be 1 in 50 among U.S. children between the ages of 6 and 17, as reported by the AP and elsewhere. Not surprisingly, the antivaccine cranks at the antivaccine propaganda blog Age of Autism are all over it, with Anne Dachel laying down her usual burning stupid, while others demand that Thomas Insel be fired and Teresa Conrick engages in her usual scientific incompetence born of the arrogance of ignorance and tries to link various observations in science by trying to link the recent report that 1 in 3 adults will die with dementia with the report that 1 in 50 children have autism or autism spectrum disorder. (Yes, vaccine are to blame for both, in adults the influenza vaccine and in children childhood vaccines.)

To understand the importance of the issue of the prevalence of autism and autism spectrum disorders (ASDs) to the antivaccine movement (as opposed to the rational, science- and reality-based community), you have to understand the central dogma of the antivaccine movement. That dogma is that the reason for the massive increase in autism prevalence over the last two or three decades must be something in the environment. Of course, antivaccine cranks being antivaccine cranks, to them there is only one thing that could be causing it, and that’s vaccines. The reason is that the beginning of the increase in autism prevalence just happened to correlate with an expansion of the vaccine schedule. In a massive case of confusing correlation with causation, antivaccine activists, against all existing reliable scientific evidence from well-designed epidemiological studies, insisted (and continue to insist against that evidence) that it must be vaccines that are causing or contributing to what they like to refer to as the “autism epidemic” or, when they’re in a cruder mood, the “autism tsunami.”

The retort to such an obvious logical and scientific fallacy is to point out other things whose rise corresponds to the increase in autism diagnoses. One example I like to use is Internet use. It exploded beginning in the early 1990s and continues to rise today. Then there’s the example of the humble CD. Introduced in 1985 in the U.S., its use skyrocketed for 20 years, although admittedly CD sales are plummeting now as CDs are being supplanted by downloaded MP3 files, as CDs supplanted LPs; so maybe that’s not the best example anymore. However, perhaps the best correlation I’ve found thus far is between organic food sales and autism. Obviously, organic food must cause autism!

In any case, the heart of the antivaccine religion is the dogma that autism prevalence is rising and that the rise is caused by vaccines. Never mind that there are many other factors that cast doubt on the idea that the true prevalence of autism is actually rising, including diagnostic substitution, increased awareness, increased screening, and increased services. The example that I like to use to illustrate this point is worth bringing up again. There is a form of breast cancer known as ductal carcinoma in situ (DCIS). Well, actually, whether it’s really cancer or not is debatable, but it is clearly a precursor to cancer, although the percentage of DCIS lesions that progress to cancer isn’t precisely known. Be that as it may, before 1975 DCIS was a very uncommon diagnosis. Now it is very common, its incident has risen by 16-fold. No one believes that the actual incidence of DCIS has risen by that much. In fact, it’s unlikely that it’s actually risen much at all, but we are detecting much more of it because of the advent of mammography screening programs in the late 1970s and early 1980s. Yes, I know I’m mixing incidence and prevalence, but the example still illustrates a general principle that if you look for a disease or condition intensively, you will always find more of it, often a lot more of it. Always. And if the principle works for something that is diagnosed by an objective test, namely a biopsy, how much more so is it for a condition that has no unequivocal biochemical or tissue test to nail down the diagnosis, like autism, particularly for something whose diagnostic criteria changed considerably 20 years ago to widen the diagnostic criteria?

I hope that puts this report into context. Yes, the apparent prevalence of autism has been reported to be 1 in 50, which is in line with a South Korean study that found it to be 1 in 38. At this point, it is useful to bring up another principle. If you screen intensively for a condition, after an initial rise in incidence and prevalence, you will eventually see a leveling off at something near the “true prevalence” of the condition, and this is what could well be happening. After all, contrary to the ridiculous claim of Julian Whitaker, autism prevalence can’t keep increasing forever until it reaches 100%. It could be that the baseline prevalence of autism and ASDs is somewhere around 1 in 50. Only time will tell whether this is true or not, but it seems reasonable based on what we know now.

So what about the report? Basically, the authors mined newly released data from the 2011–2012 National Survey of Children’s Health (NSCH). This is a telephone survey of 95,677 families. One problem with the study, as has been noted in multiple news stories, is that the response rate was low (23%). While the authors describe going to great lengths to determine whether this biased the results through a phenomenon known as nonresponse bias, I must admit that I’m not entirely convinced. It’s quite possible that parents with children with ASD would be more interested in responding to this survey than parents with neurotypical children. On the other hand, this is not a survey about autism; it’s designed to look many health conditions.

If we accept the reliability of the survey instrument and the authors’ methods, the conclusion of this study was that autism prevalence has increased from 1.16% (1 in 86) in the 2007-2008 survey to 2% in the 2011-2012 survey in children aged 6 to 17. The authors noted that this increase in prevalence was observed across all of the age ranges studied. Moreover, they noted that much of the increase in prevalence was driven by diagnoses made post-2008 of milder cases of ASD, indicating a trend towards less severe presentations since 2008. Also noted, probably not surprisingly, is that the greatest increases occurred in boys, for which prevalence nearly doubled (2007 prevalence: 1.8%; 2011-2012 prevalence: 3.23%) while in girls the increase was less dramatic (2007 prevalence: 0.49%; 2011-2012 prevalence: 0.70%). All of this, the further increase in prevalence coupled with the shift towards less severe presentations, is reminiscent of the story of DCIS and suggests to me, more than anything else, a probable screening effect responsible for the increase rather than a true increased prevalence. Or, as described in the AP story:

“I don’t see any evidence that there’s a true increase in the prevalence of autism,” said Roy Richard Grinker, a professor of anthropology at George Washington University, Washington, D.C.

Grinker said he’s been anticipating a higher count in the United States since he published a 2011 study that found an autism rate of 1 in 38 in South Korean children. “I don’t look at that and say ‘that’s so much higher than the U.S.’ I look at that as ‘the U.S. will catch up.'”

The new study found the biggest jump among older children with milder symptoms, suggesting that their autism wasn’t caught until later in childhood. By definition, symptoms of autism must be present by age 3, affect a child’s communication and social skills, and lead to restricted or repetitive behaviors such as rocking or hand-flapping.

Michael Rosanoff, associate director of research for the advocacy group Autism Speaks, said he thinks the new numbers reflect improved awareness of the condition over the past decade, leading to more diagnoses. Because these children weren’t counted in earlier studies looking at school district support, it also suggests that many children who need help with their symptoms aren’t getting it, Rosanoff said.

It is the children with milder symptoms who are most likely to be affected by a change in the definition of autism that will take place this spring. Rosanoff said this study adds urgency to the need to protect those children.

While the AP quotes actual experts, one can’t help but note the marked contrast with the antivaccine crank blog Age of Autism, which cites not experts but one of the “Thinking Moms” Alison MacNeil, who is the coauthor of a an upcoming book The Thinking Moms’ Revolution: Autism Beyond The Spectrum. MacNeil, not surprisingly is bristling with the arrogance of ignorance. Responding to the CDC’s assessment that the reason for the increase is better diagnosis and screening, MacNeil is having none of it:

I don’t think the public is buying that anymore. They might have a while back, especially when the criteria shifted in the Diagnostic and Statistical Manual, but I think now, what we’re seeing everywhere we go, we’re seeing autistic children.”

“Why do we have so many children descending into autism? What is going on? One in every 50 children is losing the ability to speak, becoming incredibly sick, detaching. There’s something behind this.

Gee, I wonder what MacNeil is referring to when she says there’s “something” behind this. Could it be…Satan vaccines?

Then there’s the AoA crew demanding Thomas Insel’s head because he doesn’t accept their belief that vaccines cause autism. True, it’s in antivaccine code. To understand the code, you have to realize that whenever an antivaccinationist says “take the autism epidemic seriously and do something” they mean to start believing that vaccines and dubious environmental causes must be the cause of the “autism epidemic.” Anything short of that, particularly accepting the science showing that there is no detectable epidemiological link between vaccines or mercury in vaccines and an increased risk of autism, is heresy.

Meanwhile Teresa Conrick does what she does best and demonstrates her ability to make irrelevant connections between conditions that do not share pathophysiology, obtained mainly by cherry picking studies. In this case, she tries to liken Alzheimer’s disease to autism:

Coincidentally, about 30-40 percent (one out of three) adults receives an influenza vaccine. Is that a coincidence or is it a clue? Since both Autism and Alzheimers are each frequently quoted as being ” A MYSTERY,” is there a pattern to their well kept secrets? Alarmingly, there is much evidence that mercury, and Thimerosal, the kind of mercury in most flu shots, can cause immune and autoimmune issues . Is there a connection to immune issues and Alzheimers? We know Autism has numerous connections to the immune system, with many children and young adults also receiving an autoimmune diagnosis.

Because autism is just like Alzheimer’s and, of course, the evil vaccines cause them both! That reminds me. Perhaps I should take on a previous post of hers to which she links as “evidence” fot the connection. It’s a perfect example of how not to make inferences based on the scientific literature.

In the meantime, I can’t resist concluding with a little tweak to an old “friend” of mine. Two weeks ago, I gave a talk at the National Capital Area Skeptics (NCAS). The talk went well (at least as far as I can tell), and a good time was had by all, including, of course, myself. Some of you were even there, and I thank you for coming! Even though the talk wasn’t about vaccines, that didn’t stop our old buddy Jake Crosby from doing what Jake does and showing up at my talk, no doubt to try to goad me into saying or doing something embarrassing or, failing that, to get himself ejected and then paint himself as some sort of free speech martyr exposing the evil pharma conspiracy. I spotted him right away, lurking in the back of the room. At the end of the talk, not surprisingly he had to ask a question, and his question was apparently based on a post of his from a couple of months ago that I completely missed in which he tried to paint me as a liar because several years ago I said I’d reconsider my rejection of the hypothesis that the mercury containing thimerosal preservative in vaccines causes autism if autism prevalence started plummeting. That was back in the early years after the removal of thimerosal from childhood vaccines, and I proposed this:

I propose as quite a reasonable measure that, if autism rates fall by 50% or more in 2010 or even 2015, I will happily admit that I was incorrect in my assessment and rejoice that such a blow has been struck against this condition. If rates fall by less than 50% but still inarguably statistically significant, I will concede that this would be pretty good epidemiological evidence that there might be a connection, although in that case the connecton would clearly not be nearly as strong as the link claimed by some activists, like J.B. Handley, founder of Generation Rescue, whose website states quite bluntly that “childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning

In retrospect, I think I was way too generous, but there it is. Now, Jake seems to think that I am a liar because he found numbers showing a 40% decline in ASDs among African-American children in Alabama that is almost certainly due to problems in case ascertainment rather than a true decrease. Based on that, he thought I should retract what I said nearly eight years ago. I, of course, do not. Indeed, I repeatedly asked Jake what’s happening to autism prevalence everywhere else, which produced the amusing spectacle of him trying (and failing) to handwave and Gish gallup. I also note that a month before my talk, Jake’s fellow AoA blogger Anne Dachel lamenting that Autism is overwhelming Alabama.

Then this study shows up, suggesting that autism/ASD prevalence is still going up 11 or 12 years after thimerosal was removed from childhood vaccines and may be as high as 1 in 50. I am amused. Too bad this study wasn’t reported two weeks ago. It would have been so much fun to rub Jake’s face in it publicly. I’ll just have to settle for doing so now.

I know it might have been excessively snarky given the circumstances, but later on while trying to question me more after my talk, Jake asked me if I knew who he was. My response was along the lines of, “Of course, I know who you are. That’s how I know you don’t know what you’re talking about.” His only response to that was to tell me I was lying, after which I was done with him. The same can be said of all the antivaccinationists trying to use the increasing prevalence of autism as evidence that it must be those horrible vaccines that have caused it. The problem is, their message is so dangerous that I can’t just disengage, as I did that day, by saying, “We’re done,” and walking away.

Comments

  1. #1 Ren
    March 29, 2013

    “an assertion I would disagree with, but only with too much verbosity for this post”

    Now you’re going to worry about verbosity? It’s kind of late for that, bud.

  2. #2 Alain
    March 29, 2013

    Direct from the paper:

    Nonresponse bias was investigated by comparing the proportion scoring 13 or greater on the AQ-20 in the 5 regions with the highest response rate and the 6 regions with the lowest response rate in phase 1: it was 1.1% and 1.2%, respectively; using weighted data, it was 1.1% and 1.3%. Refusal to take part by participants selected for a phase 2 interview was 24% overall: the proportion of those who refused and scored 13 or greater on the AQ-20 was 24.3% among individuals with an AQ-20 score of 0 to 12 and 23.3% among those with an AQ-20 score of 13 to 20.

    I can see where the statistical manipulation lowered the odds of having a diagnosis and furthermore, the modified ASSQ is published there:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076581/

    And it doesn’t have the actual test.

    I stand by my conclusion that autism is underdiagnosed in the adult population.

    Alain

  3. #3 Alain
    March 29, 2013

    Finally, you asked at one point, a better way to performing this type of test. How about, go give 2000 ADI-R + DISCOs, to a random population and see what you numbers look like without a series of weightings; without relying on something designed to capture high functioning individuals? It would be expensive and time consuming, but if you are a proponent of psychometrics, this would be a way to achieve much more solid values.

    8 to 10 years. that’s what it would take if I handled this as the solo psychiatrist diagnosing autism but it can be shortened to 2 or 3 years if I had 4 psychiatrist (myself included) involved in the project.

    3 days to diagnose, 1 day for research work and 1 day for clinical work.

    Alain

  4. #4 lilady
    March 29, 2013

    pD posts back at me…

    “Regarding a classic regressive autism ratio of 8/1, I am afraid you are rather clearly illustrating how much you have yet to learn about the subject matter. The ASQ/ASSQ is designed to capture high functioning autism, that is a much, much different condition that classic regressive autism.”

    Sweet Jeez pD, you really have a serious reading comprehension problem. Here, my post at # 161 above…

    lilady
    March 27, 2013

    (Watch for the anecdote)

    When I first got involved in advocacy more than 30 years ago, I met a number of parents and their children who were diagnosed with (regressive) “classic” autism. The parents all spoke about the ratio of males/females (8:1) who had the clinical diagnosis of autism…so that ratio that they spoke of, has been *around* for more than 30 years.

    I found this article that offers up some history about the sex difference ratios and opinions about that ratio…

    http://questioning-answers.blogspot.com/2011/03/sex-ratio-and-autism.html

  5. #5 lilady
    March 29, 2013

    There’s a new study out today, in the AAP Journal, Pediatrics.

    Matt Carey, at LBRB, has a great post/analysis of the study “that should be” the final nail in coffin of the “Too Many Too Soon Vaccines” *theory*…

    http://leftbrainrightbrain.co.uk/2013/03/29/autism-risk-not-increased-by-too-many-too-soon/

  6. #6 Denice Walter
    March 29, 2013

    Oh lilady!
    If only nails and coffins could contain this unholy thing and be the death of it! But no…
    it will burst forth from its sealed casket like Uma Thurman in ‘Kill Bill’ and return to fight again,
    even if we put a stake through its evil, unbeating heart and it dissolves into a pool of quivering, undead flesh and tainted blood,
    it will arise from that pool of black blood-( as in ‘True Blood’)-to menace and drain us again,
    even if we put it on a ship and set it afire and set it out to sea as though it were a VIking burial,
    it’ll come back in conquering mode to pillage the gates of reason. Again. And again.

    That hypothesis is not dead. It is an immortal. It concerns the myth of eternal return. And the phoenix birthed from its own ashes. And Shiva dancing on the dwarf as the Universe dies and is recreated again and again.
    Resurrected like verdant Spring from the icy shards of dead Winter.

    And we’re stuck with it.

  7. #7 lilady
    March 29, 2013

    @ Denice Walter…I’m laughing my a$$ off with your post.

    http://eldriciv.blogspot.com/2009/11/dara-obriain-quotes.html?zx=ef0147290786c081

    Dara O’Briain Quotes…

    “I get a little p!ssed off when people say that crime is going up when the numbers are *definitely* going down. And then if you go “but the numbers are going down” they go “but the *fear* of crime is rising.” Well so what? Zombies are at an all time low level but the fear of zombies could be incredibly high. That doesn’t mean we need to have government policies to deal with the fear of zombies.”

  8. #8 MH
    March 30, 2013

    Contrary to what some may think, the “big pharma shill gambit” is not old and it’s very disconcerting.

    The Center for Disease Control and Prevention (CDC) is given the responsibility of analyzing vaccines created by pharmaceutical companies before being distributed and promoted to the public, setting the childhood immunization schedule, and tracking the possible side effects. However, having them evaluate the safety of their own recommendations is not only awkward for them, but also a conflict of interest.

    Approving and promoting vaccines only to have them recalled for harmful implications and health concerns has occurred numerous times. Investigators have looked into why these vaccines were given the “ok” in the first place, discovering that there are financial ties between vaccine companies and what is supposed to be an unbiased agency.

    In 1998, the CDC had to withdraw its recommendation of the rotavirus vaccine, leading to a four month investigation that brought to light the financial investments CDC committee members had to pharmaceutical companies producing the vaccine. The investigation found that the relationship between CDC’s Vaccine Advisory Committee and pharma companies included sharing a vaccine patent, owning stock in a vaccine company, being paid for research, receiving money in order to monitor vaccine tests, and funding academic departments.

    For these companies, creating a vaccine can cost around half a billion dollars. If they want to make any profit, they need a guaranteed market once it’s finalized. A recommendation from the CDC gives them that considering there are some school boards won’t even let children attend unless they’ve had CDC-endorsed vaccines.

    In the case of the rotavirus vaccine, it was pulled from shelves after reports that the vaccine was causing “an excruciating contortion where a child’s large intestine folds over the small one.”

    The CDC panel that recommended the vaccination was ultimately reviewed, and it was found that “four out of eight CDC advisory committee members who voted to approve guidelines for the rotavirus vaccine had financial ties to pharmaceutical companies that were developing different versions of the vaccine.” In no way should they have been allowed to sit on that review panel.

    One of the committee members who approved the rotavirus vaccine, Paul Offit, even stated, “I am a co-holder of a patent for a (rotavirus) vaccine. If this vaccine were to become a routinely recommended vaccine, I would make money off of that…[But] when I review safety data, am I biased? That answer is really easy: absolutely not.”

    However, Offit has had his research funded by Merck (one of the largest pharmaceutical companies in the world) for thirteen years. Merck even buys and distributes Offit’s publications to American doctors. As well, the chairman of the CDC’s Vaccine Advisory Committee, Dartmouth Medical School professor Dr. John Modlin, owned $26,000 in Merck stock at the time of the decision.

    The rotavirus vaccine is one example of the CDC’s vaccine inquiries with a “conflict of interest.” One of which being the recalled LYMERIX vaccine (to prevent against lyme disease) where members of the CDC had financial investments in the companies creating variations of the medication. It was also found that the CDC and SmithKline Beecham (a multinational pharmaceutical company) worked together on a lyme vaccination project.

    Not to mention how most of the CDC-recommended vaccinations in the 1990s contained a mercury-based preservative called thimerosal. Manufacturers had used thimerosal, which contains ethyl-mercury, as a preservative in multi-dose vials of vaccine. The vials allow needles to be inserted repeatedly and the vaccine drawn out, making them cheaper than separate packaged doses of the vaccine. Depending on the type of vaccines a child received during the period, a visit to the doctor in the 1990s may have exposed children to 125 times the mercury limit set by the Environmental Protection Agency.

    A draft of Dr. Thomas Verstaeten’s study also appeared to show that thimerosal might cause brain problems, stating that “increasing risks of neurological developmental disorders with increasing cumulative exposure to thimerosal.” It’s been found that children with the autism genes don’t possess the mechanism to detoxify their body of mercury. “Autistic infants who experience comparable exposure to mercury were completely incapable of excreting mercury through hair levels that might have been predicted based on the excretion patterns of the control infants…autistic children will retain significantly higher levels of mercury in tissue, including the brain, than normal infants.” (International Journal of Toxicology, 22:227-85, 2003)

    The CDC’s whole prerogative is to act as an unbiased third party, but numerous facts point to financial investments and personal interests trumping the social and legal responsibility they have towards conducting research and truthfully informing the public. Considering the potential ramifications that any vaccine or medication can cause, this is an issue that needs to be monitored and individuals need to be informed upon. If the agency is unable to carry out its purpose or live up to the operating standards that’s required, then reform it, re-employ it, or start anew with one that isn’t conflicted with were it’s loyalty lies – to the public, not profit.

    Benjamin, Mark. “The Vaccine Conflict.” UPI. 20 June 2003: n.p. SIRS Issues Researcher. Web.
    Gale, Richard and Dr. Gary Null. “Vaccination: Federal Health Agencies Continue to Deceive Americans.” Global Research. 13 November 2009: n.p. Web.
    Goldman, Michael C., Dr. “Autism and Mercury Toxicity.” Web log post. September 2012: n.p. Web.
    Nash, J. Madeleine. “The Secrets of Autism.” Time. 6 May 2002: 46-56. SIRS Issues Researcher. Web.

  9. #9 Julian Frost
    NOYDB
    March 30, 2013

    @MH:

    One of the committee members who approved the rotavirus vaccine, Paul Offit, even stated, “I am a co-holder of a patent for a (rotavirus) vaccine. If this vaccine were to become a routinely recommended vaccine, I would make money off of that…[But] when I review safety data, am I biased? That answer is really easy: absolutely not.

    Offit voted to put a competing vaccine on the schedule, and recused himself when his vaccine was considered. His impartiality is proven.

    In the case of the rotavirus vaccine, it was pulled from shelves after reports that the vaccine was causing “an excruciating contortion where a child’s large intestine folds over the small one.”

    This turned out to be an exaggeration.

    Manufacturers had used thimerosal, which contains ethyl-mercury, as a preservative in multi-dose vials of vaccine.

    No, it is metabolised to ethylmercury, which is rapidly excreted by the body.

    The vials allow needles to be inserted repeatedly and the vaccine drawn out, making them cheaper than separate packaged doses of the vaccine. Depending on the type of vaccines a child received during the period, a visit to the doctor in the 1990s may have exposed children to 125 times the mercury limit set by the Environmental Protection Agency.

    The EPA regulations cover LARGE amounts of a substance and chronic exposures, not the miniscule amounts found in vaccines.

    A draft of Dr. Thomas Verstaeten’s study also appeared to show that thimerosal might cause brain problems, stating that “increasing risks of neurological developmental disorders with increasing cumulative exposure to thimerosal.” It’s been found that children with the autism genes don’t possess the mechanism to detoxify their body of mercury.

    Firstly, the miniscule amount of thimerosal in vaccines are not enough to cause problems. Secondly, the “poor excretor” theory is hogwash.
    Finally, I’ve had a look at your list of “sources”. Gary Null is a vitamin pedlar and quack who has been taken apart by Orac repeatedly. I’m not sure he’s even a doctor. One “reference” is over 10 years old; one is almost 10 years old.
    In short, we’ve seen your arguments numerous times before, we’ve deconstructed them numerous times before and we’re not impressed.

  10. #10 Krebiozen
    March 30, 2013

    MH,
    <blockquote.In the case of the rotavirus vaccine, it was pulled from shelves after reports that the vaccine was causing “an excruciating contortion where a child’s large intestine folds over the small one.”
    You mean intussusception? The current vaccine is not associated with an increased risk of intussusception, and the association between the withdrawn vaccine, Rotashield, and intussusception is by no means clear.

    Even if we accept the earlier and probably erroneous estimated adverse effects of Rotashield of 1 case of intusussception per 10,000 vaccinees, that would mean 430 extra cases if the entire US birth cohort of 4.3 million infants was vaccinated. Since vaccination would avert 14 rotavirus-associated deaths, 53,444 hospitalizations and 169,949 emergency department visits in the same cohort, the benefits of even the withdrawn vaccine greatly outweighed the risks.

  11. #11 Krebiozen
    March 30, 2013

    Oops. First paragraph should be blockquoted.

  12. #12 herr doktor bimler
    March 30, 2013

    It’s been found that children with the autism genes don’t possess the mechanism to detoxify their body of mercury.

    Citation: talking leprechauns.

  13. #13 Darwy
    Røde grøde med fløde
    March 30, 2013

    @MH

    Not to mention how most of the CDC-recommended vaccinations in the 1990s contained a mercury-based preservative called thimerosal. Manufacturers had used thimerosal, which contains ethyl-mercury, as a preservative in multi-dose vials of vaccine. The vials allow needles to be inserted repeatedly and the vaccine drawn out, making them cheaper than separate packaged doses of the vaccine. Depending on the type of vaccines a child received during the period, a visit to the doctor in the 1990s may have exposed children to 125 times the mercury limit set by the Environmental Protection Agency.

    Since the EPA has no set limit for mercury exposure via vaccines, I’d love to see your source for 125X the limit.

    If you’re trying to use the drinking water limit guideline, I’d remind you that you don’t drink 64 ounces of thimerosal daily, and that using that guideline is inappropriate.

  14. #14 Chris
    March 30, 2013

    MH, what is so funny about all the errors you made with the RotaShield versus the other two rotavirus vaccines is that the ACIP minutes are online. It takes two minutes to find them and show that the quote is off base, and Offit was not on the committee when RotaTeq was approved.

    It is bad those citations lie, but it is even worse when it easy to find the actual minutes. Like:
    http://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-oct06.pdf

  15. #15 Alain
    March 30, 2013

    I’d have to wonder where was MH when Sadie Burke said there’s no ghostwriting for vaccine because there’s no gain to be made and that vaccine are safe.

    Alain

  16. #16 Narad
    March 30, 2013

    Your guess is as good as mine is as good as Narad’s as to where 2828 comes from.

    I did at least take the straightforward step of dropping Dr. Brugha a polite note asking whether he might have the time to break out the calculation. He’s currently traveling (autoresponder), so it might be a while.

  17. #17 Krebiozen
    March 31, 2013

    I forgot to add this link to the source of the second set of numbers in my last comment. Also I’m not sure I made my point clear; the Rotashield manufacturer voluntarily withdrew its vaccine, and it looks now as if this did more harm than good. It took me a little while to get my head around this, but I find it quite interesting as another example of how the effects of vaccines can be unexpected.

    It is likely that rotaviruses increase the risk of intussusception (PMID: 23324817), and that Rotashield, a live attenuated vaccine, also increased the risk of intussusception within one week of vaccination. However, over a longer period, unvaccinated children would continue to be at a greatly increased risk of contracting a rotavirus and thus intussusception, as compared to vaccinated children, who had a slightly increased risk of intussusception immediately after vaccination, but a greatly reduced risk after that. Comparing the short-term effects of vaccines to the short-term results of not vaccinating can be very misleading – it is essential to look at the longer term to get a true picture of the balance risks and benefits.

    I also found it interesting that it was VAERS that alerted the CDC to the increased risk of intussusception:

    From September 1, 1998 to July 7, 1999, 15 cases of intussusception among infants who had received RRV-TV were reported to the Vaccine Adverse Event Reporting System (VAERS) (12). Of the 15 infants, 11 developed intussusception following the first of the three dose series and 12 developed the symptoms within one week of receiving any dose of RRV-TV. […] Based on prevaccine data on the incidence of intussusception in the United States and based on vaccine distribution data, 14.7 cases of intussusception were to be expected within one week of receipt of rotavirus vaccine due to temporal association without causation. However, in light of under-reporting of vaccine-associated adverse effects, these data suggested an increased risk of intussusception following rotavirus vaccination.

    So contrary to the repeated claims we hear from antivaxxers that VAERS is ineffective as an early warning system because adverse events are under-reported, here’s an example of VAERS showing the expected background incidence of an adverse event, yet the vaccine’s safety was scrutinized precisely because this under-reporting was understood and expected.

    I think it would have been better (in terms of morbidity and mortality) for administration of Rotashield to continue until a safer vaccine was available. Instead, children were left unprotected for several years. This seems to me to be a case of over-cautiousness about vaccine safety putting children at risk, instead of protecting them.

  18. #18 Jen
    March 31, 2013

    Alain, here’s another “Sadie Burke” who suggests there are problems with vaccine ‘science.’ Perhaps the term pharma-shill describes some and then again there are those who are simply afraid to speak out.
    thinktwice.com/fraud2.htm
    I’m not so sure about ghostwriting having any gain or role to play with respect to vaccines either (there simply aren’t that many ‘brands’ of particular vaccines and the FDA approves them, they are mandated to the schedule and they are presumed safe (obviously narcolepsy and H1N1 was a recent problem).
    In any case if there is more pressure to report adverse events or true efficacy levels – such as the Canadian reports of flu shot efficacy not being too high, I think that’s a good thing for patients, I’m sure we can agree on that. Risk/benefit analysis is only as good as the data used.

  19. #19 Chemmomo
    Re 218
    March 31, 2013

    Jen, do you have anything that’s not just conspiracy theory?

  20. #20 Chris
    March 31, 2013

    Jen:

    the FDA approves them, they are mandated to the schedule and they are presumed safe (obviously narcolepsy and H1N1 was a recent problem).

    That was in Scandinavia. You do understand that the FDA only regulates in the USA, not in Canada or Europe. The FDA did not approve that vaccine because it was not used in the USA.

  21. #21 Alain
    March 31, 2013

    @ Jen,

    How come your source stay anonymous and invent political motives?

    Alain

  22. #22 Alain
    March 31, 2013

    Quote from that website:

    when you were once part of the Club. I know one or two people who were put under surveillance, who were harassed.

    I am part of a club, the club of autism researchers whose purpose is to create diversion among scientist so they don’t examine vaccine in all their details and the illness they causes instead looking for clues in neuroimaging and behavioral studies.

    I get paid about 60 000$ per years to do that, mostly by Astra-Zeneca who has a big presence in Montreal and I am glad for it.

    There will be autistic forever 😀

    Alain Toussaint

  23. #23 Narad
    March 31, 2013

    Jon Rappoport with an anonymous source who claims that vaccine critics who “were once part of the Club” are harassed by the FBI? Way to go, Jen. You should go pick up a copy of his volume interviewing David Icke.

  24. #24 Alain
    March 31, 2013

    @ Jen,

    I’ll let you know if I am harassed by our canadian IRS and RCMP.

    Alain

  25. #25 skeptiquette
    April 1, 2013

    Ren,
    Sorry for assuming that you didn’t read pD’s post and “swatting at the hornet’s nest” a couple times. This was based simply on the one-liner you left him, not on the theoretical “breakfast chat” that we had. I fully respect the educational and professional achievements that you have made in public Health as an epidemiologist and I understand that it takes an enormous amount of diligence, time and money to earn a doctorate or master’s degree. Congrats on this accomplishment and best of luck.

  26. #26 skeptiquette
    April 1, 2013

    Lillady,
    I submit to you that you are wrong about me in many ways…

    For the record, I earned a degree in Medical Microbiology and Immunology from a top tier University. No master’s or doctorate, I don’t have the time now, but maybe in the future I will pursue a graduate degree. I’ve taken upper level courses in bio statistics and neurobiology, so you can take that assumption you made and you can probably figure out what to do with it…

    I did read Orac’s post, and I can see where he is coming from when he says that eventually the increased awareness and thus diagnoses will stabilize, which is when we will see the prevalence stabilize. This seems logical to me IF the increase in prevalence is only driven by something such as increased awareness or access to services etc. I also read that he was comfortable with the author’s reasoning as to why the prevalence increased.

    On the other hand, pD’s point that there may be an increase in prevalence that is getting masked and that consistently writing it off to increased awareness etc. could be detrimental to our children’s futures, because small percentages equate to a large amount of individuals—This also makes sense to me and this is what he was clearly arguing.

    In this epidemiological study they were able to capture info on when the diagnoses from the age subsets were made (in or after 2008 or in or Before 2007) and used the reasoning that since there were increases in the two older cohorts (10-13 and 14-17) that this was due to increase in awareness etc. I get it, since children are normally diagnosed between 3-6??(not sure of the high part of that range) then any diagnoses after this time frame, like 7 yrs old and greater, would mainly be attributable to increase in awareness etc. But if you take these people right out of the mix and add them back to the 2007 and before diagnosis of 2-13 yr olds, there is still a quarter percent increase which equates to about 10,000 children per year. Are all of these also due to better awareness?

    Ren, what do you think about the author’s reasoning? Is there a better way to correct or control for the confounding variable of increasing awareness etc.? thanks, if you answer.

    Again I would side with pD that: “What I am saying is that the ramifications of a real increase should be making us question, very seriously the concept of a stable rate of autism.”

    Lilady, the reason you may see pD’s posts as gibberish, is quite simply because you do not have the knowledge to understand them. To me they are quite clear and insightful and it comes across as pD clearly having a deeper understanding of the literature and science at hand and a special(above most people’s) ability to think critically. I mean seriously, we have had to explain some of the most fundamental concepts and you guys still argue against it! Remember when you guys argued that an immunization doesn’t cause an immune response because we are always exposed to antigens? This is a perfect example of the majority of you failing to understand basic science. How the hell would I expect you to figure out what pD is writing about? I absolutely wouldn’t!!

    But it is a bit irksome when you go swinging that rather large stick of arrogance of ignorance around and then on top of it pat each other on the back for a job well done. It is called a joke, and it’s on you, you just can’t recognize it precisely because you diligently pat each other’s backs and reinforce the nonsensical thinking.

    To be fair, I probably haven’t read all of Orac’s posts, the guy writes like a madman and I am busy, but I do read a fair majority.

    Lastly, my comment regarding appeal to authority was blown out of proportion and copious men of straw came a marchin’. Bottom line, appealing to authority and the inverse is called Fallacious reasoning, if your argument can’t hold its own, then forget it. And the inverse, if you can’t understand someone else’s argument then go educate yourself so you can or ask them nicely to explain what is not understood, don’t just go swinging in saying that he doesn’t have a degree and therefore said arguments are bunk.

    Note: above paragraph does not mean I think higher education is worthless (for those of you who like strawmen)

  27. #27 JGC
    April 1, 2013

    Not to mention how most of the CDC-recommended vaccinations in the 1990s contained a mercury-based preservative called thimerosal.

    My god, not the deadly mercury meme again…

    Manufacturers had used thimerosal, which contains ethyl-mercury, as a preservative in multi-dose vials of vaccine.

    Thimerosal does not contain ethyl mercury: following injection thimerosal instead <metabolizes and releases ethyl mercury, which is rapidly eliminated from the body (primarily by fecal excretion). In infants following vaccination ethyl mercury has a half-life of less than 4 days and blood mercury levels return to pre-vaccination levels by 30 days after vaccination. (see Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines, Pichichero et al, Pediatrics Vol. 121 No. 2 February 1, 2008 pp. e208 -e214).

    The vials allow needles to be inserted repeatedly and the vaccine drawn out, making them cheaper than separate packaged doses of the vaccine. Depending on the type of vaccines a child received during the period, a visit to the doctor in the 1990s may have exposed children to 125 times the mercury limit set by the Environmental Protection Agency.

    Those EPA guidelines, however, set limits of exposure for inorganic and methyl mercury, not ethyl mercury: because of its demonstrated low toxicity the EPA hasn’t found it necessary to set exposure limits for ethyl mercury.

  28. #28 Krebiozen
    April 1, 2013

    Skeptiquette,

    I mean seriously, we have had to explain some of the most fundamental concepts and you guys still argue against it! Remember when you guys argued that an immunization doesn’t cause an immune response because we are always exposed to antigens? This is a perfect example of the majority of you failing to understand basic science.

    Perhaps you can provide a link to this, “perfect example” of any of the regulars here making such an idiotic argument, or not understanding basic science or indeed a single example of you and pD having to explain “some of the most fundamental concepts” to anyone here. I don’t remember ever witnessing such a thing. Perhaps I missed it, but I somehow doubt it. However I do remember you misunderstanding some very basic science about the concentration of thimerosal that had to be explained to you repeatedly in increasingly simple terms before you managed to understand it, a few years ago. That was the same thread where pD came out with some rather convoluted arguments about the possible effects of a large number of vaccines (but not antigens per se, nor wild pathogens) on a child’s immune system.

    What if, instead, there are things we do not yet understand about a relationship between early life immune responses and long term, chronic neurologic dysfunction? What if, there are age dependent differences in how the immune system reacts to challenges, and the long term results mimic some of what see in autism? What if we found that the mechanism of action in these cases was dependent on components of the immune system that, it just so happens are highly increased in autism? What if, as I’ve been told, we don’t know what we don’t know?

    That’s a good example of the sort of “just asking questions” that Ren was complaining about above #155. My response to these questions is that if the answer to pD’s questions is affirmative, then contracting measles is far more likely to cause “long term, chronic neurologic dysfunction” than an an attenuated measles vaccine, and that one known cause of ASD is congenital rubella syndrome, which is prevented by MMR. We can also look at what happens to someone essentially without a functioning immune system, and see it is clear that even very young children with intact immmune systems are exposed to pathogens that their immune systems deal with quite effectively, and the great majority of them do so without developing “long term, chronic neurologic dysfunction”.

  29. #29 Calli Arcale
    April 1, 2013

    MH:

    One of the committee members who approved the rotavirus vaccine, Paul Offit, even stated, “I am a co-holder of a patent for a (rotavirus) vaccine.

    Rather notably, not the one under discussion. Which means that by your logic, he made a decision which was against his own interests by voting to approve a competing vaccine. I’m not really clear on how this supports your argument.

  30. #30 C.C.
    CA
    April 5, 2013

    in CA, it’s 1 in EIGHT Children & it is Not at Birth that it is discovered!

  31. #31 LW
    April 6, 2013

    1 in 8 children — what? What is not discovered at birth? Are you talking about autism? If so, citation required.

  32. #32 elburto
    April 6, 2013

    C.C. – [Citation Needed]

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