It always amuses me how antivaccine activists have such a love-hate relationship with academia, particularly the higher echelons of academia. On the one hand, they routinely denigrate academics because inevitably well-designed, well-executed epidemiological studies testing the hypothesis that vaccines are correlated with the risk of autism always come up empty. That’s because vaccines don’t cause autism. I used to hedge a bit when I said that, but over the 12 years I’ve been doing this, I’ve covered more studies than I can remember testing this very hypothesis, and a clear pattern has emerged. The best studies were entirely negative, and only crappy studies by “scientists” associated with the antivaccine movement showed anything resembling a positive result. So antivaxers detest, disparage, and otherwise denigrate medical academia because it doesn’t support their delusion that vaccines are harmful and cause autism. Although there are fewer studies looking at other disorders, ranging from the mild to as severe as sudden infant death syndrome, those studies, by and large, come up empty too.

On the other hand, antivaxers are desperate for validation. They crave any evidence that real scientists take them seriously or, even better, have produced evidence that supports their delusion that vaccines cause autism (or any of the other disorders, conditions, and diseases attributed to vaccines by them). That’s a good explanation for an article by President Donald Trump’s new BFF, antivaccine activist Robert F. Kennedy, Jr., Yale University Study Shows Association Between Vaccines and Brain Disorders. Seemingly having his delusions validated by Yale (and hardly mentions Penn State, the other university that contributed to the study), RFK Jr. is practically giddy with validation:

A team of researchers from the Yale School of Medicine and Penn State College of Medicine have found a disturbing association between the timing of vaccines and the onset of certain brain disorders in a subset of children.

Analyzing five years’ worth of private health insurance data on children ages 6-15, these scientists found that young people vaccinated in the previous three to 12 months were significantly more likely to be diagnosed with certain neuropsychiatric disorders than their non-vaccinated counterparts.

This new study, which raises important questions about whether over-vaccination may be triggering immune and neurological damage in a subset of vulnerable children (something parents of children with autism have been saying for years), was published in the peer-reviewed journal Frontiers in Psychiatry, Jan. 19.

Hmmm. Frontiers in Psychiatry? I’ve encountered Frontiers journals before. Suffice to say, I have not been impressed. Other Frontiers journals, for instance, have shown an unfortunate susceptibility to antivaccine pseudoscience. Be that as it may, my skeptical antennae always start to twitch whenever I see someone like RFK Jr. exulting over a study. Let’s just say it’s a long history of seeing the sort of execrable “science” he routinely embraces, as long as it supports his belief that mercury in vaccines causes autism, even though the mercury-containing thimerosal preservative that contains mercury was removed from childhood vaccines 15 years ago.

Before I examine the study itself, which, not surprisingly, is nowhere near as convincing as RFK Jr. portrays it (to put it mildly, given how awful the study is), let’s see what RFK Jr. thinks of it:

More than 95,000 children in the database that were analyzed had one of seven neuropsychiatric disorders: anorexia nervosa, anxiety disorder, attention deficit and hyperactivity disorder (ADHD), bipolar disorder, major depression, obsessive-compulsive disorder (OCD) and tic disorder.

Children with these disorders were compared to children without neuropsychiatric disorders, as well as to children with two other conditions that could not possibly be related to vaccination: open wounds and broken bones.

This was a well-designed, tightly controlled study. Control subjects without brain disorders were matched with the subjects by age, geographic location and gender.

As expected, broken bones and open wounds showed no significant association with vaccinations.

New cases of major depression, bipolar disorder or ADHD also showed no significant association with vaccinations.

I could tell from RFK Jr.’s description that there was very likely a confounder or something else that could explain the results of this study as likely being spurious or not real. In actuality, there are a number of issues with the study that make it far much less of a slam dunk than RFK Jr. and other antivaccinationists seem to think that it is. If you don’t believe me, let’s head on over to the original study by Leslie et al, Temporal Association of Certain Neuropsychiatric Disorders Following Vaccination of Children and Adolescents: A Pilot Case–Control Study, and take a look. It’s open access; so you can all read as much (or as little) of the study as you like.

My first question, before I even started to read the paper, was: Why was this study necessary? The answer is quite simple. It wasn’t. There’s already copious evidence that vaccines are not associated with autism or other neurodevelopmental disorders. For instance, a large and far study in 2007 quite emphatically did not support a causal relationship between vaccines and neurodevelopmental disorders other than autism, while the followup study to that in 2010 just as emphatically did not support a potential causal relationship between vaccines and autism. Both studies were far better designed than this one. So how do the authors justify doing yet another study to study what’s been studied ad nauseam with negative results? I’m going to use a longer quote than usual because it’s important:

In light of the role of the immune system in these central nervous system (CNS) conditions, the impact of vaccines on childhood-onset neuropsychiatric diseases had been considered and was mainly addressed with regards to the administration of the measles, mumps, and rubella (MMR) vaccine (and its various components) and the subsequent development of autism spectrum disorder (ASD). Although the controversy over MMR vaccination and ASD still exists for some members of the public, this association has been convincingly disproven (9, 10). On the other hand, the onset of a limited number of autoimmune and inflammatory disorders affecting the CNS has been found to be temporally associated with the antecedent administration of various vaccines (11). These disorders include idiopathic thrombocytopenic purpura, acute disseminated encephalomyelitis, and Guillain–Barré syndrome among others (12–16). More recently, data have emerged indicating an association between the administration of the H1N1 influenza vaccine containing the AS03 adjuvant and the subsequent new onset of narcolepsy in several northern European countries (17, 18). The immune mechanisms and host factors underlying these associations have not been identified or fully characterized, although preliminary data are beginning to emerge (18–23).

Given this growing body of evidence of immunological involvement in CNS conditions, and despite the controversy concerning the link between ASD and MMR and the clear public health importance of vaccinations, we hypothesized that some vaccines could have an impact in a subset of susceptible individuals and aimed to investigate whether there is a temporal association between the antecedent administration of vaccines and the onset of several neuropsychiatric disorders, including OCD, AN, tic disorder, anxiety disorder, ADHD, major depressive disorder, and bipolar disorder using a case–control population-based pediatric sample (children aged 6–15 years). To assess the specificity of any statistical associations, we also determined whether or not there were any temporal associations between antecedent vaccine administration and the occurrence of broken bones or open wounds.

One can’t help but note that the disorders listed that occur in the CNS after vaccines are actually quite rare, particularly Guillain-Barré. The authors of the article referenced found only 71 cases between 1979 and 2013. That’s 71 cases out of billions of doses of vaccines administered over 34 years. Remember, what this paper is claiming to look at is not serious demyelinating reactions to vaccines, which are very rare, but the reaction between vaccination and common conditions, like compulsive disorder (OCD), anorexia nervosa (AN), anxiety disorder, chronic tic disorder, attention deficit hyperactivity disorder, major depressive disorder, and bipolar disorder. One notes that the authors didn’t look at autism, and they didn’t really explain why, other than to note that the vaccine-autism link has been refuted by multiple studies, to which I respond: Then autism would have made an excellent negative control, to check the validity of the model, now, wouldn’t it? One also notes that antivaxers flogging this paper are annoyed that the authors didn’t look at autism, even though the idea that vaccines cause autism is the central myth of the antivaccine movement.

As for using the association of the H1N1 influenza vaccine with narcolepsy as a justification, it’s important to note that this is a strange case. The association was only observed in specific countries and not in others in which the vaccine does not appear to be a consistent or unique risk factor for narcolepsy in these populations. Overall, it was a confusing set of data to derive any clear picture of whether the H1N1 vaccine was a true risk factor. On the other hand, there are data suggesting that Pandemrix triggers antibodies that can also bind to a receptor in brain cells that help regulate sleepiness in genetically susceptible people. Be that as it may, the result with narcolepsy is nonetheless thin gruel to justify a study like this.

But what about the study itself? Basically, it’s a case control study. As you recall, a case control study is a form of epidemiological study that looks at risk factors in those who are diagnosed with a condition (cases) compared to those who are not (controls). For instance, a case control study might find that people with lung cancer (cases) are far more likely to have a significant smoking history than those without (controls). One thing about a case control study is that the selection of controls is critical, as it is impossible to completely randomize. Thus, the controls must be chosen to be as similar as possible to the cases in everything other than the condition being examined. This is not as easy as it sounds.

This particular case control study used data from 2002 to 2007 from the MarketScan® Commercial Claims and Encounters database, which is constructed and maintained by Truven Health Analytics. MarketScan consists of de-identified reimbursed health-care claims for employees, retirees, and their dependents of over 250 medium and large employers and health plans. Individuals included in the database are covered under private insurance plans; no Medicaid or Medicare data are included. The database includes claims information describing the health-care experiences for approximately 56 million covered patients per year and is divided into subsections, including inpatient claims, outpatient claims, outpatient prescription drug claims, and enrollment information. Claims data in each of the subsections contain a unique patient identifier and information on patient age, gender, geographic location (including state and three-digit zip code), and type of health plan.

You can see one thing right away. This is a select population, only patients with private insurance belonging to these plans. Another issue is that this is what we in the biz call administrative data. Administrative data are data collected not for research purposes, but for administrative purposes, primarily registration, transaction and record keeping, usually during the delivery of a service. In this case, the authors used a health insurance administrative datbase. That means it’s just diagnoses, procedures and interventions, some demographic data, and billing information. On the one hand, administrative data allow for huge numbers, is unobtrusive given that these are data that are collected anyway, and can uncover information that a study subject might not provide in an interview. However, there are disadvantages, too, and they’re not small. One very common drawback to using administrative data is that a lot of potentially relevant clinical and demographic data aren’t captured. In other words, the data are restricted to just the data needed to administrative purposes, and therefore the amount of data and the definitions of conditions are often insufficiently granular. There are lots of problems using administrative data. For example, the use of administrative data can frequently provide an incorrect estimate for various conditions and risk factors, as has been described for sickle cell disease, where administrative data grossly underestimated the rate of transfusion. (Discussions of the advantages and disadvantages of using administrative data can be found here and here.)

Now here’s how the authors did the study:

The study sample consisted of children aged 6–15 with a diagnosis of one of the following conditions (ICD-9 codes in parentheses): OCD (300.3), AN (307.1), anxiety disorder (300.0–300.2), tic disorder (307.20 or 307.22), ADHD (314), major depression (296.2–296.3), and bipolar disorder (296.0–296.2, 296.4–296.8). To test the specificity of the models, we also included children with broken bones (800–829) and open wounds (870–897). To identify new cases, we further limited the sample in each diagnostic group to children who were continuously enrolled for at least 1 year prior to their first diagnosis for the condition (the index date). Next, a matched one-to-one control group was constructed for each diagnostic group consisting of children who did not have the condition of interest and were matched with their corresponding case on age, gender, date of the start of continuous enrollment, and three-digit zip code. Because vaccines tend to occur during certain times of year (such as before summer camps or the beginning of school), controls were also required to have an outpatient visit at which they did not receive a vaccine within 15 days of the date that the corresponding case was first diagnosed with the condition, in an effort to control for seasonality. The date of this visit was the index date for children in the control group.

Can you see some problems already? First, in a case control study it is often desirable to use more controls than cases; that wasn’t done here. That isn’t a horrible flaw, just one that I question given that one of the key advantages of an administrative database is large numbers of subjects. More important is how few descriptors were used to match the controls: age, gender, date of insurance, and zip code. I’ll be honest and say that I’m not sure if the way they tried to control for seasonality of vaccine administration is valid or not. I will for now assume it was, as that’s not necessary for my conclusion that this paper is pretty crappy.

Now let’s look at how the analysis was done:

The analyses were performed for each diagnostic group (and their controls) separately. Children with multiple conditions (e.g., ADHD and tic disorder) were included in each of the corresponding analytic groups. First, the proportion of children who were exposed to vaccines in the period before the index date was compared across the case and control groups. Next, bivariate conditional logistic regression models were estimated to determine the hazard ratios (HRs) and 95% confidence intervals (95% CIs) associated with the effect of vaccine exposure on having the condition of interest. Separate models were run for the 3-, 6-, and 12-month periods preceding the index date for each diagnostic group.

This leads to the results as reported:

Subjects with newly diagnosed AN were more likely than controls to have had any vaccination in the previous 3 months [hazard ratio (HR) 1.80, 95% confidence interval 1.21–2.68]. Influenza vaccinations during the prior 3, 6, and 12 months were also associated with incident diagnoses of AN, OCD, and an anxiety disorder. Several other associations were also significant with HRs greater than 1.40 (hepatitis A with OCD and AN; hepatitis B with AN; and meningitis with AN and chronic tic disorder).

So the authors found some associations. Whoopee. RFK Jr. characterizes this paper as a ” well-designed, tightly controlled study.” No it wasn’t. Not at all. RFK Jr. wouldn’t know a well-designed study if it bit him in the posterior. The only reason he thinks this study is “well designed” and “tightly controlled” is because it provides results that he likes. In fact, what the authors did is the same thing authors of a recent acupuncture study I noted did: p-hacking. They did a whole bunch of comparisons using a nominal p<0.05 and don’t correct for multiple comparisons. In other words, it’s almost certainly statistical noise, given that most of the associations are modest and that the associations are all over the place.

Check out Table 2. It is the very definition of a p-hacking table. All the bold results are “statistically significant.” Just peruse the table. You don’t even have to look that closely to see that the receipt of any vaccine within 3, 6, and 12 months is correlated, both negatively and positively, with almost every condition examined, including broken bones and open wounds. (Yes, if you accept this study’s results you have to conclude just as much that vaccines are a risk factor for broken bones! A modest one, true, but a risk factor nonetheless. Yes, that’s sarcasm.) You can look down the list at individual vaccines and see that the influenza vaccine is associated with almost as many conditions. In fact, one thing the authors mention in passing is that administration of any vaccine seems to modestly decrease the risk of major depression and bipolar disorder. Again, if you accept that vaccines increase the risk of, say, anorexia nervosa, there’s no a priori reason not to accept the result that they also decrease the risk of major depression and bipolar disorder. Either that, or you have to accept that what you’re looking at is statistical noise, which is the far more likely explanation.

There also seems to be a significant bias in the results, given that more of the associations were positive than negative and given how many of them there were. One problem with a study of this type is that it can’t control for health-seeking behavior very well, if at all, and no attempt was even made here. For instance, parents who seek regular conventional medical care for their children would be more likely to keep them up to date on their vaccines. Those same parents would be more likely to have their children seen regularly enough to detect the neurological and psychiatric conditions associated with vaccines in the study. We see this confounder in studies of autism epidemiology all the time. Parents who take their children to physicians more often are more likely to have a child diagnosed with autistic disorder because screening always turns up more cases of a disorder. It could also explain why broken bones and open wounds correlate with vaccination. It’s not because vaccines cause these conditions, but rather because, for example, parents who don’t regularly take their children to the doctor might be less likely to vaccinate and less likely to take them to the emergency room or doctor’s offie=ce for cuts that might need a couple of stitches. Ditto for fractures that might not be so clinically apparent, such as a “greenstick” fracture, which is easily mistaken for a sprain and can heal on its own. Remember, administrative data often don’t give an indication of the severity of a condition, particularly given that this study used ICD-9 data, which are far less detailed than ICD-10 data given that ICD-10 coding only made mandatory less than a year and a half ago.

But wait, there’s more. Let’s take a look at the funding sources:

This research was funded by donations from RK, BR, and Linda Richmand.

Now this is bizarre. One of the authors, Douglas L. Leslie, is a health economist. Two of the other authors (Robert Kobre and Brian Richmand) self-funded the work. Linda Richmand, who also funded the work, is almost certainly Brian Richmand’s wife. This is all very strange until you realize that, like Leslie, Brian Richmand is not an epidemiologist, physician, scientist, or health researcher. He is a lawyer. Oddly enough, on his Stanford Law School page, there is this blurb:

Although Brian’s formal training has been largely in law and finance, he is most proud of his scientific work in a pediatric autoimmune disorder commonly known as PANDAS. Brian has been instrumental in designing and organizing 5 completed and ongoing immunology research studies at Yale Medical School, Oklahoma University Health Sciences Center, and Schneider Children’s Medical Center (Tel Aviv, Israel). Brian has also authored and co-authorized multiple papers published in peer-reviewed medical journals.

PANDAS. It had to be PANDAs. And guess what. Out of the four publications that I could find with him as co-author on PubMed, guess what? Surprise! Surprise! He’s authored a paper promoting the vaccine-autism link! Guess what journal it appeared in? If you guessed Medical Hypotheses, you’ve learned much from this blog. I even wrote about his awful paper when it came out! (Like, wow, man. Maybe Deepak Chopra is right, and the universe really is interconnected. Whoa.) It gets worse. though. Robert Kobre is not a scientist either. He is the Managing Director at Credit Suisse Securities (USA) LLC and also chairman of the board of directors of the Global Lyme Alliance, which from its website appears to be very much into chronic lyme disease woo. One wonders whether that colors his views of vaccines, one does.

So how is it that a lawyer from Stanford and an investment banker at Credit Suisse are listed as being affiliated with the Yale Child Study Center when neither of their names appear in an online list of faculty there? Of the other authors, James F. Leckman, is Yale Faculty, and Selin Aktan Guloksuz appears not to be faculty but could well be a student or postdoc. However, as far as I can tell, neither Richmand nor Kobre are formally affiliated with Yale. Inquiring minds want to know this can be. Yes, precious, they do. In particular those inquiring minds want to know why an academic pediatrician as distinguished as Dr. Leckman allowed his name to be put on such a shoddy paper. Actually, on second thought, check out the contribution section and then consider that same question:

DL, RK, BR, and JL designed the study and wrote the protocol. SG commented on the protocol. DL undertook the statistical analysis. BR, DL, and JL wrote the first draft of the manuscript. All the authors commented on the manuscript. All the authors contributed to and have approved the final manuscript.

So Dr. Leckman was involved in designing the study but the health economist (Leslie) alone did the statistical analysis. This is a great example of why it is mandatory for a statistician to be involved in the design of an epidemiological study like this from the very beginning and to do the statistical analysis. I don’t see anywhere how any of the authors of this article were qualified to design and analyze a case control study like this, and it shows. It’s possible that Selin Aktan Guloksuz could be an epidemiologist, but in reality I’m having trouble finding much about Guloksuz other than publication lists. Nor do the reviewers look particularly qualified to review a paper like this. They’re all psychiatrists and all from Indian universities I’ve never heard of. From my perspective, any epidemiological study needs to be reviewed by an epidemiologist or a statistician, preferably both.

There are so many dodgy things about this paper that I could continue to go on, but for purposes of a wrap-up, what you need to know is that, no, it doesn’t show that vaccines cause anorexia nervosa or tics, or the other neurological disorders linked to them; that it isn’t even good evidence of a correlation between vaccines and these conditions; that it’s funded by two of the authors and the wife of one of the authors; that one of the authors has a history of writing antivaccine articles for Medical Hypotheses; and, finally, that the other author is chairman of the board of directors for a lyme disease charity that appears to be heavily into chronic lyme disease woo. Basically, it’s bad epidemiology and statistics carried out by mostly non-epidemiologists and non-statisticians. Indeed, it’s so bad that I was surprised not to see someone like Andrew Wakefield, Mark Geier, or Christopher Shaw associated with it. How something this bad could be published by Yale faculty (plus non-Yale faculty listed as affiliated with Yale) is beyond me. When I decided to look at this paper, I hit the jackpot in terms of—shall we say?—teaching opportunities in critical thinking. Thanks, RFK, Jr.!

Comments

  1. #1 Guy Chapman
    United Kingdom
    February 10, 2017

    RFK definitely gets bonus marks for citing a tweet from Dana “Mr. Uncredible” Ullman, whose opinion on any health issue is pretty reliably wrong.

  2. #2 mikeh
    United Kingdom
    February 10, 2017

    Orac – “One notes that the authors didn’t look at autism, and they didn’t really explain why.”

    First line of the abstract states why
    “Although the association of the measles, mumps, and rubella vaccine with autism spectrum disorder has been convincingly disproven,”

    Which is an excellent start to the paper. Shame about everything else from line 2 of the abstract onwards

    • #3 Orac
      February 10, 2017

      Which would have made it an excellent negative control. I added a comment to that effect. After all, if you’re p-hacking so many conditions, what’s one more to add to the mix? 🙂

  3. #4 Dangerous Bacon
    February 10, 2017

    So:

    If you do an analysis using poorly matched controls, look at enough unrelated conditions and discard the associations that aren’t favorable to your hypothesis, you can find some that do.* Score!

    No doubt the evidence would be even more “damning” via subgroup analysis, a la Thompson.

    *I’m reminded of the comprehensive thimerosal study that found associations between increasing exposure and better intellectual and fine motor skills for certain populations. More exploitable junk data (noise) that crops up if you examine enough parameters and aren’t concerned about logic, plausible mechanisms and reproducibility. Except that pro-vaccine advocates didn’t flog such results.

  4. #5 Michael Finfer, MD
    Edison, NJ
    February 10, 2017

    One of the problems with using ICD codes for studies like this, is that we use these codes in a way that is intended to maximize reimbursement, not as a way to accurately report the patient’s diagnosed condition. I commonly use a code for something a patient may no longer have, such as a code for diverticulitis when reporting a colostomy reversal. I also occasionally use codes for something that a patient may not have, such as using a code for a clinician’s clinical diagnosis when billing a normal biopsy since using a code for normal tissue might result in a denial.

    Thus, I have to question there entire basis of this paper’s conclusions unless they they can show that the patients actually had the conditions corresponding to those codes. I suspect that ICD coding of psychiatric disorders is not necessarily accurate given what I believe to be overall problems with diagnoses in that field.

  5. #6 Orac
    February 10, 2017

    Excellent point. For instance, I’ve noticed inconclusive use of ICD-10 codes for breast cancer (as in having breast cancer under active treatment) and the code for followup after treatment for breast cancer.

  6. #7 Jay Lee
    New Mexico Highlands University
    February 10, 2017

    The surprising result from this study is the small number of ‘statistically significant associations’ given the huge size of family-wise alpha.

  7. #8 DuWayne
    February 10, 2017

    He used to spell it “ethel mercury”. Kennedy had the hardest time breaking this habit.

  8. #9 Michael J. Dochniak
    Minnesota
    February 10, 2017

    Orac writes,

    The best studies were entirely negative, and only crappy studies by “scientists” associated with the antivaccine movement showed anything resembling a positive result.

    MJD says,

    Unfortunately, when medical science makes a mistake (e.g., natural rubber latex in vaccine packaging) the exclusion process burdens R&D, manufacturing, and profits.

    In this example, product packaging appears to be the rate-limiting-step to a safer vaccine.This indicates that a powerful fiduciary variable may be present and this can erode consumer confidence.

    Although more pharmaceutical companies are embracing “Not manufactured with natural rubber latex”, based on FDA recommendations and warnings, past product-liability appears to make this a “let’s not talk about it” issue.

  9. #10 Eric Lund
    February 10, 2017

    You don’t even have to look that closely to see that the receipt of any vaccine within 3, 6, and 12 months is correlated with almost every condition examined, including broken bones and open wounds.

    You[1] fools! You fell victim to one of the classic blunders. The best known is, “Never get involved in a land war in Asia.” But almost as well known is this: “Correlation does not imply causation.”

    Normal children play hard. Sometimes a little too hard. Scraped knees, broken arms, etc. are the occasional result. One wonders if the “special snowflakes” who are too precious to be contaminated by vaccines are too precious to be allowed to play like normal children.

    [1]By which I mean the co-authors of this paper.

  10. #11 rork
    February 10, 2017

    I agree with Eric Lund basically, but think the exact cause of confounding could be from many things. Perhaps kids who get noticed to have these disorders have a higher probability of getting vaxed, or of getting noticed as having gotten vaxed. Could be as simple as some kids get less medical attention than others.
    I think p-hacking is not a big problem, at least for any vaccine results (however it doesn’t help that I am not really sure of the model – conditional logistic regression was conditional on WHAT – saying it’s bivariate didn’t explain it). For any vaccine they did 27 tests, 23 of which gave p<.05. Yeah, some of those are expected to be false positives, but not many, unless we are letting ourselves be bayesians, have low priors, and are picky about what positive means.
    Also, as I commonly do, I advise not to criticize people's sample sizes when they are getting small p-values – that doesn't make any sense.
    For the one vaccine at a time analyses, except for flu, it's not much more than chance, so claiming much there would constitute bad practices of not thinking about multiple testing hard enough. Decent review would help.

  11. #12 Narad
    February 10, 2017

    Quoth Leslie et al. (something that they repeat):

    More recently, data have emerged indicating an association between the administration of the H1N1 influenza vaccine containing the AS03 adjuvant and the subsequent new onset of narcolepsy in several northern European countries (17, 18).

    “The”? Did somebody forget about Canada?

  12. #13 rork
    February 10, 2017

    I’ll give an anecdotal example. My doc doesn’t know if I got flu vax or not and would not be able to figure it out if he wanted to. I don’t see him very often, and when I do it’s the wrong time of year. I just get it at work with all the others (we are part of a health system). If I saw my doc often, he’d probably offer me the jab himself when the time case around.

  13. #14 Narad
    February 10, 2017
    DL, RK, BR, and JL designed the study and wrote the protocol. SG commented on the protocol. DL undertook the statistical analysis. BR, DL, and JL wrote the first draft of the manuscript. All the authors commented on the manuscript. All the authors contributed to and have approved the final manuscript.

    So Dr. Leckman was involved in designing the study and he alone did the statistical analysis.

    Either I need more coffee, or Leslie did the analysis.

    • #15 Orac
      February 10, 2017

      Brain fart. Corrected. That’s what I get for rushing to finish a post before I have to leave for work.

  14. #16 rork
    February 10, 2017

    Conditional is about the matched pairs I finally get. Calling it bivariate is what was goofy for me.

  15. #17 Richard
    Netherlands
    February 10, 2017

    About the Pandemrix – narcolepsy connection: data on Chinese swine flu patients strongly suggest a causal link between exposure to particular H1N1 proteins and an autoimmune reaction in certain groups of genetically susceptible people. In this study, the following observation is mentioned:
    “In China, new cases of narcolepsy increased threefold in the 6 mo after the peak of the [swine flu] outbreak, then decreased to the normal rate of onset by 2011 after the pandemic had been contained.”
    This mechanism is further corroborated by this study.

    So even if the vaccine was a suspected cause of narcolepsy, an H1N1 infection itself was even a stronger trigger — quite apart from the other risks commonly associated with flu.

  16. #18 rork
    February 10, 2017

    I notice for major depression and bipolar disorder they are LESS likely to be vaxed. Not sure I have a theory for that, perhaps cause I’m so ignorant about kids with such conditions. I mention it hoping someone can provide a theory about propensities to not get such children vaxed.

  17. #19 Narad
    February 10, 2017

    About the Pandemrix – narcolepsy connection: data on Chinese swine flu patients strongly suggest a causal link between exposure to particular H1N1 proteins and an autoimmune reaction in certain groups of genetically susceptible people.

    Yah, Leslie et al. mention this in the second paragraph of the discussion. I’m not exactly convinced by their rationale for harping on narcolepsy:

    “Our findings showing that children with AN, OCD, or a tic disorder were more likely to have received the influenza vaccine in the preceding periods were noteworthy given the findings of increased incidence of narcolepsy in Finland, Sweden, Ireland, Norway, England, and France after vaccination with AS03-adjuvanted H1N1 vaccine (17, 18).”

  18. #20 Young CC Prof
    February 10, 2017

    @ Rork #11: That was my first thought. These aren’t infant-onset disorders, they show up in school-aged kids or adolescents (or adults sometimes.) And some of what they may be finding is a correlation between being up to date on vaccines and getting enough medical care to be diagnosed with a non-emergency psychiatric disorder.

    Even with acute injuries such as “broken bones and open wounds,” some parents are quicker to go to the doctor than others. (Not getting medical attention for a compound fracture is negligence, home treating a probable sprain or something that maybe could use a couple stitches isn’t necessarily negligent.)

  19. #21 Orac
    February 10, 2017

    You both make good points, of course. I had meant to emphasize the likelihood of confounders in more detail. In fact, when I first saw this study, that was going to be the main criticism in my post. However, somehow as I wrote things morphed. It happens.

    Since it’s lunch time, I took a few minutes to add a paragraph talking about how this study didn’t control for health-seeking behavior. It’s an important point, because failure to control for health seeking behavior is a frequent confounder that leads to false-positive studies looking at correlations between vaccines and autism. It could also explain the seemingly positive results for fractures. For example, greenstick fractures are often mistaken for sprains and, for the most part, heal on their own pretty well. If such a child isn’t taken to the doctor because the parents think he has a sprain, he’ll never be X-rayed and never be found to have a fracture.

  20. #22 rork
    February 10, 2017

    Pandemrix. That summary Richard#17 pointed to is not getting it quite right I think. It’s not the virus’s protein that blocks hypocretin receptor. It’s the antibody some people make to the virus’s protein that then cross-reacts with the receptor. So it is an immunity thing. http://stm.sciencemag.org/content/7/294/294ra105 is the actual paper. Can’t tell if there’s a paywall cause the computers know I’m sitting in ivory towers at the moment. Abstract may suffice though.

  21. #23 Narad
    February 10, 2017

    I notice for major depression and bipolar disorder they are LESS likely to be vaxed. Not sure I have a theory for that, perhaps cause I’m so ignorant about kids with such conditions.

    I’m wondering what the usual lead time is for a diagnosis of anorexia nervosa. (“The average age ranged from 9.5 ± 2.5 for children with tic disorder to 13.3 ± 1.7 for children with AN.” The latter is right around menarche, and it looks like three months’ amenorrhea was a DSM-TR-IV criterion in this group.)

    • #24 Orac
      February 10, 2017

      Also, kids that old get fewer vaccines, as they are through the part of the schedule where the most doses of vaccines are administered. Wouldn’t one naturally expect from the vaccine schedule that children who are diagnosed at older ages with something would probably be less likely to have been vaccinated within 12 months? Not sure I’m correct about this, just speculating. OTOH, the ages for sprains and other diagnoses aren’t that different.

  22. #25 Dorit Reiss
    February 10, 2017

    I thought RFK’s thing was thimerosal. That that, in his view, was the culprit. It’s not part of this study.

    Is he moving from “mercury bad” to “all vaccines are bad”? Or did he already make that move and I missed it?

  23. #26 sirhcton
    Still close to Bagdad
    February 10, 2017

    . . . (Yes, if you accept this study’s results you have to conclude just as much that vaccines are a risk factor for broken bones! A modest one, true, but a risk factor nonetheless. Yes, that’s sarcasm.) . . .

    How long will we have to wait until JAPANDS (The Journal of American Physicians and Surgeons) uses this study or parts thereof for another article blaming vaccines for inducing “shaken baby syndrome?” How long before MJD criticizes the study for not looking at latex as the cause for all the listed conditions?

  24. #27 James Lind
    February 10, 2017

    Dorit,

    Remember all RFK’s efforts with Nation of Islam to spread CDC Whistleblower fears. That was an MMR story, not thimerosal.

    • #28 Dorit Reiss
      February 10, 2017

      I do, but I also remember that he said several times during those talks that MMR has thimerosal.

  25. #29 sirhcton
    February 10, 2017

    Damn it! That will teach me to post before reading the comments. MJD was too quick on the draw. No adhesives holding his gun stuck in the holster.

  26. #30 Devil's advocate
    February 10, 2017

    The diagnosis of these conditions is very subjective as well. A GP who prefers a heavy handed medical approach may well be diagnosing normal kids with these conditions without proper psychiatric investigation. So many kids are labelled these days and stuck on meds when they’re just being kids.

  27. #31 James Lind
    February 10, 2017

    #28

    Fair enough. I think thimerosal is the only science-y complaint he has made. But he’s so far down the rabbit hole, or is that cesspit, of corruption that he suggests other vaccines cause harm, too.

  28. #32 Dangerous Bacon
    February 10, 2017
  29. #33 Eric Lund
    February 10, 2017

    Also, kids that old get fewer vaccines, as they are through the part of the schedule where the most doses of vaccines are administered.

    Not that I’m an expert on the subject, but wouldn’t girls who get the HPV vaccine get it right around menarche? Combine that with a tendency for anorexia nervosa to be diagnosed around that time, and that would give you a false positive for associating the anorexia nervosa diagnosis with the HPV vaccine.

  30. #34 Denice Walter
    February 10, 2017

    @ DuWayne:

    Isn’t his mother named Ethel?

  31. #35 Denice Walter
    February 10, 2017

    Unfortunately, I heard Null rave about this study a few days ago. At least the hoary old woo-meister keeps his woo up to date instead of perseverating upon Rife and others from 40-50 years ago.

  32. #36 Audi Byrne
    February 10, 2017

    The authors found associations with anorexia nervosa, OCD, anxiety disorder and tics. Aren’t these all long term things that parents would save till a routine visit to discuss with their doctor? Then the doctor does some follow up and these diagnoses are made around the time of their routine visit, when they’d also very likely have received some vaccines. (Since this is the main reason for making a routine doctor visit.)

    The controls in contrast were broken bones and open wounds — the sort of emergency things that would not wait for a routine doctor visit and so are more likely to happen anytime during the year.

    Would this not account for the different strengths of the associations? (Or am I missing something in the structure of the study?)

  33. #37 JP
    February 10, 2017

    Not that I’m an expert on the subject, but wouldn’t girls who get the HPV vaccine get it right around menarche?

    The HPV vaccine can be given as early as nine years of age, but is recommended for girls of age 11-12. The average age of onset of menarche is 12.42 years of age (I started at 11).

    The average age of onset of anorexia nervosa, however, is 16-17.

  34. #38 Robert L Bell
    February 10, 2017

    Good Lord,this “fishing trip” paper is positively rotten with multiple comparisons.

    Back of the envelope, they cross nine medical conditions with seven vaccine conditions and declare victory on four significance flags.

    Of course, with the (sloppy) conventional 5% significance flag, that means they can expect – on average – 3.15 false positives for a data set of this structure.

    That’s on average. Given the discreet nature of events, four or five or even six false positives would be completely banal.

    So four “hits” is nothing to write home about.

  35. #39 Eric Lund
    February 10, 2017

    Isn’t his mother named Ethel?

    Indeed she is. Which might or might not be a Freudian slip.

    According to a book published in 2015 (my Google search turned up references to this book in People magazine and the New York Post), Ethel Kennedy was a neglectful parent. I have no idea whether this book should be considered a reliable source.

  36. #40 herr doktor bimler
    February 10, 2017

    RIP Major Stubblebine. Another victim of the Big-Pharma kill teams!

  37. #41 herr doktor bimler
    February 10, 2017

    Ethel Kennedy was a neglectful parent
    Obligatory.

  38. #42 JustaTech
    February 10, 2017

    Good lord, so many confounders! And probably most of them are artifacts of health-seeking behavior.
    In theory, everyone is supposed to get a flu shot every year. Let’s say a kid’s parents take them in for a flu shot and the doctor or nurse notices behaviors that might indicate OCD or tics or AN, and suggests that the parents get the child checked out by a mental health professional. That takes a while to set up and then maybe more than one appointment to test for, and then you have diagnosis 3-12 months after vaccination.

    Devil’s Advocate @30: Given that AN is one of the most fatal mental health conditions (given the damage to the body that persists after treatment), it needs to be aggressively diagnosed and treated. Also, what’s the evidence that these children were not properly evaluated? Most health insurance covers mental health.

  39. #43 DuWayne
    February 10, 2017

    Isn’t his mother named Ethel?

    Exactly. That’s why his favorite chemical is ethyl skatole.

  40. #44 JP
    February 10, 2017

    Devil’s Advocate @30: Given that AN is one of the most fatal mental health conditions (given the damage to the body that persists after treatment), it needs to be aggressively diagnosed and treated. Also, what’s the evidence that these children were not properly evaluated? Most health insurance covers mental health.

    Why is this devil’s advocate? Anorexia nervosa is indeed a deadly condition. I was anorexic as a teenager (roughly age 14-17 (which is why I was so scrawny and flat chested and often called “it” – I have since definitely over corrected, trying to lose some weight during a very harsh and snowy winter) and I never received care for this. (For part of the time we didn’t have any insurance – my mom eventually got us on Basic Health.) I did get some counseling after a suicide attempt, but even our PCP didn’t ask why my weight was so low. (About 100 pounds, but I wasn’t getting my period. I have a sticky frame naturally.)

  41. #45 JP
    February 10, 2017

    *stocky

  42. #46 DuWayne
    February 10, 2017

    From Major Stubblebine’s Wiki page:

    Stubblebine became a proponent of psychic warfare and initiated a project within the U.S. Army Intelligence and Security Command, which he commanded from 1981 to 1984, to create “a breed of ‘super soldier'” who would “have the ability to become invisible at will and to walk through walls”. He attempted to walk through walls himself — but failed, as he himself described in a 2004 interview.

    Major Scheisskopf much there buddy?

  43. #47 JustaTech
    February 10, 2017

    JP @44: Sorry, I was responding to Devil’s advocate who had posted at 30 that too many kids were being improperly diagnosed. I was trying to argue that, whatever one might think of overdiagnosis of ADHD, AN is a very, very serious condition and should be addressed.

    I’m glad you’ve gotten better!

  44. #48 JP
    February 10, 2017

    Oh, duh. I didn’t look at the nym I guess, and assumed you were playing devil’s advocate.

  45. #49 herr doktor bimler
    February 10, 2017

    I have a sticky frame naturally.
    Stocky

    I am glad to hear that you are no longer adhesive.

  46. #50 JustaTech
    February 10, 2017

    That’s a part I don’t play, it was always taken by my more irritating friends. That and I’m a terrible BS-er, I have no poker face at all. (Which, interestingly, is not required to win at poker, you just have to be sufficiently unpredictable.)

  47. #51 JP
    February 10, 2017

    (Which, interestingly, is not required to win at poker, you just have to be sufficiently unpredictable.)

    I always used to win while playing with grad school friends by just not knowing what I was doing and making no sense.

  48. #52 Rod McClymont
    Bathurst, Australia
    February 10, 2017

    I’ll confine my comments to my area of expertise in assessment and management of eating disorders and the prominent comment in the abstract about temporal association between onset of anorexia nervosa and timing of immunization. The very fact that the authors could make such a statement with commenting upon the extreme difficulties of establishing the time of onset of anorexia nervosa reveals marked ignorance of anorexia nervosa.
    Nearly always the true time of onset of anorexia nervosa ( that is the commencement of behaviour aiming to loose weight because of distress about perceived weight or shape which has been around long before that) is months or years before anyone starts to become aware of obvious behaviour sorry weight loss. There may be a point in time where the issue started to accelerate significantly and concerns escalate but this is long after onset and the accelerating phase is typical regardless of age of onset of anorexia nervosa.
    Often it is only well after the person is significantly recovered from the neurocognitive effects of starvation that they can even recall much about events before the preceding few months and are able to recall that they had the impulse and distress to restrict intake and/or purge and/or over exercise starting many months or years before the diagnosis and that they had been exhibiting the core behaviors long before anyone had even an inkling that there was a problem occurring. There are many more co-founders here but when a study totally ignores key issues in one area, the veracity of it overall is always in doubt

  49. #53 JustaTech
    February 10, 2017

    Exactly!

    Also, being tired and wanting to go home makes me very, very good at poker (which makes me have to stay; it’s very counter productive).

  50. #54 Eric Lund
    February 10, 2017

    I always used to win while playing with grad school friends by just not knowing what I was doing and making no sense.

    It’s not just poker. They say that experienced martial arts fighters have the most to fear from novices, because the novices don’t know that you aren’t supposed to do certain things. Opponents with even a little bit of experience are much more predictable.

    Even when it comes to card games, bridge columns are full of little old ladies who somehow make the right play for a given situation, although they invariably do so for the wrong reasons.

  51. #55 Rich Scopie
    February 10, 2017
  52. #56 Narad
    February 10, 2017

    RIP Major Stubblebine.

    G-DAMMIT. It’s like I’m handing away the next year’s deadpool picks over and over again.

  53. #57 JP
    February 11, 2017

    I’m glad you’ve gotten better!

    Look away, look away.

  54. #58 Murmur
    UK-ia
    February 11, 2017

    Rod @ 52

    I was going to point out that often very long period between commencement of eating disorder behaviours, someone noticing and then assessment and diagnosis…

    Re ADHD: I have heard it suggested, but am not aware of any actual data, that In Merkinania there is rather more diagnosis than over here, which was said to be to do with differences in how healthcare is paid for and how special educational needs are defined and funded…

  55. #59 Audi Byrne
    United States
    February 11, 2017

    Robert L Bell @38

    Of course, with the (sloppy) conventional 5% significance flag, that means they can expect – on average – 3.15 false positives for a data set of this structure.

    “Of course, with the (sloppy) conventional 5% significance flag, that means they can expect – on average – 3.15 false positives for a data set of this structure.

    That’s on average. Given the discreet nature of events, four or five or even six false positives would be completely banal.”

    How does the strength of the association factor in? For example, if one association is much stronger than the others.

    That is, representing a REAL correlation.This still doesn’t mean causality. Noticing, for example:

    “Rates of receipt of specific vaccines were fairly low, ranging from 0.5% for the hepatitis vaccine among children with tic disorder to 8.4% for the influenza vaccine among children with tic disorder.”

    Kids are done with their HepB vaccines by 12 months, so a lower value for that could be explained by a lower diagnoses of tics in first year. Can statistics show if the influenza-tic [correlation] is real? (I mean, even in the context of p-hacking by looking at the strength of association).

    The study may not have been well designed (I don’t like the choice of controls) but it’s still a large study — what can be salvaged from the data?

  56. #60 Dangerous Bacon
    February 11, 2017

    I’m not sure Gen. Stubblebine’s death will be fodder for the natural-healer-murder-conspiracy folks. Stubblebine and his wife Rima Laibow of Natural Solutions Foundation fame were the targets of venom from their competitors, on suspicion of being Government Disinformation Agents.

    http://www4.dr-rath-foundation.org/THE_FOUNDATION/Events/codex-moderngeneral.html

    Maybe the gummint murdered Stubblebine because he was about to change sides and name his official collaborators?/?!?!?!?

  57. #61 Antaeus Feldspar
    February 11, 2017

    I understand there’s been some trouble with a troll who impersonates others. Could the mysterious link to Whale Dot To at #52 be the troll?

  58. #62 Julian Frost
    Gauteng East Rand
    February 11, 2017

    For your entertainment.
    https://en.wikipedia.org/wiki/The_Men_Who_Stare_at_Goats_(film)
    Based partly on Stubblebine’s experiments.

  59. #63 Leigh Jackson
    February 11, 2017

    Kennedy partially quotes the study’s conclusion: In a carefully worded conclusion, the researchers caution making too much of these results while also urging further investigation. “This pilot epidemiologic analysis implies that the onset of some neuropsychiatric disorders may be temporally related to prior vaccinations in a subset of individuals,” they write. “These findings warrant further investigation, but do not prove a causal role of antecedent infections or vaccinations in the pathoetiology of these conditions.”
    He fails to mention the authors’ advice which immediately follows: “Given the modest magnitude of these findings in contrast to the clear public health benefits of the timely administration of vaccines in preventing mortality and morbidity in childhood infectious diseases, we encourage families to maintain vaccination schedules according to CDC guidelines.”
    His concealment of the medical advice of the study’s authors reveals him to be a public menace.

  60. #64 Robert L Bell
    February 11, 2017

    @Audi Byrne #59

    Excellent! I love interesting questions, gets the conversation flowing.

    So you ask “How does the strength of the association factor in? For example, if one association is much stronger than the others.”

    That can be a tough call. We all instinctively believe (in our guts) that a smaller p-value is stronger evidence for a proposition being correct. But that is not actually right, especially in these larger studies where variation from sampling fluctuations (which is really what the p-value measures) gets overwhelmed by variation from (as they say) extraneous, confounding, and uncontrolled variables.

    In this context I like to mention that Bonferroni Correction, which attempts to account for the multiple comparisons issue by adjusting the critical value down so as to exclude “hits” of largish p-vales in order to bring the total false positive rate (for the entire data set) back to 5%.

    People do this, but I consider it theoretically unsound. It’s possible to have a real, if smallish, effect that shows up as a p-value of 0.04 just as it’s possible to have a no-effect sample show up with a p-value of 1e-6. Rare, of course, but we run billions of tests every year and weird stuff does happen.

    That’s why I use the approach that I use, comparing the observed hit counts to the null case of no effect anywhere. If your troll through the samples brings up twenty hits when four are expected to be false, you are on solid ground and your job is now to sift the wheat from the chaff. If however you see four hits when three are expected to be false, the probability is high that all of them are false.

    On the other hand, you might also have some real effects that fluked low. This is the old Receiver Operating Characteristic problem, in which you trade off false positive rates against false negative rates in order to maximize your own utility.

    So, what can we salvage? They now have four candidates for further study, so get busy and check them out! This kind of thing is the meat and potatoes of the scientific enterprise.

    I will caution that I consider studies of this kind to be preliminary and not in themselves worthy of publication – for reasons that should be obvious, on top of the fact that idiots like Kennedy are out there waiting to pounce upon studies they do not understand but superficially appear to advance their little crusades.

    My practice is to do the fishing trips – we all need preliminary data – but to report the fishing trip as supporting evidence in the paper where the targeted validation studies are the main event.

  61. #65 Leigh Jackson
    February 12, 2017

    @Robert #64

    By coincidence you touch on a point which I had been mulling over. Which metaphor is most appropriate here, and more generally? “Hacking” or “Fishing”.

    I am thinking that whilst hacking is post hoc, fishing is ex ante.

  62. #66 Robert L Bell
    February 12, 2017

    @Leigh Jackson #65

    Daran hatte ich gar nicth gedacht.

    My quick response is that both terms, as you use them, imply practices that are deliberate and disreputable if not outright dishonest.

    Here I use “fishing trip” as a handy label for the common practice of gathering a basket of data and examining it to see what you got, as opposed to (if I understand you correctly) “fishing” as the flagrantly dishonest practice of making repeated samples with the intent of finding that one sample that says what you want it to say – and then misrepresenting it as typical of the population as a whole.

    “P-hacking” is the related practice of making up one irresponsible speculation after another until one happens to pass a significance test and can be passed off as a successful hypothesis.

    Just to be very clear, I do not suspect the authors of the original paper of either of these sins. At worst, I say that they did not think deeply or clearly about their statistical analysis and thus wandered into a snare that they did not recongize.

    That said, I suspect that they are setting themselves up for difficulties in the sense of Andrew Gelman’s Garden of Forking Paths critique. He sees, as do I, a disturbingly large number of lines of research in which one dubious result forms the basis for the next dubious result – each individual step passed some significance test, but the resulting intellectual edifice is rickety and its foundations unsound.

    Unfortunately there is no quick and mechanical test for extraneous, uncontrolled, and confounding variables to match the quick and mechanical test for statistical significance with respect to sample size. We are working on this problem, but it’s not clear how to proceed.

  63. #67 Narad
    February 12, 2017

    variation from sampling fluctuations (which is really what the p-value measures)

    “Really”?

  64. #68 Robert L Bell
    February 12, 2017

    @Narad #67

    Yes, really.

    Get back to us when you can demonstrate some understanding of the issues at hand.

    If I may expand upon that for a moment, the snarky comment that appeals to the ignorant mob is what you do. A coherent statement of what I mean and what I am trying to do – supported by evidence – is what I do.

    People are free to chose who to respect.

  65. #69 Robert L Bell
    February 12, 2017

    @Narad #67

    If I am wrong, show that I am wrong.

    In internet terms, stop the dumb insinuations and put up with your derivation.

  66. #70 Julian Frost
    Gauteng North
    February 13, 2017

    Is #61 really the return of Antaeus Feldspar?
    Or is it just Mr Schwochert being a colossal [blankety-blank-blank]?

  67. #71 Rich Scopie
    United Kingdom
    February 13, 2017

    That wasn’t me.

  68. #72 Antaeus Feldspar
    February 13, 2017

    Yes, it really is me. I know I’ve been away a long time — I started running out of data because the comment threads were so huge and my blanket-blank browser kept crashing, meaning they had to be reloaded over and over! But my data usage seems to have stabilized, so I’ll try to be around again more…

  69. #73 Julian Frost
    Gauteng East Rand
    February 13, 2017

    It’s good to have you back, Antaeus.

  70. #74 Narad
    February 13, 2017

    Get back to us when you can demonstrate some understanding of the issues at hand.

    The p-value is calculated; it doesn’t know what it’s “measuring.” What is being described is chance (or “sampling error”) iff all the assumptions of the underlying statistical model hold true, which is in general unknown.

    If I may expand upon that for a moment, the snarky comment that appeals to the ignorant mob is what you do.

    Sometimes I have more time than other times.

    A coherent statement of what I mean and what I am trying to do – supported by evidence – is what I do.

    I wouldn’t have made my comment in the first place if you had actually done this.

    People are free to chose who to respect.

    Yup. Neither do I expect any for no particular reason.

  71. #75 Narad
    February 13, 2017

    It’s good to have you back, Antaeus.

    Indeed.

  72. #76 JP
    February 13, 2017

    Did anybody ever hear anything from Krebiozen? About a year ago he mentioned problems with hypotension and falling. Makes me worry.

  73. #77 sadmar
    February 13, 2017

    Hi Antaeus! Great to see you back here, and hope you’re well!

  74. #78 Julian Frost
    Gauteng North
    February 14, 2017

    @JP, I haven’t heard anything either and I’m also worried. His last comment appeared on February 28 last year. Since then, silence.

  75. […] “vaccine injury” to use to change federal vaccine policy; that is, when he’s not flogging risibly bad science claiming to find a link between thimerosal in vaccines and neuropsychiatric conditions other than […]

  76. #81 Robert L Bell
    February 16, 2017

    OK, let’s wrap this up.

    You get a population, and you start measuring people for some characteristic – let us say “ego size” for convenience – and you find that individuals have different values.

    It is then convenient and informative to compute the sample mean and the variance, which we know are (probably) close to the true population mean and variance. Each time we take a new sample we look at different individuals and we get a new sample mean – these are the sampling fluctuations, inevitable due to the heterogeneity of the population.

    We generally do not know the true distribution for the population, but the distribution of estimates for the mean is a generic feature of this world we live in (provided certain conditions are met).

    The feature that concerns us here is that small fluctuations are common while larger fluctuations are less common. (Which gives the game away: in this sense, size and probability are two sides of the same coin, given the known distribution function that links them.)

    Now we turn to comparing two populations, finding some difference between the means. We would like to know whether the observed effect is real, but we have no way to make that determination.

    What we do instead is to invoke the Null Hypothesis and ask a very specific question: if the true effect size is zero, how likely is it – given the variance structure of the two populations and the sample sizes – to get a measured value this large (or larger than) given then know structure of the sampling fluctuations?

    This we can do, the quantitative result is the p-value, which is a measure of the fluctuation size needed to produce the observed result (expressed in probability units).

    I say that this is perfectly orthodox stuff, everyone gets it in sophomore statistics (although many people fail to fully grasp the point).

    Thus I have no idea what Narad thinks he is babbling about. Obviously, his Proof by Accusation technique falls on its face as a logical proposition.

    If anyone wants to point out an error or inconsistency, please please please please please do so. It’s good to clear out the incorrect thinking, ASAP.

    If anyone would like to discuss subtleties, let’s get going. The authors of the original paper, the one that RFK jr has hijacked to his own dishonest purposes, would have done well to have thought more deeply about the subtleties as well.

  77. #82 jay joffe
    france
    February 27, 2017

    I have only see rfk jr. one time. He said that he looked to see how the pharm industry has proven that ethyl mercury gets out of the body. He said he couldn’t find it but that he found proof that it crosses the blood brain barrier easily. He suggested that this mercury goes into the brain and stays there. Can you point out the studies that you sugges he must have missed which shows how the ethyl mercury (thimerisol) leaves the body after a vaccine? If you can’t that means it stay in the body and he is right. If you can’t respond to that then all of what you’ve written above seems to be unimportant details.

  78. #83 Dangerous Bacon
    February 27, 2017

    “Can you point out the studies that you sugges he must have missed which shows how the ethyl mercury (thimerisol) leaves the body after a vaccine?”

    You can start with this one.

    “We observed that blood mercury levels after intra-
    muscular administration of thimerosal-containing vac-
    cines to newborn, 2-month-old, and 6-month-old in-
    fants were at their highest level shortly after vaccination
    and returned to prevaccination levels within a few
    weeks. Prevaccination levels of blood mercury in
    6-month-olds were not higher than those in 2-month-
    olds, suggesting that exposure to thimerosal-containing
    vaccines does not result in an accumulation of mercury
    in blood as might have been predicted if the blood half-
    life were similar to that of methyl mercury.”

    http://www.slipe.org/documentos/Gentile_Thimerosal_I.pdf

  79. #84 Lawrence
    February 27, 2017

    So, all the decades of research to find a way to pass medications through the BBB & all they had to do was study how Thimerosal does it?

    Wow, never would have thought….(god, anti-vaxers are so ignorant of basic biology, it’s just pathetic).

  80. #85 Narad
    February 27, 2017

    have only see rfk jr. one time. He said that he looked to see how the pharm industry has proven that ethyl mercury gets out of the body. He said he couldn’t find it but that he found proof that it crosses the blood brain barrier easily. He suggested that this mercury goes into the brain and stays there.

    Assume for the sake of argument that this is correct. Did he bother to say in what form the molecule’s mercury stays there? I mean, is it actually doing anything? If it is, wouldn’t there then be a steadily progressive neurotoxic effect?