I don’t know if I could be a pediatrician right now.

True, I probably don’t have the personality to be a pediatrician, at least not a primary care pediatrician on the front lines. After all, if I did, I probably wouldn’t have become a surgeon, much less a hyperspecialized cancer surgeon. One reason (among many, of course) is that I don’t have the patience to deal with non-vaccinating parents, particularly parents with massive cases of Dunning-Kruger disease. The same goes for being a pediatric nurse practitioner or nurse, who are also on the front lines in dealing with the antivaccine movement. In any case, you remember the D-K phenomenon, don’t you? It’s the phenomenon whereby people who are unknowledgeable or incompetent about a topic have a falsely elevated estimate of their own knowledge base. In the antivaccine movement, the D-K phenomenon tends to take the form of parents who think that their University of Google knowledge trumps the knowledge of physicians and scientists who have dedicated large swaths of their lives to the rigorous study of conditions such as autism and the question of how vaccines work.

Nowhere is the D-K effect more intense and painful to behold than at blog with a name so arrogantly misplaced that it lights up the planet with its waves of burning stupid. I’m referring, of course, to The Thinking Moms’ Revolution (TMR), where the denizens think so highly of themselves that they refer to themselves as “Thinkers” (yes, capitalized) and dismissively attack (using arguments of pure pseudoscience and nonsense) the medical profession, scientists, and those who follow the science to realize that, no, vaccines don’t cause autism, and, yes, vaccines are effective and far safer than letting children suffer “naturally” from the diseases that vaccines are designed to prevent. The mothers who blog there also give themselves annoying pseudonyms like DragonSlayer, Goddess, Mountain Mama, Sugah, and Professor. So, naturally, the TMR bloggers are the most insufferable non-vaccinating parents you will ever see, and they like to brag about it. I just saw an example of this the other day that caught my attention and made me contemplate at how difficult it must be to be a pediatrician now. Not only is pediatrics one of the worst-reimbursed specialties, but pediatricians have to put up with moms like The Rev (those ‘nyms again!), describing incidents like this description of one of the “Thinkers” telling her fellows about being fired by her pediatrician for not being willing to vaccinate:

Let me set the scene for you.

A bitter cold Friday night in Chicago. Some Thinking moms decide to get together to break up the monotony of a seemingly endless winter. Several bottles of yummy wine lay interspersed among their mostly green, mostly raw, mostly organic food fest. They laugh and talk and enjoy one another’s company. The topic turns to pediatricians.

“I got fired from Dr. * this week.” Says, the youngest one of the bunch. This Thinker has a remarkably healthy child who eats well and is developing normally with no learning disabilities or developmental delays.

“Whaaaaaat did you just say?” We all rubbernecked, saucer-eyed and slack jawed in her direction; our delicate sips turning into large lapping gulps.

“Yep, he sent one letter certified and one to my house . . . Not sure what the point in that was.”

The funny thing is, I totally pictured many of the “Thinking Moms” to be just like this, a crunchy, woo-infused crowd hanging around with each other and getting drunk while they bask in each other’s self- and group-perceived awesomeness and commiserate with each other over glasses of wine, tales “biomedical” quackery to treat autism, and stories of mean and nasty doctors who have the temerity to insist on treating their patients according to the standard of care on vaccines to protect their patients. I realize that this is a controversial issue among pediatricians, and I can see both sides of the argument. Some pediatricians, noting that vaccines are critical to preventing serious childhood diseases and that nonvaccinating parents take up a lot of their time (which is not billable beyond a certain point) and potentially endanger patients in the waiting room, particularly if there are immunocompromised patients there, decide not to deal with the hassle anymore. There’s also an issue of conflict and trust, wherein nonvaccinating parents don’t trust the doctor who is simply trying to do his best for their child, and the doctor doesn’t trust the nonvaccinating parent to do what he recommends. Such doctors might reasonably conclude that it would be better for all concerned if the parents found a different doctor for their child. As one pediatrician put it:

If a family refuses to vaccinate after a discussion of the issue, he tells them “there are so many things we’re not going to see eye-to-eye on.”

On the other hand, some pediatricians, seeing their duty to their patients and feeling very reluctant even to be perceived as abandoning their patients, much less actually “abandoning” them. In any case, contrary to the conspiratorial twaddle peddled by “Thinkers” like The Rev, pediatricians are under an extreme ethical dilemma when confronted with nonvaccinating parents. Evidence-based medicine tells them that it is very important for the child’s health that he receive his vaccines on time. When the parents prevent this (or prevent any vaccination of their child at all), they prevent the doctor from providing what he knows to be the best care for the child. Faced with such compromised care, the ethical dilemma often leads to a choice between keeping the patient and continuing to try to bring the parents around or setting them free to prevent the disruption of his practice and the potential endangerment of his other patients. There’s a third choice that some pediatricians no doubt make, and that’s to give up in weariness and stop mentioning it. Morally, a lot of pediatricians can’t make that choice, and more power to them. Perhaps that’s why there appears to be a trend among pediatricians to “fire” patients, as this young “Thinker” was fired from her pediatrician. One notes that it’s still clearly a minority of pediatricians.

In fact, this young “Thinker” described by The Rev has exactly that issue. She goes on and on, asking what will she do if her child gets sick and she doesn’t have a doctor who knows her child and whom she trusts. (Why she trusts a doctor who wants her to vaccinate her child when she doesn’t, who knows?) Leave it to the “Thinkers” to claim that it’s all about the money:

“Well, first off . . .” said my tipsy brilliant Thinker-friend, “There is no way to code ‘baby got weighed and measured, is well fed and perfectly healthy.’ You are taking up their billable time with your healthy baby! Vaccines are what make the ‘well baby’ visit a ‘well baby’ visit. You have every right to challenge your dismissal from their practice.”

This mother is just plain ignorant. First off, the young mother can’t challenge the dismissal of her child from the pediatrician’s practices, at least not if the pediatrician followed the laws of the state in which he practices. She (and the other “Thinkers” who chimed in) also don’t know much about medical billing, either. All it would take would be a look at the list of billing codes to know that well baby visits are indeed billable as routine infant or child health checks, complete with CPT and ICD-9 codes. For those codes, it doesn’t matter if the child gets an immunization or not. My guess is that this young mother probably had an insurance plan for her child that covered well baby visits 100% but required a copay for vaccines, which is likely why she didn’t get a bill for those visits in which her child didn’t get a vaccine, not because the pediatrician didn’t bill for them.

In fact, depending on the practice, vaccines can be money losers for pediatricians. Indeed, a study from three years ago by athenahealth found that in almost half the cases, payments for vaccines weren’t enough to cover the cost of storing and administering them. A study in Pediatrics from 2009 concluded that for privately insured patients pediatricians vaccines produce little or no profit and that when losses from vaccinating publicly insured children (i.e., receiving Medicaid) most pediatrics practices lose money from vaccines. Indeed, a recent news report indicates that it’s gotten so bad that pediatricians have become very dissatisfied with insurance and government reimbursement for vaccines to the point that 10% of pediatrics practices admit to considering not offering vaccines anymore, instead referring their patients elsewhere for them.

Another rather hilarious claim is that “nurses can’t harass” you about vaccines. “Harassment.” You keep using that word. I do not think it means what you think it means. Of course, what these “Thinkers” refer to as “harassment” is no doubt nothing more than the nurse doing her medical duty according to the standard of care to ask the parents which vaccinations the children have had and to suggest trying to get their vaccines up to date. It’s part of the frikkin’ pediatric history and physical, fer cryin’ out loud! That’s why it’s no surprise that nurses, at every visit, will ask the parents about vaccines and suggest to nonvaccinating parents that they start getting their child caught up on recommended vaccines. It’s their job!

What’s really depressing is what The Rev recommends to maintain the health of her children:

It is in our child’s best interest to build a team of healthcare professionals. After all, we all share a common goal: the health of all our child, right? A couple pediatricians, a chiropractor, a whole foods nutritionist (who understands grains and the gut), homeopath, naturopath, and homotoxicologist are all good team members. The pediatricians and healthcare professionals are covered by insurance so you can have as many of these on staff as you want! I enjoy having a few doctors because then I can weigh what one says against the other and decide for myself what the best course of action is for my child. For instance, my daughter had bronchitis three weeks ago. I tried my best to tackle it with essential oils and homeopathy, two methods of preventative and responsive medicine that are often quite effective for my family. They’ve helped assuage eye twitches, nausea, ear infections, minor allergic reactions, bruises, eczema and a myriad of other ailments. But, this bronchitis was nagging despite the fact that she did not have a fever and was still very active. She needed an antibiotic, so I took her to a pediatrician who prescribed one. My children do not get them very often, so I was willing to take the risk, off set them with probiotics, and make some dietary changes for the duration of their use. Days after she got the clean bill of health, she came down with an ear infection. Some Galilean olive oil with a dab of Thieves and she was good to go. Sometimes allopathic medicine is an option. Sometimes, simply educating ourselves about proper nutrition and preventative care is an option, too.

Yes, The Rev recommends trying quackery first, and when that fails acquiescing to those nasty, reductionist pediatricians and their big pharma-produced toxic chemicals. Just hope that the disease isn’t serious enough that, by the time The Rev abandons quackery and chooses real medicine, it’s not too late for her child.

Maybe that’s why she concludes her nauseatingly self-congratulatory post by congratulating mothers who have gotten letters firing them from their pediatricians’ practices because they are now “Thinkers”:

If and when that letter from your pediatrician arrives? Consider it a victory. You are now a Thinker, and you have been invited to take an active role in guiding healthcare policy in this country. May I gleefully suggest there are several medical, chiropractic, whole-health physician practices in your urban/suburban areas that will be more than happy to care for your child? Investigative physicians that treat the individual child are out there.

Sorry, Rev. None of what you’ve written above sounds even remotely like thinking, much less “Thinking,” to me.

Comments

  1. #1 anon
    March 11, 2014

    2)This publishing company publishes other books which are not bullshit.
    3)This publishing company publishes books which are bullshit.
    4)This is called freedom of the press.
    If any issue arises there are courts in which to sue.
    5)Unfortunately what maybe legal is often unethical or immoral.

  2. #2 anon
    March 11, 2014

    #400
    2)This publishing company publishes other books which are not bullshit.
    3)This publishing company publishes books which are bullshit.
    4)This is called freedom of the press.
    If any issue arises there are courts in which to sue.
    5)Unfortunately what maybe legal is often unethical or immoral.

  3. #3 anon
    March 11, 2014

    #400
    2) This publishing company also publishes bullshit.
    3) This is called freedom of the press.

  4. #4 Chris,
    March 11, 2014

    Freedom of the press does not mean freedom from criticism.

    There is a difference.

    By the way, you have not yet answered my questions:

    What is safer for a a baby to get: a DTaP vaccine or an infection from diphtheria, tetanus and pertussis?

    And when was your last tetanus booster before you were told to get a Tdap?

  5. #5 Krebiozen
    March 11, 2014

    anon,
    You need to learn what a syllogism is to understand what Antaeus is getting at. This is a very useful tool to unpick the deductive reasoning we use to figure out what is true, or not. It can often reveal errors in our thinking, where we have made unwarranted assumptions or made leaps of faith.

  6. #6 Antaeus Feldspar
    March 11, 2014

    You don’t have any bloody idea how a syllogism works, do you, anon? I’m also starting to think you have no idea how civilized discussion or common courtesy work, either. Here’s a free hint: Don’t go trying to drag the discussion off-track just because your ideas are being shown for the indefensible trash they are.

    I think it’s time we introduce you to the practice of the ultimatum question. The way it works is, we ask you a question, and if you make three comments on this or any other thread without answering, you are treated as having assented by default to an answer you will probably find unfavorable.

    The question is this: “In what way is anything that’s been said about Skyhorse in this conversation debunked or even put in different context by the observation that they publish one legitimate book which happens to be in the public domain?” Choosing not to answer means your answer will be taken as “It doesn’t have any relevance at all; I was merely attempting to disrupt the conversation by demanding attention for that book as if its existence meant something.”

  7. #7 skeptiquette
    March 12, 2014

    I don’t want to be a tone troll, but sheesh, sometimes you guys are difficult to engage. I think you are dismissing anon out of hand and missed a really important opportunity to learn something. And based on the recent findings that your message and/or delivery may actually be backfiring, this would be an area that I would be actively evaluating if I were you… Diplomacy ain’t for everyone.

    I will try to briefly summarize the study that Anon was referring to up-thread, it is actually very interesting, informative and both relative to this discussion as well as some things that were unclear in our previous discussion (leaving the cult of anti-vaccinationism and alt-med.)

    A recent study published in PNAS (anon provided the press release for this study) developed a non-human primate model of whooping cough. I will do a quick breakdown of the study so those that are interested can understand and think critically about the implications.

    1. Baboons were vaccinated with the normal infant series of DTaP or inactivated whole cell pertussis vaccine wP.

    2. These two sets of baboons as well as naïve (non-vaccinated, non-infected) and convalescent (previously infected) sets of baboons were exposed to D420, a B. pertussis clinical isolate that causes severe infection in humans and baboons.

    The convalescent animals showed no evidence of colonization or infection upon re-exposure. Whereas the naïve animals experienced colonization and eventual clearance 30 days after exposure. Now, what is interesting is that the aP vaccinated baboons showed slightly slower colonization pattern, equivalent peak levels of colonization, but clearance was slower than the naïve baboons, with clearance around 35-40 days. The wP animals experienced a similar pattern of colonization as aP vaccinated animals, but clearance was on the order of 18-20 days.

    Although the vaccinated animals showed evidence of colonization, they did not have any outward symptoms (asymptomatic.) This indicates that the aP vaccine is effective at limiting the symptoms of disease, but not colonization by Bordetella pertussis.

    Next, the research group probed the ability of transmission to the aP vaccinated animals as well as the ability of the aP vaccinated animals to transmit the bacteria to naïve hosts. First, the two aP individuals and a naïve animal were co-housed with a directly challenged unvaccinated host, which resulted in indistinguishable peak levels and colonization patterns in both the naïve and vaccinated animals. Next, the researchers placed two aP vaccinated animals that were challenged with D420 in a housing setup with two naïve hosts, which resulted in the naïve hosts contracting the bacterial infection and coming down with full-blown whooping cough.

    These are very important findings as they alert us that the most likely suspects of transmission may well be the aP vaccinated population as they can carry the bacteria for a long time (35+) days without symptoms, but with the full capability of transmitting disease to a naïve host.

    So to further clarify this thought, let’s say you have two kids, one has been vaccinated with the aP vaccine, the other child was not vaccinated (he has a crunchy mommy). These two kids were both exposed to someone that has whooping cough, so if we extrapolate the findings from this non-human primate model to humans, we would assume that both children are colonized similarly with B. pertussis. Now, crunchy kid has full blown pertussis and is in bed coughing to the point of throwing up (I had it when I was 13 and this is what I remember), whereas, non-crunchy kid is non-symptomatic, so he is out at school, goes to his sports activities, a birthday party, to the grocery store with mom, etc, etc… all the while crunchy-kid is at home in bed.

    Which kid is going to transmit the infection to more people?

    @Narad

    I will try to answer your question re: “carrier” to the best of my ability.

    Based on the findings I presented above, I think it is safe to say that one could be a carrier for 30-40 days, even if you have been vaccinated. I remember from my Med Micro text book that Bordetella pertussis is a transient normal flora of humans, but there was no indication as to how long this transience persisted.

    One thing I would be interested in is a longitudinal follow up of the aP vaccinated baboon cohort. My curiosity would be whether the aP vaccinated individuals that have been exposed to the clinical isolate D420 that went through the colonization and clearance indicated in the results, upon re-exposure, if they have a similar pattern of colonization and clearance or one that more closely resembles the convalescent cohort.

    This is important because technically if it is the former, then the definition of carrier could be expanded to an indefinite time frame depending on exposure of that individual to other carriers.

    What’s interesting is the paper that pD cited (not this thread, but the other I referred to) re; “locking in” of CD8 T-cells could help us to understand if this programming phenomenon is plausible. Kreb, was the only one who commented on that paper, but I got the feeling he didn’t read it, because I came to a different conclusion than he did based on what I read.

    This is a long post already, but there is a lot more I would like to write about (immunological details of why this is happening), seeing as this is a perfect example to help explain why and how a vaccine can provoke qualitatively different immune responses vs. infection or even different formulations/combinations of the same vaccine, a topic that seems to be unclear to commenters here. This would also be a good time to help explain how vaccines may differ from normal antigenic exposure and how they can persistently modulate innate immunity (heterologous effects). If people are interested in this discussion, I will elaborate, but I won’t waste my time if no one cares.

    hope this helps!
    skeptiquette

  8. #8 Jubilee
    March 12, 2014

    Freedom of the press is totally irrelevant here. No one is saying Skyhorse cannot publish what it chooses, and even if one of us were, we are not the government. But the choices a publisher makes absolutely goes to its credibility and its positioning, in good ways and bad ways, and one book that is an outlier either way doesn’t disprove a general trend.

  9. #9 squirrelelite
    March 12, 2014

    @skeptiquette 407,

    Any thoughts on my comment 291?

    anon is a puzzling case, because occasionally they (she?) say something that sort of makes sense.

    But, some of the comments like 19 are just references with no statement of what they think about what they are linking to.

    And others, like the whole diptheria sequence starting at 280, indirectly argue against vaccination without quite being willing to come out and say so.

    And there’s a lack of response to short direct questions.

    So it can get a bit frustrating after a while trying to fiigure out just what anon is trying to tell us, or progress from simple comments into a conversation.

  10. #10 skeptiquette
    March 12, 2014

    Hi squirrelelite,

    Actually, your response at 291 was very well written and on point!

    Sorry if I lumped you in, it’s hard to keep track of everything people say.

    I would only argue that your last paragraph may not be fully accurate (but partially):

    And, in places where a lot of people react to their fears by refusing to vaccinate, we are already seeing significant outbreaks of pertussis and babies who are too young to be vaccinated yet are dying as a result.

    The increase in incidence of whooping cough may be a result of both waning immunity due to issues with the vaccine (as you mention) as well as this new found phenomenon that I have mentioned. I think that your paragraph reads that this increased incidence is caused by people not vaccinating due to fears, which can’t be ruled out. However, I would argue that it is too early to pin the cause on the decision to not vaccinate, and that in doing so SBM credibility takes a hit because it looks like we are latching on to something that is expedient to our way of thinking vs. objectively evaluating the evidence (which in this case is just coming in.)

    Thanks for pointing out your rational response, I missed it earlier.

    Skeptiquette

  11. #11 squirrelelite
    March 12, 2014

    You’re welcome, skeptiquette.

    I think my comment sort of got lost in the flood, which can happen easily enough.

    I agree whooping cough is difficult to blame exclusively on refusal to vaccinate because of the lower effectiveness of the vaccine. And, most scientifically aware reports are very tentative about that.

    But, a lower vaccination rate certainly doesn’t help.

  12. #12 skeptiquette
    March 13, 2014

    I guess my point was that it is almost more logical to blame the resurgence of whooping cough on the aP vaccine rather than vaccination refusal, because the aP vaccine allows for one to be a carrier without any overt symptoms, thus increasing the likelihood of passing it on to others in the community (i.e. non-vaccinated infants)

    Which is why I was trying to explain ( a while ago) how misguided and difficult it would be to try to take legal action against someone who refused vaccination and allegedly transmitted the disease agent to a vulnerable citizen.

    Am I the only one who came to these conclusions based on the available evidence?

  13. #13 Krebiozen
    March 15, 2014

    Skeptiquette,
    I’m late to reply to this, but anyway:

    What’s interesting is the paper that pD cited (not this thread, but the other I referred to) re; “locking in” of CD8 T-cells could help us to understand if this programming phenomenon is plausible. Kreb, was the only one who commented on that paper, but I got the feeling he didn’t read it, because I came to a different conclusion than he did based on what I read.

    I assume you mean:

    Acute neonatal infections ‘lock-in’ a suboptimal CD8+ T cell repertoire with impaired recall responses

    I did read it, and I didn’t see how it related to pD’s claims that an early immune insult could disrupt neurodevelopment. I still don’t. This paper is essentially about how early acute infections can affect the immune system in mice. It found that a neonatal acute replicating viral infection led to a muted immune response to the same pathogen in adults. I don’t believe neonates are given attenuated viral vaccines, or that you could extrapolate from an acute infection in mice to a live vaccine in humans even if they were.

    What were the different conclusions you came to and why? If you are suggesting that this study shows that early vaccination might make an adult less able to respond to the pathogen they were vaccinated against, I agree, it does raise that theoretical possibility, but I see no evidence of it in humans, and this wasn’t what pD was arguing.

    I did write a longer response to your suggestion that aP may be responsible for the increase in pertussis, rather than a fall in vaccine uptake, but decided against posting it. In short, I think you may be right; the possibility of asymptomatic people spreading the infection is not a new idea.

    I think we should learn from this that putting unpleasant but temporary adverse effects of the cellular pertussis vaccine ahead of efficacy was a serious mistake. It would have been better if we had stuck with the whole cell vaccine.

    I’m curious. Are you in favor of bringing back the whole cell pertussis vaccine? What about vaccinating pregnant women or newborns? Both these solutions would alleviate these problems, with the only problem being the incidence of unpleasant but temporary adverse reactions.

  14. #14 Sarah A
    United States
    March 15, 2014

    I’ve been wondering the same thing – if it’d be feasible to bring back the whole-cell vaccine at this point. Were the side effects really significantly worse than those for other vaccines? I know at least some of the cases of seizures and such that got a lot of publicity later turned out to be due to preexisting genetic conditions.

  15. #15 Krebiozen
    March 15, 2014

    Sarah A,

    Were the side effects really significantly worse than those for other vaccines?

    Yes, this recent study found that local, systemic and febrile reactions were more commonly observed in infants who received DTwP vaccines than in those who received DTaP vaccines: 9·09% vs 0·85% for local reactions, 12·12% vs 1·00% for systemic reactions, and 26·26% vs 2·58% for febrile reactions, all P<0·001. I'm not sure what the distinction is between "systemic" and "febrile" reactions – I don't have full access from my current location. That's quite a large increase in distress for both child and parents.

    However, I don't think the evidence shows that the long-term or permanent sequelae were any worse, despite considerable hysteria about this possibility. Some cases that were initially ascribed to the wP vaccine were subsequently found to be due to Dravet syndrome. I'm most familiar with what happened in the UK, where it was stated in the House of Commons in 1974 that “between 1,000 and 2,000 children in the UK had suffered irreversible brain damage as a result of the vaccine”. Subsequent research found this was not true, but not before, understandably, vaccine uptake fell, there were large outbreaks, and dozens of children died unnecessarily.

    Is a fever in more than 1 in 4 and a sore arm in 1 in 10 worth the increase in efficacy the wP component might confer? I don’t know. One serious problem in assessing the efficacy of pertussis immunization is the cyclical nature of the disease. I wonder how much this has skewed the results of efficacy trials of both wP and aP. This, along with the possibility of aP resulting in more asymptomatic patients, reported mutation of pertussis to become vaccine-resistant and the spread of parapertussis make this a complex and confusing area.

    BTW, a couple of things in my first reference above caught my eye, that I should have know but didn’t: firstly that aP was first used here as a booster, as the wP is too immunogenic. The second was that pregnant women were immunized here in 2012 as part of a program to address unexpected increases in pertussis incidence.

    There seem to be a number of different possible approaches to these problems, but I don’t envy any public health authorities trying to figure out which have the best risk-benefit ratio and are most cost-effective.

  16. #16 AnnB
    March 15, 2014

    #415 Krebiozen,

    This is a great summary of the differences b/t the two. I am going to “borrow” it for my discussions with others. Thx!

  17. #17 Krebiozen
    March 16, 2014

    AnnB,
    Glad to be of assistance. One change I would make to what I wrote is to remove my speculation about cycles of pertussis outbreaks affecting clinical trial results, as I don’t think that’s true. I do think the cyclical nature of pertussis outbreaks can mislead us into thinking something has recently gone wrong, when it hasn’t. Whooping cough has an approximately four year cycle with two years of lower incidence and two years higher, and there are large variations in different peaks and troughs, so it can take a while to see the results of changes in vaccines and schedules. It’s another factor that makes it hard to see what’s going on.

    I would also add that I believe another reason the wP was replaced with the aP is that the former contained thimerosal and the latter didn’t.

    Lastly I see that Tdap immunization is already recommended for unvaccinated pregnant women in the US. This will provide newborns with some maternal pertussis antibodies, which should protect them until they are vaccinated themselves.

  18. #18 skeptiquette
    March 18, 2014

    I did read it, and I didn’t see how it related to pD’s claims that an early immune insult could disrupt neurodevelopment. I still don’t.

    That’s probably because he never used this reference to support the claim that early immune insults could disrupt neurodevelopment, but rather used this reference to support the claim that the timing of an immune challenge is important to consider when discussing the impact of early-life immune challenges.

    This was in response to your assertion that antigenic challenges do not generally cause immune dysfunction or dysregulation; they are part of normal immune function.

    See below:

    Kreb: Antigenic challenges do not generally cause immune dysfunction or dysregulation; they are part of normal immune function.

    pD: Your assertion is at odds with a great amount of literature when developmental timeframe is taken into consideration.

    Here is an example of this:

    Acute neonatal infections ‘lock-in’ a suboptimal CD8+ T cell repertoire with impaired recall responses (PLoS Pathog. 2013 Sep;9(9):e1003572. doi: 10.1371/journal.ppat.1003572. Epub 2013 Sep 12.)

    Kreb: That’s not an example of an antigenic challenge causing immune dysfunction, it’s an example of a less robust immune response by neonatal primary CD8+ T cells to an acute infection (not a vaccine) as compared to adult memory T cells, in mice. This less robust neonatal response is “outgrown by the adult primary response”.

    pD: What might account for the fact that only the treatment group showed differential immune capacities in adulthood, if, indeed, antigenic exposure was not causing persistent immune dysregulation? Do you suppose the treatment group also got broccoli.

    Kreb: A less robust response to a specific antigen that neonatal primary CD8+ T cells were previously exposed to does not constitute, “persistent immune dysregulation”. I fail to see even a tenuous connection to your hypothesis.

    So, I based my comment off the above exchange. I see pD attempting to explain how timing is important when it comes to an immune challenge and using the cited paper as a supporting reference.

    Quick breakdown of this reference:

    1. A set of neonatal mice were acutely infected with vaccinia virus expressing the gB-8p peptide (VACV-gB, i.p.) which is the immuno-dominant epitope of Herpes Simplex Virus-1 (HSV-1.)
    This strategy was used because:

    “In this way, we were able to mimic neonatal vaccinations with live viral vectors and preferentially prime the neonatal T cells that were available in early life.”

    Vaccinia virus is the active component of small pox vaccine and is a good vector for vaccination against other pathogens (such as HSV-1 apparently).

    2. A set of adult mice were given the same immune challenge (vaccinia virus with HSV-1 expressed peptide.)

    3. Both sets were then re-challenged with HSV-1, this is NOT the same pathogen.

    kreb: “It found that a neonatal acute replicating viral infection led to a muted immune response to the same pathogen in adults”

    emphasis kreb.

    I think this point needs to be clarified. The animals were acutely infected with vaccinia virus (the active component of small pox vaccine) that expressed the immunodominant protein of Herpes Simplex Virus, therefore making vaccinia a live viral vector for the peptide of interest. Then they were re-challenged with HSV-1, NOT vaccinia.

    4. The mice that were vaccinated as neonates had a different immune response to the HSV-1 challenge than the mice that were vaccinated as adults. Timing of vaccination was important and this is evidenced by the impaired/dysfunctional recall response of the mice that were infected as neonates.

    “kreb: “What were the different conclusions you came to and why? If you are suggesting that this study shows that early vaccination might make an adult less able to respond to the pathogen they were vaccinated against, I agree, it does raise that theoretical possibility, but I see no evidence of it in humans, and this wasn’t what pD was arguing.”

    So the conclusions I came to were:

    1. pD properly used this reference to support his contention that the timing of an immune challenge can cause persistent or long-term immune dysfunction or impairment.

    This is further confirmed by the authors themselves:

    “Here, we demonstrate how the developmental stage of the host at the time of vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections.”

    2. I see the altered composition of the long-lived memory T cell pool and impaired recall response as an example of persistent immune dysfunction that is directly attributable to the timing of the immune challenge.

    3. Yes, I also came to the conclusion that it is theoretically possible that the timing of an immune challenge (vaccine) in humans could dictate the resultant immune response when re-challenged. I agree that we can’t just extrapolate these results in animal models to humans, but I do think that these results offer insight and hypothesis generating material.

    I will get to the pertussis stuff next. It offers a good example of persistent immune modulation from vaccination and how qualitatively different immune responses affect outcomes.

  19. #19 Krebiozen
    March 18, 2014

    Skeptiquette,

    2. A set of adult mice were given the same immune challenge (vaccinia virus with HSV-1 expressed peptide.)

    3. Both sets were then re-challenged with HSV-1, this is NOT the same pathogen.

    Perhaps my sloppy language is to blame, but my point is it’s the same antigen whether it’s produced by GM vaccinia or by HSV-1. This isn’t some generalized immune dysfunction caused by early infection as I thought pD was implying.

    I see the altered composition of the long-lived memory T cell pool and impaired recall response as an example of persistent immune dysfunction that is directly attributable to the timing of the immune challenge.

    I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all. It certainly isn’t the sort of dysfunction that could even theoretically affect neurodevelopment as far as I can see. Of course our immune systems respond differently at different ages, this is well known, and is largely the basis of the vaccine schedule. The fact that, “vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections”, is the basis of immunization and is hardly a surprise.

    I still don’t see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

    Have I missed something?

  20. #20 Krebiozen
    March 18, 2014

    Just one more thing, briefly. A muted immune response isn’t necessarily dysfunctional. There are lots of antigens we don’t want to react to. For example, it may be a good idea not to mount a full-scale immune response against an antigen that a newborn is exposed to; it may be something in the environment the child has been born into.

  21. #21 Chris,
    March 18, 2014

    Krebiozen:

    I still don’t see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

    It does seem to be putting the cart in front of the horse. They keep try to find a way that vaccines cause autism, when there does not seem to be any real evidence that autism is caused by vaccines.

    Plus, there is the Htrae leap that the immune reaction from a vaccine would be greater than that of a full blown infection.

  22. #22 lilady
    March 18, 2014

    I remember (and have since forgotten), when the CDC approved acellular pertussis vaccines for all 5 doses of pertussis-containing-vaccines. Prior to 1997, the first three doses of whole cell petussis vaccines were given and acellular pertussis vaccine was approved by the CDC for the fourth and fifth doses, only.

    http://www.cdc.gov/mmwr/PDF/rr/rr4607.pdf

    Tdap booster vaccines are recommended for all pregnant, for all of her pregnancies, even if her pregnancies are close together.

  23. #23 lilady
    March 18, 2014

    Oops “Tdap booster vaccines are recommended for all pregnant ^ woman, for all of her pregnancies, even if her pregnancies are close together.”

  24. #24 AC
    March 19, 2014

    lilady, have you seen this one?

    gianelloni.wordpress.com/2014/03/14/thanks-pharma-you-created-the-anti-vaccine-movement/

    The comments alone (which appear to be heavily moderated) make me want to bang my head on the wall and simultaneously vomit.

  25. #25 lilady
    March 19, 2014

    I’ve already seen that blog…a perfect example of the Dunning-Kruger effect. 🙂

  26. #26 Krebiozen
    March 19, 2014

    lilady,

    Tdap booster vaccines are recommended for all pregnant, for all of her pregnancies, even if her pregnancies are close together.

    You’re quite right, of course. I missed that in the recommendations I linked to at #417, but I now see this has been the ACIP recommendation for every pregnant woman, regardless of vaccination status, since 2012.

    To maximize the maternal antibody response and passive antibody transfer and levels in the newborn, optimal timing for Tdap administration is between 27 weeks and 36 weeks of gestation, although Tdap may be given at any time during pregnancy .

    This, or neonatal vaccination, is effective in baboons, but it’s too early to say if it is effective in humans, especially since vaccination uptake is low; I was unable to find figures for the US, but in the UK uptake of Tdap in pregnancy is around 50-60%. Increasing this seems to me to be the best way of closing that 2 month window of vulnerability to pertussis in neonates.

    It’s reassuring to me that after blundering around the literature to see what the most rational response to increasing pertussis incidence might be, I find that this is precisely what public health authorities both the US and UK have already implemented.

  27. #27 Antaeus Feldspar
    March 19, 2014
  28. #28 Renate
    March 19, 2014

    @Antaeus Feldspar
    Reading that blog makes me think of all the wrong arguments I see in it. It really is terrible. Yes measles is an innocent disease not worse than common cold. Well, tell that to the parents of a 8 moth old child that landed in a hospital in The Hague, because it got measles from an unvaccinated child in daycare. The 8 month old was to young to get vaccinated. Alas all articles are in Dutch, so I won’t add links to the story.

  29. #29 Antaeus Feldspar
    March 19, 2014

    Renate –

    What did you think of the rebuttal linked in the upper right corner?

  30. #30 Renate
    March 19, 2014

    I think it sums up nicely what I would like to say and more.

    And if Big Pharma would be so cynical as the Gianelloni family seems to think they are, they should thank the anti-vaccinationists for creating more diseases, which bring more profits than vaccinations.
    b.t.w. I doubt they are that cynical.

  31. #31 skeptiquette
    March 19, 2014

    Hi Antaeus,

    It’s hard to say how effective the rebuttal will be at changing people’s minds…

    It was well written, but the tone of it may come off as condescending, which directly inhibits the effectiveness of any message no matter how true it is.

    This is a tough area: what strategies to use to deliver the message most effectively?

    Something that I think needs to be considered ASAP amongst skeptics. I have a few ideas, but definitely something worthy of further consideration.

    One thing that is clear is that we have to be sure to have all the facts straight and be open minded and this rebuttal failed on the former.

    Fore example, It may be possible to contract measles from the vaccine, and it may be possible to transmit or shed the measles vaccine virus and for it to become an infection in another individual.

    It is also possible for an outbreak’s index case to be fully vaccinated, however, this is much, much more rare than the index case being an un-vaccinated individual.

    Either way, I think it is important to be accurate, otherwise credibility can take a hit and the message can be ignored. often it is hard to be fully accurate, as information is changing quite rapidly these days.

  32. #32 skeptiquette
    March 19, 2014

    I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all. It certainly isn’t the sort of dysfunction that could even theoretically affect neurodevelopment as far as I can see.

    Maybe I am misreading you or something, but it still seems like you are unclear about the details and results of the study.

    You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

    The muted response that you are talking about was in adult mice, not neonatal mice.

    The muted response was only seen in the adult mice that were previously vaccinated during the neonatal timeframe, not the adult mice that were vaccinated during adulthood then rechallenged.

    Of course our immune systems respond differently at different ages, this is well known, and is largely the basis of the vaccine schedule. The fact that, “vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections”, is the basis of immunization and is hardly a surprise.

    I guess the results were surprising and novel to me. Why do you think that they would study and present results that are “hardly surprising”?

    my feeling is that you are missing something.

    Just one more thing, briefly. A muted immune response isn’t necessarily dysfunctional. There are lots of antigens we don’t want to react to. For example, it may be a good idea not to mount a full-scale immune response against an antigen that a newborn is exposed to; it may be something in the environment the child has been born into.

    I agree that a muted immune response during the neonatal period may have advantages, but this is not what we are talking about.

    Let’s try it a different way.

    Let’s say that the immune response to HSV challenge of the mice that were vaccinated in adulthood = functional. Meaning they clear the infection and have a normal functional immune response to the HSV challenge.

    Whereas the immune response to HSV challenge of the mice (adult) that were vaccinated as neonates = dysfunctional. Meaning they clear the infection more slowly and do not have as effective or functional response.

    The precipitating factor here is the timing of vaccination/ infection.

    I still don’t see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

    Have I missed something?

    Probably not.

    the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

    A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

    B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

    C) The immune system is a critical component of normal brain development.

    D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

    E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

    I guess it’s just that I see evidence for A, B, C, and D so that leads me to E.

    I will try to avoid bringing this stuff up anymore, as it is pretty tired out and boring (to you). Thanks for engaging me, though.

    I may be just helplessly lost in a vast array of immunological details and somehow I see a pattern(it may be real or just a figment of my imagination) that others don’t see. Either way, I still find interest in reading about these topics and may mention things occasionally.

  33. #33 Krebiozen
    March 20, 2014

    skeptiquette,

    I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all.

    Maybe I am misreading you or something, but it still seems like you are unclear about the details and results of the study.

    You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

    The muted response that you are talking about was in adult mice, not neonatal mice.

    Yes, I read the study, and understood it. Do I really have to spell everything out in full? Perhaps I should have written:

    it’s a muted immune response to a specific antigen by neonatal memory CD8+ T cells as compared to naïve adult CD8+ T cells’ response to that antigen, that’s all.

    The muted response was only seen in the adult mice that were previously vaccinated during the neonatal timeframe, not the adult mice that were vaccinated during adulthood then rechallenged.

    Yes, I understand this, but but it is only to a specific antigen. Claiming that exposure to an antigen at a specific age causes “persistent immune dysregulation” makes it sound like the immune system is permanently damaged in some way. It isn’t. There is just a muted response to the antigen the mouse was exposed to neonatally.

    I guess the results were surprising and novel to me. Why do you think that they would study and present results that are “hardly surprising”?

    Are you familiar with medical research at all? If you think that only research that is surprising and novel is published I suspect not. The vast majority of research I have been involved with has been confirming what is already expected to be true. Published papers that are surprising and novel are the ones that make the newspapers.

    my feeling is that you are missing something.

    My feeling is that you are reading something into this that just isn’t there.

    I agree that a muted immune response during the neonatal period may have advantages, but this is not what we are talking about.

    You described this response as “impaired/dysfunctional”. If it has advantages then it isn’t impaired or dysfunctional.

    Let’s say that the immune response to HSV challenge of the mice that were vaccinated in adulthood = functional. Meaning they clear the infection and have a normal functional immune response to the HSV challenge.

    Whereas the immune response to HSV challenge of the mice (adult) that were vaccinated as neonates = dysfunctional. Meaning they clear the infection more slowly and do not have as effective or functional response.

    That’s just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

    The precipitating factor here is the timing of vaccination/ infection.

    Yes, I understand that. An immature immune system responds differently to a mature one. This is something we need to be aware of when planning vaccine schedules, or we may find a vaccine given too early will have unexpected effects later. Isn’t this one reason we don’t give live vaccines before the age of one when the immune system is more mature?

    the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

    I read it, and to me it reads like someone trying to rationalize a preconceived idea. Turning my nitpicking setting up to 11:

    A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

    Autism is not an immune mediated condition in any sense of the term I understand. An immune mediated condition is something like an allergy or an autoimmune disease. Autism is a condition that may be caused by changes in cytoarchitectural and neuronal organization. There may be immune mediated processes involved in these changes, and some immunological anomalies are associated with autism, but that really isn’t the same thing as it being an immune mediated condition. There are a lot of maybes in here, and it is by no means clear whether the immunological anomalies we see are a cause, an effect or the results of something that also causes autism.

    B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

    How do vaccines modulate the innate immune system? Live vaccines and some adjuvants stimulate the innate immune system, obviously, but ‘modulate’ implies they somehow modify or control it. I don’t think they modulate the innate immune system any more than a natural infection does.

    C) The immune system is a critical component of normal brain development.

    Parts of the immune system may be involved in normal neurodevelopment. There is a lot of evidence pointing in that direction, but it really isn’t clear yet. It certainly isn’t clear that the kinds of changes in immune functions that vaccines can cause are the same as those that are involved in neurodevelopment.

    D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

    If by “this critical period” you mean the second trimester of pregnancy, and by “immune system dysfunction/disturbances” you mean a maternal rubella infection then I agree. I don’t see any evidence for a further period of neurodevelopmental vulnerability post-natally, nor do I see evidence for vaccines being involved in these “dysfunction/disturbances”. Why would vaccines create a more disrupting effect on neurodevelopment than the natural infections that human babies have been exposed to for millennia?

    E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

    Is that really a syllogism? If so it seems very shaky indeed to me.

    I guess it’s just that I see evidence for A, B, C, and D so that leads me to E.

    I still see this as little more than, “autism may have something to do with the immune system, vaccines do something to the immune system, therefore vaccines may cause autism”. It’s a logical possibility, but I don’t see any of the other dots I would need to see to connect this up the way you have. I could do the same thing with my broccoli hypothesis: “autism may have something to do with the immune system, broccoli contains immunomodulatory substances, therefore broccoli may cause autism”. In both cases there is a glaring lack of supporting epidemiological and other evidence which, in the case of vaccines, people have been looking for for the past 15 years or more.

    I will try to avoid bringing this stuff up anymore, as it is pretty tired out and boring (to you). Thanks for engaging me, though.

    I wouldn’t engage you unless it interested me too, or at least how you came to these conclusions interests me.

    I may be just helplessly lost in a vast array of immunological details and somehow I see a pattern(it may be real or just a figment of my imagination) that others don’t see.

    That’s a human failing we all have to guard against.

    Either way, I still find interest in reading about these topics and may mention things occasionally.

    It would get pretty dull around here if everyone agreed about everything all the time 😉

  34. #34 skeptiquette
    March 20, 2014

    Yes, I read the study, and understood it. Do I really have to spell everything out in full? Perhaps I should have written:

    You don’t have to spell everything out in full, you just have to in a way that is actually clear that you understand what it is you are talking about.

    Sorry, the way you spelled things out made it unclear.

    Are you familiar with medical research at all? If you think that only research that is surprising and novel is published I suspect not.

    Of course I am familiar with medical research and realize that many publications are replicative studies or off shoots of other work. I gave the wrong impression with the sentence I wrote, I hope this is clarified.

    Published papers that are surprising and novel are the ones that make the newspapers.

    I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

    My feeling is that you are reading something into this that just isn’t there.

    Ok. not sure what that is… since I have been very explicit.

    You described this response as “impaired/dysfunctional”. If it has advantages then it isn’t impaired or dysfunctional.

    Well, it could be advantageous as a neonate to have a muted response, but it may not be advantageous for that muted response to become “locked in.” Again we are talking about two different things here, the immune response of a neonate and that of an adult. It may be advantageous for the developing infant to have a muted response, but may be very disadvantageous to the adult to have this “locked in” muted response, as it translates to impaired immunity and slower clearance of that specific pathogen.

    That’s just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

    No, I was just describing the results from the study in a different way, one that I thought would make it more clear. I never defined an adult unvaccinated response as normal, I defined the adult vaccinated response as “normal/functional.”

    Yes, I understand that. An immature immune system responds differently to a mature one.

    Ok. But again that is not what was being compared. They were comparing the immune response of two different sets of mature mice to HSV-1 challenge.

    Isn’t this one reason we don’t give live vaccines before the age of one when the immune system is more mature?

    I don’t know, you tell me. Is that what the available evidence is telling you? Are there trials with live viral vaccines in infants that resulted in a situation where they were had an impaired response to the pathogen later in life that you are gleaning this from? (this is a serious question, I haven’t looked into it at all and am curious)

    I always thought it was because there were safety concerns about using live viral vaccines in infants under one, but that may be just one part of a larger set of reasons.

  35. #35 skeptiquette
    March 20, 2014

    A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

    Autism is not an immune mediated condition in any sense of the term I understand. An immune mediated condition is something like an allergy or an autoimmune disease. Autism is a condition that may be caused by changes in cytoarchitectural and neuronal organization. There may be immune mediated processes involved in these changes, and some immunological anomalies are associated with autism, but that really isn’t the same thing as it being an immune mediated condition. There are a lot of maybes in here, and it is by no means clear whether the immunological anomalies we see are a cause, an effect or the results of something that also causes autism.

    Fair enough. Perhaps I was a bit over-zealous in my characterization of autism as immune mediated. I think what you have presented is a fair interpretation of the evidence; there may be immune underpinnings of various importance, but the direction of causality isn’t fully established.

    On a side note, I did begin to organize the immune/autism research that I have looked at and have a doc going that I will post sometime (sorry Alain and MOB, I promised this a few weeks ago, I did start it at least…)

  36. #36 skeptiquette
    March 20, 2014

    B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

    How do vaccines modulate the innate immune system? Live vaccines and some adjuvants stimulate the innate immune system, obviously, but ‘modulate’ implies they somehow modify or control it. I don’t think they modulate the innate immune system any more than a natural infection does.

    This is actually a growing area of interest, as it relates to the paradigm shift amongst immunologists of innate immunity having memory (trained immunity)

    Here are a few references:

    PMID: 17116347 – this one is very relevant as it shows persistent modulation of the infant cytokine response based on whether the infant received aP or wP and not just to re-challenge (in vitro of course) with pertussis antigens, but to general antigens as well.

    Which is why the authors came to similar conclusions that I have espoused, such as:

    “Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

    With more specific wording in the paper to this effect:

    The capacity to induce a Th1- or a Th2-type immune response seems to be linked to the intrinsic properties of the encountered antigens, and this is probably most important in infants, who do not yet have memory cells for these antigens. Factors amplifying early Th2 imprinting may skew subsequent immune responses toward Th2-polarized immune memory, whereas Th1-type cytokine-inducing antigens may antagonize such a Th2-polarized immune memory. The identification of the environmental factors that may orient the immune responses of infants toward a Th2 or a Th1 pattern may therefore be very important.

    More PMID’s of interest: 23572484, 24352476, 23869409.

    I will try to get to the rest of your post in the near future.

    Cheers!

  37. #37 Narad
    March 20, 2014

    Fore example, It may be possible to contract measles from the vaccine, and it may be possible to transmit or shed the measles vaccine virus and for it to become an infection in another individual.

    Show me a single documented case of measles disease due to either scenario.

  38. #38 Alain
    March 20, 2014

    @skeptiquette,

    Ok.

    Alain

  39. #39 Antaeus Feldspar
    March 21, 2014

    the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

    A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

    B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

    C) The immune system is a critical component of normal brain development.

    D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

    E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

    It is very hard to believe you’re attempting to act in good faith, skeptiquette, when we catch you telling falsehhods like this. I am personally very offended that you are treating me so shabbily, utterly ignoring everything I have to say and yet name-dropping me as if I had at some point sanctioned your determined wrong-headedness.

    The above is not “the syllogism that [you] constructed (and Antaeus revised)”. It is, word-for-word, the exact same text that you originally proposed to be a ‘syllogism’.

    Exactly where do you get off saying I “revised” it when it has not been revised one bit? When you in fact utterly ignored my pointing out serious problems with it, not least of them being that it isn’t a syllogism because E introduces a new entity (namely, ‘possibilities of factors contributing to both the prevention and etiology of autism that should be explored’) that does not exist in any of the premises!

    If you absolutely must LIE, skeptiquette, and tell everyone that the bundle of vaguely related ideas above is a ‘syllogism’ (false) which has been ‘revised’ (LIE), then at least do not tarnish my name by pretending I had any role in that non-existent revision-in-response-to-feedback. Tell people it was Gooby, the purple goblin in your head, who helped you ‘revise’. That’s far closer to the TRUTH.

  40. #40 Antaeus Feldspar
    March 21, 2014

    Damn blockquotes.

    And damn SCUMBAG LIARS.

  41. #41 skeptiquette
    March 21, 2014

    @Narad

    Show me a single documented case of measles disease due to either scenario.

    Actually, I just stumbled across them after I read the blog that Antaeus linked.

    They were PMID’s: 24439074 and 24330942 for the first claim.

    They are documented case-studies.

    From the first PMID: 24439074

    A 23-year-old healthy man was given a measles vaccine, not rubella or mumps vaccine at the same time, on March 27, 2013, as part of an occupational health protocol; how-ever, he presented with a high fever (40C) at 18 days post-vaccination. At 20 days post-vaccination, a rash appeared on his trunk, legs, and arms. Koplik’s spots, a runny nose, and red eyes also were noted. Two days after disease onset, blood samples, a throat swab, and a urine sample were collected and tested for measles virus by reverse transcription-polymerase chain reaction. A sequence cor-responding to the measles N protein (533 bp) was amplified from the serum, peripheral blood mononuclear cells, and throat swab, and was identical to that of the genotype A virus (DQ345721). The subject had no history of travel before the vaccination or contact with patients with measles. Before vaccination, he tested negative for serum antibodies against the measles virus. Thus, he was diagnosed with vaccine-associated measles.

    Also,

    Clinicians should be aware of the possibility of vaccine-associated measles in both children and adults.

    The other pmid is open access so you can read it and let me know what your thoughts are.

    Regarding the second claim, I drew this from the pmid: 24330942

    Where they stated:

    Of note, only one case report of transmission from vaccine-associated measles has been identified [15,16].

    And I haven’t gotten that paper, but I did find one other mention in another paper that makes me more skeptical of the claim. from pmid: 23543773 is this statement:

    There is a case report suggesting the transmission of vac-cine strain between immunocompetent siblings, but the conclusion was based only on clinical presentation, with no laboratory confirma-tion of infection (11,12).

    Here are the citations 11, 12 for your reference.

    11. Millson D. Brother-to-sister transmission of measles after measles, mumps and rubella immunization. Lancet 1989;333:271.

    12. Campbell AGM. Brother-to-sister transmission of measles after measles, mumps and rubella immunization. Lancet 1989;333:442.

    Again, I did not say these scenarios were common, just possible. However, I will retract the second claim as there was no laboratory confirmation and it happened back in 89’ (practically prehistoric times when it comes to medical science)

  42. #42 skeptiquette
    March 21, 2014

    I’m sorry Antaeus.

    what I wrote was very poorly worded. Let me revise that to set the record straight.

    the attempt at a syllogism that I constructed (and Antaeus revised, the revised version is not shown, just my original attempt) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

    etc. etc.

    To everyone: I formally retract the statement I initially made and would like it to be replaced with what I have written above.

    Let me suggest that instead of calling somebody a scumbag liar you could proceed more cordially, such as:

    Antaeus: Hi skeptiquette, I noticed you referred to your attempted syllogism as my “revised syllogism” could you please correct your wording so as to clarify that.

    me: Of course Antaeus, Im very sorry about that mistake, thanks for bringing it to my attention. I will correct the record for everyone to see.

    As you are well aware, I don’t have any track record of lying, actually quite the opposite–I am very forthright about being wrong or making a mistake and acknowledging those instances.

    I don’t think you understand my motivation. This isn’t some life or death battle that I am going to get even remotely emotionally worked up about. I am trying to take these opportunities to learn something, through discussion with like minded people. That is really what I love about the internet; it’s that I can have a conversation with kreb or anyone else, who lives halfway around the world, and learn new things, think of new avenues to explore, etc.

    Im sorry that you got so upset, it certainly wasn’t my intention.

  43. #43 Narad
    March 21, 2014

    The other pmid is open access so you can read it and let me know what your thoughts are.

    Actually, they both are. Let me first note what the CDC has to say generally on the subject:

    “During outbreaks, measles vaccine is administered to help control the outbreak, and in these situations, vaccine reactions may be mistakenly classified as measles cases. A small proportion of measles vaccine recipients experience rash and fever 10–14 days following vaccination.”

    PMID 24439074, Kurata et al.: They state that they found DQ345721. This seems a little weird, since that’s CAM-70, whereas Japan uses the AIK-C strain, but I’m not competent to speculate further. They do not state whether they looked for parvovirus B19.

    Taking Koplik spots as pathognomonic of measles disease proper (i.e., disregarding PMID 1401292, which I can’t see anyway), this seems pretty solid.

    PMID 24330942, Murti et al.: I’ll go with the authors; highly suggestive, but weird as all get-out at 37 days, making speculation on some sort of immunocompromise not outside the question. Then again, if it’s basically undetectable, it amounts to nearly the same thing.

    I’m also unable to see PMID 15804301, “Vaccine-associated ‘wild-type’ measles.”

    So, OK, it seems possible.

  44. #44 skeptiquette
    March 21, 2014

    This seems a little weird, since that’s CAM-70, whereas Japan uses the AIK-C strain, but I’m not competent to speculate further.

    Interesting, thanks for looking into that. I’m not competent enough to speculate further either. Where is Prometheus when you need him… wasn’t he really well versed in everything measles?

    Taking Koplik spots as pathognomonic of measles disease proper (i.e., disregarding PMID 1401292, which I can’t see anyway), this seems pretty solid.

    Ahhh, now I understand why they tested for parvovirus B19 in the canadian case study, it can present in a similar fashion.

    I will look at PMID 15804301

    Yea, possible but very rare.

  45. #45 Krebiozen
    March 21, 2014

    skeptiquette,

    Sorry, the way you spelled things out made it unclear.

    Perhaps. You wrote:

    You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

    To clarify what was done (from the study):

    Neonatal and adult B6 mice were vaccinated with VACV-gB and challenged 6 weeks later with HSV-1. […] Naive adult B6 mice were also infected with HSV-1 for comparison with the secondary CD8+ T cell responses.

    A six week old mouse is equivalent to a human aged 3-4 years, not an adult.

    When I wrote:

    I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all.

    The “adult response to that antigen” I was referring to was the naive adult response to HSV-1, as compared to the response in the six week old mice. I shall try to be clearer in future.

    Published papers that are surprising and novel are the ones that make the newspapers.

    I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

    How is what I wrote inconsistent with that? You implied that the results must be novel and surprising otherwise they would not have been published in a journal, which is not true. The vast majority of published research is neither novel nor surprising, to the layperson anyway, which is why it doesn’t make the newspapers.

    My feeling is that you are reading something into this that just isn’t there.
    Ok. not sure what that is… since I have been very explicit.

    The connections between the different elements in your ‘syllogism’, for example. I don’t see them.

    Well, it could be advantageous as a neonate to have a muted response, but it may not be advantageous for that muted response to become “locked in.”

    Again we are talking about two different things here, the immune response of a neonate and that of an adult. It may be advantageous for the developing infant to have a muted response, but may be very disadvantageous to the adult to have this “locked in” muted response, as it translates to impaired immunity and slower clearance of that specific pathogen.

    It may be or it may not be, we don’t know, which is why I would argue against labeling it “dysfunctional” or “impaired”. A newborn has just emerged from an environment where it was surrounded by foreign antigens; it had to mute its responses to its mother’s proteins, this is quite normal. Developing a full adult immune repertoire is a process that takes a while.

    That’s just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

    No, I was just describing the results from the study in a different way, one that I thought would make it more clear. I never defined an adult unvaccinated response as normal, I defined the adult vaccinated response as “normal/functional.”

    Maybe my sloppy language is to blame again. There are two different vaccinations being discussed here: VACV-gN and MCV-1. By “adult unvaccinated response” I meant the response, to the HSV-1, of an adult that was not vaccinated with VACV-gB as a neonate.

    Basically I object to this ‘locked-in’ muted response being labeled as dysfunctional, abnormal or impaired. I think it may be a normal response to being exposed to large amounts of an antigen at a very early age. The implication of the language pD, and you, have used is that this study supports the idea that neonatal vaccines may somehow damage the immune system generally, including those parts that may be involved in neurodevelopment, possibly leading to autism, and I don’t think there is any evidence that this is the case.

    Yes, I understand that. An immature immune system responds differently to a mature one.

    Ok. But again that is not what was being compared. They were comparing the immune response of two different sets of mature mice to HSV-1 challenge.

    This is getting weird. If a neonatal mouse is exposed to large amounts of HSV-1 antigens (from a GM vaccinia infection), its immature immune system responds by muting its future responses to that antigen. That’s the effect the study was looking at, an effect that is the result of an immature immune system being exposed to large amounts of an antigen.

    Isn’t this one reason we don’t give live vaccines before the age of one when the immune system is more mature?

    I don’t know, you tell me. Is that what the available evidence is telling you? Are there trials with live viral vaccines in infants that resulted in a situation where they were had an impaired response to the pathogen later in life that you are gleaning this from? (this is a serious question, I haven’t looked into it at all and am curious)

    It’s been a long time since I studies vaccine development, so I’m not sure of that specifically. There were trials of high titer measles vaccines that were found to lead to higher mortality rates than the regular vaccine, for example, and I remember reading of other unexpected effects of vaccines that have led to changes in timing, dosing and types of vaccine. There has been a lot of trial and error over several decades to get to the current schedule.

    I always thought it was because there were safety concerns about using live viral vaccines in infants under one, but that may be just one part of a larger set of reasons.

    Lack of efficacy as well as safety I think. Maternal antibodies persisting in newborns can interfere with a reaction to vaccines, for example.

    I’ll take a look at the effects of vaccines on the innate immune system when I have some time this weekend.

  46. […] some cases the most wantonly dishonest, to insist that they and they alone know and bravely speak The Truth: […]

  47. […] It appears the anti-vaccine caucus has bubbled up to the tepid surface again. It’s always worth revisiting Dunning-Kruger syndrome, a phenomenon that never seems to really ebb. It’s the tendency of the least informed, most willfully ignorant or in some cases the most wantonly dishonest, to insist that they and they alone know and bravely speak The Truth: […]

  48. #48 rob
    March 22, 2014

    The problem is that those parents that refuse to have their children vaccinated are refusing to take part in the social contract that used to be followed in this country. I’m sorry but all children are equally valuable and your refusal to have your child vaccinated put other children at risk while at the same time depending on the ‘herd immunity’ for your child’s health and safety. Perhaps you could move where no one is vaccinated and see how that works out for your child.

  49. […] It appears the anti-vaccine caucus has bubbled up to the tepid surface again. It’s always worth revisiting Dunning-Kruger syndrome, a phenomenon that never seems to really ebb. It’s the tendency of the least informed, most willfully ignorant or in some cases the most wantonly dishonest, to insist that they and they alone know and bravely speak The Truth: […]

  50. […] Shiga Toxin–producing Escherichia coli Protein May Hold the Key to Who Gets Alzheimer’s Pediatricians versus the Dunning-Kruger effect on vaccines Vaccine Financing From the Perspective of Primary Care […]

  51. […] It appears the anti-vaccine caucus has bubbled up to the tepid surface again. It’s always worth revisiting Dunning-Kruger syndrome, a phenomenon that never seems to really ebb. It’s the tendency of the least informed, most willfully ignorant or in some cases the most wantonly dishonest, to insist that they and they alone know and bravely speak The Truth: […]

  52. #52 LW
    March 23, 2014

    Regarding the question of vaccinating neonate mice and challenging them six weeks later, Krebiozen observes, “A six week old mouse is equivalent to a human aged 3-4 years, not an adult.”

    Yes, and they’re also only six weeks old. A mouse is not a human being with every metabolic process sped up proportionally. If mammalian immune processes take a more or less fixed time to respond — if the mouse immune system does not in fact respond thirty or so times as fast as the Hunan immune system — then what this experiment may be telling us is the breath-taking revelation that an immune system responds a little differently a few weeks after initial exposure than it does on initial exposure.

  53. #53 Krebiozen
    March 23, 2014

    2nd try:
    skeptiquette,
    You wrote:

    vaccines may differ from normal antigenic exposure and […] they can persistently modulate innate immunity (heterologous effects).

    To which I replied:

    I don’t think they modulate the innate immune system any more than a natural infection does.

    I had a quick look at the papers you cited:
    PMID: 17116347 which compared responses to wP and aP in infants, with the aP inducing a Th2-skewed reponse at 6 months (Th2 responses are unwanted allergic responses, Th1 are inflammatory i.e. the response you want from a vaccine) . This might suggest that, “vaccines may differ from normal antigenic exposure”, however, this study found that, “the global Th2 bias observed in 6-month-old infants vaccinated with a Pa vaccine was normalized at 13 months”. So this appears to be a transient effect.

    PMID: 2357248 is about non-specific effects of vaccines. We know that measles vaccine and BCG protect against a number of other diseases, and that other vaccines may increase the risk of other diseases, such as DTP in developing countries. I don’t think this is a property unique to vaccines, I see no reason to think this does not occur with early infection too.

    PMID 24352476:

    the innate immune system displays epigenetic memory of an earlier infection or vaccination, a phenomenon that has been named “trained immunity.”

    Again, this is an effect common to early infection and vaccination.

    PMID: 23869409 again about training innate immunity, and again nothing to suggest a long term qualitatively different effect of vaccines on the innate immune system as compared to natural infection.

    If anything these findings make it even more important to be sure children are vaccinated, as a natural infection early in childhood may have long-term consequences that are bound to be more severe than those caused by vaccination.

    I don’t see anything here that supports the idea that vaccines may somehow damage the immune system and lead to neurodevelopmental problems

  54. #54 anon
    March 23, 2014

    I am in conflict with a non-vaccinating cousin who continually sends me articles such as the following link. My grand children are vaccinated, hers are not. Obviously, we are not scientists.
    http://www.gaia-health.com/gaia-blog/2011-10-24/vaccines-may-be-fueling-the-increasing-rate-of-non-hodgkins-lymphoma-cancer/

  55. #55 anon
    March 23, 2014

    She also sent me this- (She is retired and has a lot of time on her hands)
    http://www.ncbi.nlm.nih.gov/pubmed/18752390
    Development of unilateral cervical and supraclavicular lymphadenopathy after human papilloma virus vaccination.

  56. #56 skeptiquette
    March 24, 2014

    Ok, Thanks for looking those over.

    Do you think that it would be worthwhile to more thoroughly look at the effects of various vaccinations and/or combos of vaccines on the innate immune system? (i.e. large scale prospective studies)

    This is basically where I stand. It would make sense to me to do these types of studies. The results could be used in a number of subsequent studies, but at the very least we would have a bunch more data to better understand both safety and efficacy of current vaccines.

    Thanks,

    Skeptiquette

  57. #57 Politicalguineapig
    March 24, 2014

    skeptiquette: I don’t think you understand my motivation. This isn’t some life or death battle that I am going to get even remotely emotionally worked up about. I am trying to take these opportunities to learn something, through discussion with like minded people.

    No, we understand your motivation all right. You are anti-vax to the core, and keep pretending the studies haven’t been done. All I ask is that you quit weaseling around. Stop pretending you’re ‘on the fence,’ no one is fooled by that act.

  58. #58 skeptiquette
    March 24, 2014

    PGP,

    lol… No, you obviously and evidently do NOT.

    If I were anti-vax to the core, as you promulgate, why would I have had my kids vaccinated?

    that may be a tough one to answer, but, please answer that question.

    Prospective studies looking at the innate immune responses of infants after the normal pediatric vaccine schedule have not been done. Why do you think the authors of the study (2007) I cited above said:

    “Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

    Also, PMID: 19423079 is interesting in that it explores how inflammation from a vaccine (typhoid) can alter brain activity and connectivity in an adult resulting in mood changes.

    Specifically:

    Inflammation-associated deterioration in total mood was also associated with a marked decrease in activity within amygdala, a region central to processing emotional information from faces. Connectivity analysis also showed that inflammation-associated mood change modulated the connectivity between sACC and arMPFC, a region activated when thinking about others, and with right STS and amygdala, regions implicated in processing social/emotional information from faces. These changes might under-pin the marked reduction in social behavior associated with acute sickness, possibly reflecting an internal self-reorientation of attentional focus (9) and the heterogeneity of symptoms associated with inflammation-associated mood change.

    So, I ask myself, what happens when a one day old infant or a two, four, six or twelve month infant gets a vaccine, what type of inflammatory response occurs? What is the magnitude and duration of the inflammatory response? Are there changes in activity and connectivity in brain regions that are implicated in empathy and social/emotional processing (like we see from above study or other important changes)? If changes do occur, how long do they last? How does this inflammatory response differ among individuals? i.e. how does genotype, how do other developmental (prenatal) occurrences impact this response?

    You can call that “a just asking questions ploy” or “weaseling”, I just call this critical thinking and trying to fill voids in our collective ignorance. IF you have answers to those questions or could point me in the direction where I can find answers, then just do so. From what I can tell, we do not have data to answer these questions, hence large scale prospective studies are warranted.

    Wouldn’t you rather be armed with more information rather than less when trying to counter the anti-vaccine movement… Sometimes I think that you wouldn’t.

  59. #59 skeptiquette
    March 24, 2014

    @LW

    Regarding the question of vaccinating neonate mice and challenging them six weeks later, Krebiozen observes, “A six week old mouse is equivalent to a human aged 3-4 years, not an adult.”

    I don’t really know why Kreb announced this. I never made any claim that a six week old mouse is the equivalent of an adult human. I though it was more of an FYI announcement.

    There were three groups of mice in the study:

    1. Neonatal mice that were vaccinated/infected that were 1wk old. These mice were then rechallenged 6-8 weeks later, making them 7-9 wk old adult mice.

    2. There was an unvaccinated adult group challenged at 8-12 weeks.

    3. There was a 8-12 week adult group that was vaccinated and then rechallenged 6-8 weeks later, making them 14-20 weeks old.

  60. #60 skeptiquette
    March 24, 2014

    Skep: I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

    Kreb: How is what I wrote inconsistent with that? You implied that the results must be novel and surprising otherwise they would not have been published in a journal, which is not true. The vast majority of published research is neither novel nor surprising, to the layperson anyway, which is why it doesn’t make the newspapers.

    I did imply that the first time around, but clarified it with this statement:

    Of course I am familiar with medical research and realize that many publications are replicative studies or off shoots of other work. I gave the wrong impression with the sentence I wrote, I hope this is clarified.

    WRT the question of “how is what I wrote inconsistent with that?”

    that being:

    There are constantly findings that are novel and surprising in all different disciplines that never get press

    by press I mean written about in newspapers.

    what you wrote being:

    Published papers that are surprising and novel are the ones that make the newspapers.

    Aren’t those two statements entirely contradictory/inconsistent?

    You are saying that if a published paper reveals findings that are surprising or novel that there will be some sort of story or recognition of that in the newspaper, right?

    Whereas, I am saying that if a published paper reveals findings that are surprising or novel there is a better chance that it will go unnoticed (norm vs. exception).

    Am I missing something?

  61. #61 skeptiquette
    March 24, 2014

    WRT to vaccines and the natural infections that they protect against:

    It always seems to be brought up the the infection can also cause inflammation or from Krebs recent analysis that it can also modulate the infant immune system, but I guess I have never understood the logic that if the infection can do “it” or worse, then we don’t need to understand or study how vaccines may be able to do “it.”

    To me this is just faulty logic.

    This recent abstract that I read was completely in line with how I perceive this.

    PMID: 24514081

    Part of the abstract from above PMID:

    …The risk of onset or relapse of CNS demyelination following infections against which the vaccines are aimed to protect, is substantially higher and the benefits of vaccinations surpass the potential risks of CNS inflammation. This does not in any way exempt us from“learning” the lessons taught by the reported cases and searching new and safer ways to improve vaccination techniques and increase their safety profile.

    Does this position make sense to others?

  62. #62 Krebiozen
    March 24, 2014

    skeptiquette,

    Why do you think the authors of the study (2007) I cited above said:
    “Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

    Did you miss what I wrote above? This study found that the Th2 response observed had disappeared by age 13 months.

  63. #63 skeptiquette
    March 24, 2014

    Nope, didn’t miss it.

    Did you miss what the authors concluded?

    “Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

    There was an early modulation, right? TH2 skewed response through 13 months, right?

    So, somehow you know if and/or what the long term consequences of this are?

    Please share.

  64. #64 Krebiozen
    March 24, 2014

    skeptiquette,
    This probably isn’t worth pursuing but I find your position baffling regarding these two statements:

    There are constantly findings that are novel and surprising in all different disciplines that never get press (by press I mean written about in newspapers).

    And

    Published papers that are surprising and novel are the ones that make the newspapers.

    To which you responded:

    Aren’t those two statements entirely contradictory/inconsistent?

    Not at all. The logic seems crystal clear to me. The only papers that get attention in the press are those with surprising or novel findings. That doesn’t mean that all papers with surprising or novel findings make the newspapers, of course they don’t. However, papers without findings that are in some way surprising or novel, or controversial are very unlikely to get attention from the media. My point was that the papers we see discussed in the press are in no way representative of the thousands of papers that are published every day.

    You are saying that if a published paper reveals findings that are surprising or novel that there will be some sort of story or recognition of that in the newspaper, right?

    No, not necessarily.

    Whereas, I am saying that if a published paper reveals findings that are surprising or novel there is a better chance that it will go unnoticed (norm vs. exception).

    Where do you get that idea from? That’s the very opposite of what I see in practice. A quick Google of today’s medical news finds:
    1. An argument about 2 studies on statins in the BMJ that found, “statins did not reduce mortality and that side effects meant they did more harm than good”.
    2. Difficulty getting pregnant could be due to stress.
    3. California doctors speed up Valley fever diagnosis.
    All of these are novel or unexpected, aren’t they?

    The important point is that you can’t claim that a paper has unexpected results just because it exists or has been published in a journal. That did appear to be your argument at #473 when you wrote, “Why do you think that they would study and present results that are “hardly surprising”?”

  65. #65 skeptiquette
    March 24, 2014

    I just skimmed that follow up study and they do not mention the need for large prospective studies.

    So, are you thinking that since they found the Th2 skewing to be transient, they no longer are concerned with large prospective studies?

    I understand what you are saying if this is the case.

  66. #66 skeptiquette
    March 24, 2014

    Gotcha.

    This was just a misunderstanding. I understand your position now.

    Thanks.

  67. #67 skeptiquette
    March 24, 2014

    I am in agreement with you.

  68. #68 Krebiozen
    March 24, 2014

    skeptiquette,

    “Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

    There was an early modulation, right? TH2 skewed response through 13 months, right?

    So, somehow you know if and/or what the long term consequences of this are?

    Please share.

    The first study found a change in Th1/Th2 ratio, the second study explored this effect further, finding that it did not persist, that, “the global Th2 bias observed in 6-month-old infants vaccinated with a Pa vaccine was normalized at 13 months”.

    I see no reason to expect a temporary change in Th1/Th2 ratio to have long-term consequences. Do you?

  69. #69 Krebiozen
    March 24, 2014

    Sorry, cross-posted.

  70. #70 skeptiquette
    March 24, 2014

    I am really not sure. The immune system during developmentally sensitive time frames is something we are just starting to understand.

    I am a bit more cautious than you, and would say that until we have prospective studies examining this, we cannot say one way or the other.

  71. #71 Krebiozen
    March 24, 2014

    skeptiquette,

    WRT to vaccines and the natural infections that they protect against:

    It always seems to be brought up the the infection can also cause inflammation or from Krebs recent analysis that it can also modulate the infant immune system, but I guess I have never understood the logic that if the infection can do “it” or worse, then we don’t need to understand or study how vaccines may be able to do “it.”

    To me this is just faulty logic.

    I don’t think it’s about logic, I think it’s a difference in approach. There are a million things that it would be interesting to research in depth. The problem is deciding which are the most potentially fruitful areas to look at.

    I think it’s best to look at the data to see what isn’t adequately explained by our current understanding, and focus our attention there. I don’t see what data it is that might be better explained by a “vaccines cause neurodevelopmental delay” hypothesis than our current models. I don’t see any data that supports the hypothesis, and I see quite a lot of data that isn’t consistent with it.

    Just because something is logically possible doesn’t mean it is a promising possibility to follow. If early post natal infection or vaccination was an important cause of neurodevelopmental delay, I would have expected to see very much more developmental delay in the pre-vaccine era and in the developing world, when exposure to infection was and is far greater than in the US. I would expect vaccination to reduce the incidence of these conditions, and I’m not at all convinced we have see any significant changes at all, certainly not in severe autism, for example.

  72. #72 passionlessDrone
    March 24, 2014

    @Krebiozen –

    A few (very few) thoughts:

    Does the observance of a six month change in cytokine profiles based on vaccine type give us any insight into the broccoli analogy? Presumably the infants in the first study had a lot of *other* things happening during the months following last ap/wp vaccine, but those other insults didn’t turn the vaccine type into noise, as you might expect if there were millions of other things also modeling the immune milieu. (?) How should we fit this data into a model that assumes vaccination cannot modify immune systems characteristics other than generation of antibodies?

    I see no reason to expect a temporary change in Th1/Th2 ratio to have long-term consequences. Do you?

    Again, I think we probably disagree on the right application of the precautionary principle, but my thoughts on this question is that if our outcome measure is neurodevelopment, we might want to express great skepticism at the notion that because we can’t conceive of a mechanism, there must not be one. Worse, we have mechanisms by which change can be affected.

    Consider briefly some of the studies I referenced previously on microglial participation in neurodevelopment. Those cells, the microglia, are known to change morphology as a function of immune signaling in the periphery. So, *if* we are modifying what that peripheral signaling looks like, and *if* that signal manifests centrally as changes to microglial morphology, how might this affect the ongoing participation of microglia in brain formation? While there are plenty of *ifs* there, I don’t think we are nearly clever enough to understand this question and the fact that our existing analysis is based on very imprecise animal models doesn’t make me feel any better, if anything, it makes me feel like we are a lot dumber about what’s happening than we might want to be.

    The development of the brain during infancy is a time of once in a lifetime operations; you get one chance to perform the synaptic pruning that occurs between late gestation and two years of age. There are lots of players interacting all at once; it isn’t like a game of solitaire you can leave for a few months and then come back and pick up on. This is why I get a little bit worried with the idea that because a change in the immune backdrop appears transient, that therefore, it cannot be having an effect. You might reply that you think it is unlikely such a change could be occurring, and you may be right, but it is only within the past five years we have even begun to realize microglia could be participating in neurodevelopment at all. Ten years ago if I were to suggest the immune system played any part in brain formation you’d probably have had the same level of skepticism toward that idea.

    You might also consider the work that has been done regarding the apparent training of microglia into different states when challenged during critical timeframes. PMID 22322212 is a good review of this.

    OK!

  73. #73 Krebiozen
    March 24, 2014

    pD,

    Again, I think we probably disagree on the right application of the precautionary principle, but my thoughts on this question is that if our outcome measure is neurodevelopment, we might want to express great skepticism at the notion that because we can’t conceive of a mechanism, there must not be one. Worse, we have mechanisms by which change can be affected.

    Briefly, as I’m not saying anything new, we have mechanisms by which it is very remotely conceivable that vaccines might have some effect on neurodevelopment, I agree. However, I’m not aware of any evidence whether epidemiological or mechanistic, that suggests that they are having any effect. There is a lot of evidence which, taken in its entirety, argues strongly against any such thing happening.

    When there is no evidence to suggest something is happening, why look for mechanisms by which it might happen? Isn’t this the essence if tooth-fairy science?

    You mention the precautionary principle, but no one in their right mind is arguing that vaccines do more harm than good. I think the precautionary principle supports making sure vaccine uptake is as high as possible, and to continue post-marketing surveillance to detect any possible adverse events due to vaccines. Unless and until such adverse events are detected, digging about looking for possible ways in which they might be caused seems to me to be a waste of time and energy.

  74. #74 Dangerous Bacon
    March 24, 2014

    pD’s there-might-be-a-mechanism-even-if-we-can’t-conceive-of-one reminds me of arguments currently used by anti-GMOers.

    These folks and antivaxers increasingly share much in common, notably FUD-spreading on the grounds that we can’t know all the possible ramifications of immunization or genetic modification of foods, therefore it is imperative to be very worried about engaging in either activity (even when it is demonstrated that they are beneficial, have an excellent safety record and there is no plausible reason to think they might be doing the Bad Things detractors believe they are).

    Both groups have also taken to epigenetics in a big way. When you can’t otherwise make your case, wave your hands about what horrible things could be happening to our genomes years down the line due to vaccines or GMOs (but don’t be concerned about the effects of infectious diseases or non-GMO foods).

  75. #75 Politicalguineapig
    March 24, 2014

    skeptiquitte: If I were anti-vax to the core, as you promulgate, why would I have had my kids vaccinated?

    Possibility 1: You’re lying.
    Possibility 2: Kid 1 was fine, kid 2 has something (ADD, dyslexia, maybe some form of spectrum thing, asthma or allergies) that you’re desperately trying to blame on something, anything, other than your own genes.
    Possibility 3: You’re a troll pretending not to be one. I personally favor this, since you’re really selling the bubbly cheerleader act.

  76. #76 Krebiozen
    March 25, 2014

    Just to demonstrate how starting with a hypothesis and then looking for evidence to support it can be very misleading, I have decided to do just that with my broccoli-autism hypothesis. I don’t believe this hypothesis is correct, but I wanted to show how you can find evidence to support almost any hypothesis you care to formulate.

    Broccoli and other brassicas as a possible cause of autism spectrum disorders
    We know that the immune system may play an important role in neurodevelopment, for example PMC3059681. Disruption of normal immune processes could theoretically interfere with neurotypical development, leading to autism.

    My hypothesis is that potent modulators of the innate immune response system present, in broccoli are readily absorbed (PMID: 17164373) by weaned infants and are very probably present in breast milk of mothers that have consumed brassicas. These immunomodulatory chemicals may interfere with neurodevelopment by suppressing andrgogens and inhibiting the apoptosis of cells that is an essential part of neurodevelopment.

    From Wikipedia:
    “The 3,3′-Diindolylmethane found in broccoli is a potent modulator of the innate immune response system with anti-viral, anti-bacterial and anti-cancer activity. Broccoli also contains the compound glucoraphanin, which can be processed into an anti-cancer compound sulforaphane, though the anti-cancer benefits of broccoli are greatly reduced if the vegetable is boiled. Broccoli is also an excellent source of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells.”

    PMID: 12665522
    “Using fluorescence imaging with green fluorescent protein androgen receptor and Western blot analysis, we demonstrated that DIM inhibited androgen-induced androgen receptor (AR) translocation into the nucleus. Results of receptor binding assays indicated further that DIM is a strong competitive inhibitor of DHT binding to the AR. ”

    This androgen-blocking property may be related to the striking gender differences in autism, by blocking androgens during normal neurodevelopment. PMID: 21359227 found that retinoic acid-related orphan receptor-alpha (RORA) regulates conversion of estrogen to testosterone:

    In addition, we demonstrate that RORA transcriptionally regulates aromatase, an enzyme that converts testosterone to estrogen. We further show that aromatase protein is significantly reduced in the frontal cortex of autistic subjects relative to sex- and age-matched controls, and is strongly correlated with RORA protein levels in the brain.

    PMID: 11294972 tells us that DIM in broccoli can affect aromatase activity .

    DIM can also affect inflammatory cytokines PMID 18156398:
    3,3′-Diindolylmethane suppresses the inflammatory response to lipopolysaccharide in murine macrophages.
    ” Downregulation of NF-kappaB and AP-1 signaling may be one of the mechanisms by which DIM inhibits inflammatory responses.”

    This downregulation of inflammatory cytokines at a time of neurodevelopmental sensitivity could prevent the normal pruning of neurones, and account for the extra white matter seen in autism.

    PMID: 18840677 found suppression of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced nitric-oxide synthase 2 expression in astrocytes by a novel diindolylmethane analog protects striatal neurons against apoptosis. This supports my hypothesis that maternal or infant ingestion of broccoli during windows of neurodevelopmental sensitivity inhibits the pruning of neurones.

    There is also epidemiological evidencethat supports my hypothesis:
    “Americans consumed 2 billion pounds of broccoli in 1998. On a per capita basis, this works out to about 8 pounds, which is 34 percent higher than in 1990 and nearly 3 times the 1980 level. ”
    Autism diagnoses have increased in parallel with broccoli consumption – see http://twitpic.com/dzce0w .

    I hope my point is clear.

    So, pD and skeptiquette, why are your hypotheses that link vaccination to autism more compelling than my broccoli-autism hypothesis?

  77. #77 skeptiquette
    March 25, 2014

    Possibility 1: You’re lying.

    Im not lying, but It’s your choice to believe me or not. I don’t care.

    Possibility 2: Kid 1 was fine, kid 2 has something (ADD, dyslexia, maybe some form of spectrum thing, asthma or allergies) that you’re desperately trying to blame on something, anything, other than your own genes.

    Nope, wrong again. All kids are fine, with no ADD, Dyslexia, Spectrum, or asthma or allergies. (but Im probably lying, right?)

    Possibility 3: You’re a troll pretending not to be one. I personally favor this, since you’re really selling the bubbly cheerleader act.

    from Wiki:

    In Internet slang, a troll (/ˈtroʊl/, /ˈtrɒl/) is a person who sows discord on the Internet by starting arguments or upsetting people,[1] by posting inflammatory,[2] extraneous, or off-topic messages in an online community (such as a forum, chat room, or blog), either accidentally[3][4] or with the deliberate intent of provoking readers into an emotional response[5] or of otherwise disrupting normal on-topic discussion.[6]

    I don’t seem to fit into any of those descriptions… but I would like the opinions of others that may see this differently.

    What the hell do you even mean by “bubbly cheerleader”?

    This just seems to be another shining example of how your assumptions and categorization are not in-line with reality.

  78. #78 anon
    March 25, 2014

    This chart from the CDC shows 12 doses by 4 months old.
    http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
    Look at the contents of these vaccines. Look at the vaccine load at 2 mos.
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf
    PCV13 at 2 mos. -What the ? casamino acids, yeast, ammonium sulfate, polysorbate 80, succinate buffer, aluminum phosphate, soy peptone broth.
    And only 1 vaccine out of the 6 recommended at 2mos.
    As I said my children were vacinated years ago on a different schedule with no protests from parents that I could remember.
    Where is the science behind this huge increase in doses?

  79. #79 Lawrence
    March 25, 2014

    @anon – there is plenty of science behind it, if you’d care to look – even the CDC has a very clear explanation as to how the vaccine schedule came about….also, scared of ingredients?

    Perhaps you should do some research on those ingredients and the quantities in which they are used – a good place to start is:

    http://antiantivax.flurf.net/

    Your fears are completely unfounded….and back in the day, kids were exposed to thousands of more antigens from old vaccines than they are today. Science does indeed march on.

  80. #80 Politicalguineapig
    March 25, 2014

    skeptiquite: What the hell do you even mean by “bubbly cheerleader”?

    Basically, you type like you’re twelve, and the Miss Polly Sunshine act is both annoying and stolen from the (un) thinking moms. No one who’s hit 20 uses ‘lol’ in anything outside of texts.

  81. #81 Politicalguineapig
    March 25, 2014

    *Your*- long day and no spellcheck.

  82. #82 Krebiozen
    March 25, 2014

    anon,

    As I said my children were vacinated years ago on a different schedule with no protests from parents that I could remember.

    My son was caught up in a pertussis outbreak in the UK in the late 80s. He couldn’t be vaccinated for medical reasons, but the outbreak itself was caused by a vaccine scare. Spread by rumor and hysterical media reporting, the belief that the pertussis vaccine caused permanent brain damage led to a dramatic reduction in vaccine uptake. Immunity fell below the herd immunity threshold and thousands of children were infected, hundreds were hospitalized and dozens died. My son was lucky to get away with a few weeks in the hospital coughing until his lips turned blue.

    A few years later large studies exonerated the vaccine. All those children suffered and died needlessly, because of antivaccine hysteria, essentially.

    So, when someone like you tries to tell me that things were just fine in the good old days, I have to laugh (in a rather bitter way, to be honest).

    BTW :

    casamino acids, yeast, ammonium sulfate, polysorbate 80, succinate buffer, aluminum phosphate, soy peptone broth.

    As a biomedical scientist, none of those ingredients look in the slightest bit noxious to me, in fact most sound very nutritious (my local Japanese restaurant does a fine soy peptone broth, though they call it miso soup). I would happily swallow or be injected with a few ml of any of them.

  83. #83 Narad
    March 25, 2014

    More on Skyhorse

    Hey, they have a new title coming up!

  84. #84 Chris,
    March 25, 2014

    So anon, do provide scientific documentation to support your answers to the following questions:

    What is safer for a baby: PCV13 vaccine or a bacterial pneumonia, meningitis or bloodstream infection?

    What is safer for a baby to get: DTaP vaccine or a pertussis infection?

    What is better for a baby to get: Hib vaccine or a haemophilus influenzae type b infection?

    What is better for a baby to get: rotavirus vaccine or a rotavirus infection?

    What is better for a toddler to get: varicella vaccine or a chicken pox infection?

    What is safer for a toddler: the MMR vaccine or a measles infection?

  85. #85 anon
    March 25, 2014

    #482 I am sorry about your son. I never tell parents not to vaccinate. I am not an MD nor am I a scientist. But I read what MDs have to say, like many parents who are not scientists. I cannot evaluate this following link but he makes his case. My granddaughter had a very high fever with the DTap and behaviorial issues afterwards, but she is fine now. http://www.nvic.org/Doctors-Corner/Aluminum-and-Vaccine-Ingredients.aspx
    #484 My grandaughter got the DTap-
    You are asking absurd questions again.

  86. #86 Lawrence
    March 25, 2014

    @Anon – I don’t think those questions are absurd at all – what is safer, the vaccine or the infection?

  87. #87 Narad
    March 25, 2014

    But I read what MDs have to say, like many parents who are not scientists. I cannot evaluate this following link but he makes his case.

    Palevsky also insists that peanut oil is used in vaccines and badly embarrasses himself in the process. If you’re going to skulking around for antivax gibberish and then say “I can’t evaluate it, but MD! MD!”, then you’re simply being intellectually dishonest.

  88. #88 Chris,
    March 25, 2014

    Come on, anon. You brought the PCV13 vaccine and its scary ingredients. One of which is used in ice cream. Obviously you would never ever feed your grandkids ice cream.

    So which would you prefer a grandchild to get: the PCV13 vaccine or the bacterial infections it prevents? Give us an answer, not an excuse.

  89. #89 anon
    March 25, 2014

    #487 What I do know are my biases, which are only my opinions and not facts.( I am glad that I am not a pediatrician.) I would never tell any one not to vaccinate. I found the following-
    “In 1964 Merck produced the adjuvant 65-4 that contained up to 65 percent peanut oil plus Arlasel A, aluminum stearate, and other ingredients with 13-fold higher levels of antibodies than previous vaccines. During the 1970s and 1980s peanut oil became a common practice and ingredient in vaccines.” Heather Fraser in her 2010 book, The History of the Peanut Allergy Epidemic.

  90. #90 Denice Walter
    March 25, 2014

    @ Narad:

    Holy crap!
    I suppose that that new title further supports my thesis that Sky Horse indeed prints material not even fit for wrapping fish.

    I’ve had a very long day but staying up and linking to that made it all worthwhile.

  91. #91 anon
    March 25, 2014

    http://www.smartvax.com/?option=com_content&view=article&id=73
    “In 1964, Merck announced that it had patented a revolutionary peanut oil vaccine adjuvant.  This news was reported in 1964 and 1966 in The New York Times[10] with follow up in medical literature through the early 70s. Merck’s Adjuvant 65-4 provoked such high levels of antibodies – 64 times higher than the same vaccine in an aqueous solution — that any vaccine to which it was added could produce many years worth of immunity. Was this potency safe?  A 1973 WHO report co-written by Adjuvant 65-4 inventor Maurice Hilleman found the use of peanut oil was relatively safe if properly injected to avoid “severe adverse reactions”.[11] But the safety of the adjuvant was challenged by others including D. Hobson in the Postgraduate Medical Journal (March, 1973).  Hobson documented the power of this adjuvant to sensitize recipients to vaccine proteins. This adjuvant created allergies.”

  92. #92 Narad
    March 25, 2014

    “In 1964, Merck announced that it had patented a revolutionary peanut oil vaccine adjuvant….

    Thank you for proving my point about intellectual dishonesty. Now show me the part where it was ever used in a licensed vaccine. Would you like a hint?

  93. #93 Chris,
    March 25, 2014

    Oooh, a book! By Heather Fraser, MA, BA, B.Ed… none of those are scientific. And another Skyhorse published book. Really?

    We are not interested in your opinions, but just the facts. When you present us with nonsense, you will be asked questions that you need to support with actual citations. Not books by biased parents.

  94. #94 Narad
    March 25, 2014

    As I recall, the last time I actually suffered going through Fraser on G—le Books, she basically conceded the point. Nice to know that Anon had the copy-and-paste right at her fingertips, though.

  95. #95 lilady
    March 25, 2014

    I’ve seen prior posts by “anon” lying about peanut oil in licensed vaccines. Anon and the others who get their vaccine information from AoA, the NVIC and whale.to, have never been able to show us documentation that peanut oil was ever used in an FDA licensed vaccine:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130368/

  96. #96 Chris,
    March 25, 2014

    Well, there is a PubMed link:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192090/

    It is an ad.

    anon, answer the question: Would you rather a grandchild get the PCV13 vaccine or one of the several bacterial infections it is designed to prevent?

    Also, do you also make sure none of your grandchildren get anything with yeast? No bread? No pizza? Wow.

    No pizza and ice cream parties at your house.

  97. #97 AnnB
    March 25, 2014

    Why would they be able to run an ad that even remotely looks like an article, including the URL? It reminds me of internet advertising that appears to be an article or the copy being stuck in the middle of the article; so blatantly deceiving that they have to advertise that they are an advertisement.

  98. #98 Narad
    March 25, 2014

    Why would they be able to run an ad that even remotely looks like an article, including the URL?

    PubMed Central simply takes in Canadian Family Physician wholesale, and the journal runs publisher announcements. You can see the entire TOC for this issue here.

  99. #99 ann
    March 25, 2014

    Wow.

    There are some busy bees posting here this evening, aren’t there?

    A swarm of them, seemingly.

    How nice.

    In books, or work, or healthful play,
    Let my first years be passed,
    That I may give for every day
    Some good account at last.

  100. #100 Alain
    March 25, 2014

    I ain’t posting but if I where, it would be at the assh*le who is calling someone or everyone an imbecile.

    Alain

  101. #101 Alain
    March 25, 2014

    Oh, and I lost faith in humanity.

    Alain

  102. #102 anon
    March 25, 2014

    #495 lilady- the link you provided stated “A comparison was made of the antibody response and subjective reactions to zonally-purified influenza vaccine in aqueous suspension and in peanut oil adjuvant 65-4. Both preparations contained 700 CCA units of A/Aichi/2/68, and 300 CCA units of B/Mass/1/71. Subjective reactions were recorded by asking the volunteers to complete a record daily for 5 days. Pain at the injection site was recorded by 64 per cent of the recipients of the oil adjuvant vaccine compared with 35 per cent of the aqueous recipients, but local redness was more frequent after aqueous vaccine.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130368/
    Was this not FDA approved?

  103. #103 Narad
    March 26, 2014

    Was this not FDA approved?

    You didn’t even bother to read the paper, did you? Or notice the title of the journal?

  104. #104 anon
    March 26, 2014

    #492 See #502
    “Adjuvant emulsions-
    “This class includes oil in water or water in oil emulsions such as FIA, Montanide, Adjuvant 65, and Lipovant17. The mechanism of action of adjuvant emulsions includes the formation of a depot at the injection site……
    “Adjuvant 65 offers the advantage over the mineral oil used in IFA(57, 58, 59) that it can be metabolized(23).
    http://www.nature.com/icb/journal/v82/n5/full/icb200475a.html

  105. #105 anon
    March 26, 2014

    #503 Narad didn’t even bother to read the paper, nor notice the title of the journal.

  106. #106 lilady
    March 26, 2014

    anon: That link I provided to you was for A-65 adjuvant, which was tested on volunteers during the 1960s-1970s. It was never, ever, ever, used in an FDA licensed vaccine.

    You should ask Heather Fraser why that peanut oil based adjuvant wasn’t approved by the FDA as a vaccine adjuvant.

    Look at this. A Federal Regulation about the required listing of all ingredients (culture media, excipients…and adjuvants) in every biological manufactured in the United States. (Vaccines are biologicals, “anon”).

    http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=610&showFR=1&subpartNode=21%3A7.0.1.1.5.7

    Would you like Narad to interpret the Federal Code for you?

  107. #107 Chris,
    March 26, 2014

    Anon, do you really deny your grandchildren both pizza and ice cream? Wow. That must make you quite unpopular.

    So, anon, would you rather a grandchild get the PCV13 or Hib vaccine or get bacterial meningitis? Answer the question.

    Do not let the fact that one of the contestants on the present “Dancing with the Stars” program is doing well, despite losing both kidneys and legs below the knee due to bacterial meningitis. While she is performing well, I am sure the time spent dealing with kidney transplant medications is not pleasant.

    So, really, is it safer to get those vaccines or bacterial meningitis? Give us an answer. You have two more tries.

  108. #108 ann
    March 26, 2014

    lso, PMID: 19423079 is interesting in that it explores how inflammation from a vaccine (typhoid) can alter brain activity and connectivity in an adult resulting in mood changes.

    Specifically:

    Inflammation-associated deterioration in total mood was also associated with a marked decrease in activity within amygdala, a region central to processing emotional information from faces. Connectivity analysis also showed that inflammation-associated mood change modulated the connectivity between sACC and arMPFC, a region activated when thinking about others, and with right STS and amygdala, regions implicated in processing social/emotional information from faces. These changes might under-pin the marked reduction in social behavior associated with acute sickness, possibly reflecting an internal self-reorientation of attentional focus (9) and the heterogeneity of symptoms associated with inflammation-associated mood change.

    So, I ask myself, what happens when a one day old infant or a two, four, six or twelve month infant gets a vaccine, what type of inflammatory response occurs? What is the magnitude and duration of the inflammatory response? Are there changes in activity and connectivity in brain regions that are implicated in empathy and social/emotional processing (like we see from above study or other important changes)? If changes do occur, how long do they last? How does this inflammatory response differ among individuals? i.e. how does genotype, how do other developmental (prenatal) occurrences impact this response?

    You can call that “a just asking questions ploy” or “weaseling”, I just call this critical thinking and trying to fill voids in our collective ignorance. IF you have answers to those questions or could point me in the direction where I can find answers, then just do so. From what I can tell, we do not have data to answer these questions, hence large scale prospective studies are warranted.

    Not by that study, which showed that the eight healthy male adults who got the typhoid vaccine had a transient dip in mood three hours later, along with transient changes in activity/connectivity that were consistent with some of what’s known about the neurology of depression.

    And if there’s one thing about infants between the ages of one day and twelve months that’s been completely stable over a very long period of time and comprehending both the pre- and post-vaccine era, it’s this:

    They’re extremely subject to sudden, rapid, transient shifts in mood.

    Because, you know. If vaccine-induced inflammation was having a significant effect along those lines, they’d have gotten moodier. And autism isn’t:

    (a) a mood disorder;
    (b) inflammation-related;
    (c) immune-mediated; or
    (d) demonstrably linked to vaccines in any way.

    You’re basically saying:

    “There’s a tiny study here about the neurology of illness-related low mood, which resembles that seen in low mood of unknown etiology. A large-scale prospective study of infants seeking the answers to questions that are utterly unconnected to it in every way is therefore warranted.”

    I wouldn’t call that “weaseling,” necessarily. But I wouldn’t call it critical thinking, either.

  109. #109 anon
    March 26, 2014

    Take a look at the lawsuits against Pharma. I once was prescribed Paxil and had awful side effects. Several years later…….
    Glaxo Agrees to Pay $3 Billion in Fraud Settlement
    http://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html?

  110. #110 Narad
    March 26, 2014

    Take a look at the lawsuits against Pharma. I once was prescribed Paxil and had awful side effects. Several years later…….
    Glaxo Agrees to Pay $3 Billion in Fraud Settlement

    Oh, look, it’s time to randomly change the subject!

  111. #111 Narad
    March 26, 2014

    Here. Now kindly stop barfing up stuff that you’re too passive aggressive to bother thinking about.

  112. #112 lilady
    March 26, 2014

    anon:

    How about staying on topic?

    How about defending your inane statements about vaccine adjuvants?

    How about answering Chris’ questions about specific vaccines?

    Perhaps you want to consult Heather Fraser, before you post any more comments here.

  113. #113 anon
    March 26, 2014

    #508
    FAQs: The meaning of neuroinflammatory findings in autism
    http://www.neuro.jhmi.edu/neuroimmunopath/autism_faqs.htm

  114. #114 anon
    March 26, 2014

    #513 continued-” What type of immune reactions are present in the brain of autistic patients?
    In our study, we have demonstrated a marked increase in neuroglial responses, characterized by activation of microglia and astroglia, in the brains of autistic patients. These increased neuroglial responses are likely part of neuroinflammatory reactions associated with the central nervous system’s (CNS) innate immune system. In innate immune reactions of the CNS, microglial activation is the main cellular response to CNS dysfunction. This is in contrast to adaptive immune responses, in which lymphocyte and/or antibody mediated reactions are the dominant responses. In our sample of autistic patients, microglial and astroglial activation was present in the absence of lymphocyte infiltration or immunoglobulin deposition in the CNS. It also was associated with increased production of pro-inflammatory and anti-inflammatory cytokines such as MCP-1 and TGFß-1 by neuroglia.”

  115. #115 Narad
    March 26, 2014

    The meaning of neuroinflammatory findings in autism

    Explain in your own words (1) what this means or (2) if you cannot, why you have seen fit to leave it here.

  116. #116 lilady
    March 26, 2014

    ann @ # 508: I’m trying to figure out what the link to this study about short duration psychiatric manifestations (depressions for ~ 3 days) in adult men following S. typhi vaccines, is germane to the topic of infant vaccines.

    http://www.ncbi.nlm.nih.gov/pubmed/19423079

    Are infants and young children, every vaccinate against typhoid?

    http://www.vaccines.gov/diseases/typhoid_fever/

    “There are two vaccines to prevent typhoid. One is an inactivated (killed) vaccine gotten as a shot, and the other is live, attenuated (weakened) vaccine, which is taken orally (by mouth).

    Typhoid vaccine is recommended for:

    Travelers to parts of the world where typhoid is common (NOTE: typhoid vaccine is not 100 percent effective and is not a substitute for being careful about what you eat or drink.)

    People in close contact with a typhoid carrier

    Laboratory workers who work with Salmonella Typhi bacteria

    Inactivated Typhoid Vaccine (Shot)

    Should not be given to children younger than two years of age

    One dose provides protection. It should be given at least two weeks before travel to allow the vaccine time to work

    A booster dose is needed every two years for people who remain at risk

    Live Typhoid Vaccine (Oral)

    Should not be given to children younger than six years of age

    Four doses, given two days apart, are needed for protection. The last dose should be given at least 1 week before travel to allow the vaccine time to work

    A booster dose is needed every five years for people who remain at risk

    Either vaccine may be given at the same time as other vaccines.”

  117. #117 Antaeus Feldspar
    March 26, 2014

    Narad: Well, since anon has already admitted posting just to disrupt the conversation my guess would be that he’s doing just that again.

  118. #118 ann
    March 26, 2014

    ann @ # 508: I’m trying to figure out what the link to this study about short duration psychiatric manifestations (depressions for ~ 3 days) in adult men following S. typhi vaccines, is germane to the topic of infant vaccines.

    There is no link. It’s an eensy study that it’s arguably not wrong to say may, perhaps, turn out to have implications for the etiology of depression in some people sometimes some day.

    Also, it was of some inherent interest. I thought.

    But it says nothing about vaccines generally. Or infants. Or neurodevelopment.

  119. #119 ann
    March 26, 2014

    Take a look at the lawsuits against Pharma. I once was prescribed Paxil and had awful side effects.

    What awful side effects?

    Had you been informed they were possible?

    Was it prescribed to you because you went of your own volition to a physician, reported symptoms of depression, filled a prescription for Paxil, then took it with full knowledge that you were free to discontinue it at any time?

    Several years later…….
    Glaxo Agrees to Pay $3 Billion in Fraud Settlement
    http://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html?

    There’s no question that they’re wicked capitalists who are as prone to corporate malfeasance as any. Or that antidepressants are both overprescribed in themselves and by doctors who don’t know much about the drugs or the condition. They’re also frequently wrongly prescribed. And possibly underprescribed, to some demographics.

    Furthermore, they’re not very effective for a lot of clinically depressed people. And they often have bothersome side effects.

    Here’s a challenge for you.

    See if you can identify the serious problem and/or group of people afflicted by it anywhere in there, from the perspective of anyone who had a heart..

  120. #120 ann
    March 26, 2014

    #508
    FAQs: The meaning of neuroinflammatory findings in autism
    http://www.neuro.jhmi.edu/neuroimmunopath/autism_faqs.htm

    …is completely consistent with all the other evidence strongly suggesting that autism is innate and unrelated to vaccines:

    These observations suggest that the adaptive immune system does not play a significant pathogenic role in this disorder, at least not during its chronic phase, and that the main immune mechanism involves predominantly innate immune reactions.

    Says so in so many words elsewhere in the FAQ, too, pretty much.

  121. #121 ann
    March 26, 2014

    Are there changes in activity and connectivity in brain regions that are implicated in empathy and social/emotional processing (like we see from above study or other important changes)?

    I forgot to say:

    It’s a myth that people with ASDs lack empathy.

    And not a pretty (or empathetic) one.

  122. #122 AnnB
    March 26, 2014

    @ ann “There are some busy bees posting here this evening, aren’t there?”

    It is what one with middle insomnia does. Too tired to study, and too intelligent to watch Guy Fieri on the Food Network channel for the hundredth time.

    In my previous comment @497, I should have stated “why does anyone tolerant ads that even remotely look like an article” instead of “allow.” It is their publication, they can run it they way they wish; I just won’t be buying a book that is advertised the same way the wootastic crap is marketed. And, I am glad I know the difference between PubMed and PubMed Central, thanks Narad.

    Nothing of substance next; just my rant about ads. I had to stop reading the Psychiatric Times (I know; not a journal.) because they weren’t content with ads thrown all over the page; now it has to open with an overlay ad before I can even read the page.

  123. #123 ann
    March 26, 2014

    It is what one with middle insomnia does.

    Ah. What a drag. One empathizes with one. And sympathizes.

    They say that regular bed- and wake-up times help. And morning sunlight.**.

    I find that reassuring. But only notionally. I’ve never noticed that they do.

    **When it’s in one’s face really shows one’s age. (“Maggie May.”)

  124. #124 Chris,
    March 27, 2014

    So, anon, would you rather a grandchild get the PCV13 or Hib vaccine or get bacterial meningitis?

    Stop the diversionary tactics: answer the question.

  125. #125 skeptiquette
    In a land of Dogs and dog toys....
    March 27, 2014

    Seemed to have slowed down here at RI…

    You guys chewed up all your dog toys!

    I will respond if I have time to the posts directed at me (other than the one from PGP, she is a bit too off the wall for me), I just have a lot of other things going on in my life right now that are higher priorities.

    Thanks

  126. #126 skeptiquette
    March 27, 2014

    *seems*

  127. #127 Politicalguineapig
    March 27, 2014

    skeptiquette: I’m not off the wall, I just hate hypocrisy. Playing both sides of the fence on the vaccine issue is annoying. Either admit you’re anti-vax, or stop posting.

  128. #128 skeptiquette
    March 27, 2014

    That is just my perception, it could change based on new findings…

  129. #129 Narad
    March 27, 2014
    It is what one with middle insomnia does.

    Ah. What a drag. One empathizes with one. And sympathizes.

    Segmented sleep was the norm until the 19th century. I’ve got the ol’ free-running disorder instead, which can be medicated down to DSPD.

  130. #130 Narad
    March 27, 2014

    Playing both sides of the fence on the vaccine issue is annoying. Either admit you’re anti-vax, or stop posting.

    One might note that many have expressed annoyance at your seemingly bottomless reserve of baseless generalizations, but I don’t recall anyone purporting to issue “orders” over it.

  131. #131 AnnB
    March 27, 2014

    One empathizes with one. And sympathizes.

    Thanks, ann. I never found sleep hygiene all that helpful either.
    The psychologist at the sleep clinic called the CBT “sleep restriction” experiment before I was going to. He saw how much worse it was making me. And, yes, it was.

    Sunlight does help, yet the sun is rarely out anymore.

    Oddly, and quite accidentally, I found dehydration causes enough drowsiness to reduce my total awake time in the wee hours. But, that isn’t a trade-off I am willing to make for obvious reasons.

    I hope you find better rest, yourself.

  132. #132 AnnB
    March 28, 2014

    Narad,

    Surprisingly, I was aware of segmented sleep being normal in centuries past. Learned that reading one of the sleep apnea boards. I think my biggest issue is silent reflux. I wake up suddenly for no apparent reason, yet I am never anxious or worried or anything; just wide awake.

    I dodged RLS, but did have some PLMD when I first started cpap. Luckily that resolved as I didn’t need one more condition.

    Glad to read meds help you. I don’t think people realize how easy it is to take sleep for granted, but you learn fast when sleep isn’t easy anymore.

  133. […] people who are most impressed because they think they understand when they don’t. The Dunning-Kruger effect and motivated reasoning can indeed affect even people like the Clintons—or maybe […]

  134. […] member of that wine loving, vaccine hating, coffee klatch of mommy warriors for whom the terms Dunning-Kruger effect and arrogance of ignorance were coined. I’m referring, of course, to the other wretched hive […]

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