White Coat Underground

The Autism Omnibus Trial is a conundrum for the infectious disease promotion movement. Still, their ability to pick up the goalposts and run is unmatched, and that is just what David Kirby and Robert Kennedy, Jr. have done in today’s Huffington Post.

To review, the recent Omnibus decision looked at a few test cases for the “vaccine causes autism” hypothesis, and tossed them for being inconsistent with reality. This correlates well with what science has to say about the issue.

But of course the overwhelming evidence isn’t going to deter these superheroes. They know the answer, and they’re strong enough to make any facts fit their hypothesis.

Their answer to the Omnibus findings was, “but look over here—here’s a case were a judge said vaccines cause autism.” If this is where they are planting their goalpost, then it’s going to be another “own goal” for K&K. Let’s try to take an organized look at their chaotic ramblings.

What is alleged?

What K&K are alleging in their latest rant is that the Omnibus finding (that vaccines do not cause autism) is not relevant and of little importance, since the “vaccine courts” have already found the connection to be true.

This is, of course, false. Let’s review, with a little help from Orac. Here is what the vaccine court is:

In the U.S., because of rising litigation that jeopardized the vaccine program and threatened to drive pharmaceutical companies out of the vaccine business, Congress passed the National Childhood Vaccine Injury Act of 1986 (Public Law 99-660), which created the National Vaccine Injury Compensation Program (VICP). The idea was to create an alternative to the tort system through which people injured by vaccines could be efficiently compensated. Vaccine litigants, if denied compensation, could still sue in conventional courts, but all claims for compensation had to go first through the VICP. Moreover, the standards of evidence in the Vaccine Court of the VICP are arguably markedly lower than in conventional federal courts. For example, regardless of whether one thinks they are too restrictive or not, in the Vaccine Court Daubert rules for scientific evidence do not apply. Indeed, all that is necessary is a scientifically plausible-sounding mechanism by which a plaintiff might have been injured by vaccines, and compensation can be awarded. In essence, lowering the Daubert standard and allowing “science” that has not yet been peer reviewed makes meeting the standard of evidence showing a 51% or greater chance that the plaintiff was injured by the vaccine in question easier because it opens the door to an antivaccinationist version of the Gish Gallop, forcing the defense to answer and refute all sorts of bad science.

In the vaccine court, the standard of evidence is very low:

It is axiomatic to say that the Petitioners bear the burden of proving, by a preponderance of the evidence – which this Court has likened to fifty percent and a feather – that a particular fact occurred. Put another way, it is required that a special master, “believe that the existence of a fact is more probable than its nonexistence before [he] may find in favor of the party who has the burden to persuade the [special master] of the fact’s existence.”

There is a good reason for this—the mandate of the court, as Orac notes in the quote above, is to protect the public health by lowering the risk to manufacturers and others who would otherwise be so burdened by merit-less cases that they would never bother to sell vaccines. The court is not mandated to follow the best scientific evidence. And neither, apparently are K&K. It is the vaccine court’s mandate to find for the plaintiffs even in somewhat questionable cases. The Omnibus court gave a very clear smackdown to the antivaccine movement. To have as your best retort, “yeah, but one time they agreed with me sort of” is a rather weak argument. In fact, it’s not an argument at all—it is a non sequitur.

And to continue the non sequitur…

The Banks case to which K&K are referring is interesting as a case of “I don’t think it means what you think it means.” The case examined a young patient who received an MMR vaccine, and then 16 days later suffered a seizure. He was evaluated and at least one doctor felt he had ADEM, a severe neurological disease. The best statistics estimate a rate of ADEM after measles vaccination of about 1-2 per 1 million, although the vaccine has never actually been proved to cause ADEM. The rate of ADEM associated with measles infection is about 1 in 1000, a proven causation.

Some time after his seizure, he was diagnosed as having pervasive developmental delay, a diagnosis that falls on the “autism spectrum”. Because of the temporal relationship of these disorders, and because there was at least some scientific plausibility to connect the vaccine to his later neurologic illness, the court found in favor of the plaintiff. Notice, this is not a “vaccines cause autism” finding—it is a “in this particular case, a vaccine may have cause ADEM, which may have lead to an autism-like disorder.” If this is the best argument K&K can come up with, they probably should have given up a long time ago.

A danger to public health

These irresponsible rantings are in a sense boring (it’s always the same old song), but that doesn’t diminish the danger. Imagine an analogous situation: the son of a famous politician and a washed-up journalist convince a major media outlet to publish their assertion that chlorine used in large-scale water purification plants that supply our cities causes autism. Despite the lack of evidence, the convince large numbers of people to get “safe water”, say, out of lake Huron (clean lake, not all that polluted). Eventually, enough people are buying in to this idea, that rates of giardiasis, cryptosporidiosis, and eventually typhoid begin to rise to levels not seen in over a century. What would we do with these idiots?

The infectious disease promoters are a threat to public health. They probably haven’t broken any laws, but they have preyed on the fears of people in need, and had a disproportionately large negative effect. Once again, I call on you to speak out against them, talk to you friends and neighbors, the parents in your kids’ schools. Let it be known that you want every child protected and that those who talk people out of vaccinating are endangering children. This ain’t no foolin’ around.

Comments

  1. #1 Harold L Doherty
    February 25, 2009

    Name calling? Not very persuasive.

    The court, as you grudgingly acknowledge, found in favor of the plaintiff, including the allegation that the vaccine caused ADEM which resulted in PDD-NOS which, according to that radical publication the DSM-IV, is a pervasive developmental disorder or autism spectrum disorder.

  2. #2 PalMD
    February 25, 2009

    Brilliant non sequitur, harold. Next time read for comprehension.

  3. #3 HCN
    February 25, 2009

    Take note that the title of the ruling says:
    “Non-autistic developmental delay; Acute Disseminated Encephalomyelitis; Expert Credibility; Evidentiary Reliability; Scientific Validity; Burden of Proof; Causation in Fact; Proximate Causation”

    Did you notice it starts with “Non-autistic”?

    PalMD quoted from it “The case examined a young patient who received an MMR vaccine, and then 16 days later suffered a seizure.”

    That is very close to what happened to my son. Except at that time he was suffering from a severe gastrointestinal bug (possibly a rotavirus) and was dehydrated. He had similar delays, and even after ten years of speech therapy still has speech issues, and is still learning disabled.

    Never did get any other kind of diagnosis, all follow-up EEGs were pretty normal (including the sleep EEG and the one with the flashing lights). He never had an MRI since that was still big, expensive and not routine.

    My, how times change. Looking at the dates, my son is ten years and about six weeks older than young Master Banks.

  4. #4 Sam C
    February 25, 2009

    I don’t agree with your comment:

    In the vaccine court, the standard of evidence is very low…

    which is followed by a comment about the standard of proof rather than the standard of evidence. And anyway, isn’t the balance of probability the usual standard in non-criminal cases? (Certainly it is in the UK, where the criminal standard is “beyond reasonable doubt”.)

    The point with the vaccine court is that it was generous about admissibility of evidence. It refused to toss out evidence – or “evidence” with scare quotes – before hearing it. Rather, it heard the evidence, then decided how good it was. So it listened patiently to the claimants’ experts, then decided they were woo-mongering quacks talking rubbish, which avoided any problems of the claimants squealing “waaa!!! unfair! we weren’t allowed to put our case!”.

    Throughout the hearing, the Special Masters made a point of being flexible to avoid the case failing for pedantic legal reasons; rather they aimed for a full and fair hearing.

    I think the Special Masters did an excellent job, and they and Judge Jones at the Kitzmiller/Dover trial demonstrated a judicial system at its best: coming to a clear, correct and well-reasoned decision where clarity was needed.

  5. #5 Nik
    February 26, 2009

    Note to Harold: You are infact confused on the diagnosis.

    The court found that the vaccine may have caused ADEM, which may have led to Pervasive Developmental Delay (NOT Pervasive Deveopental DISORDER – Not otherwise specified)
    Both are often (confusingly) abbrieviated PDD, but Pervasive Deveopmental Delay is a broaderumbrella, under which austism falls, rather than a specific disease in the autism spectrum.

    So to claim anything about autism based on this is like saying “well look, this medicine causes seizures (one neurologic sequelae), give me money because I had a stroke (a completely different neurologic problem)” – A complete nonsequitur.

  6. #6 John Fryer
    February 26, 2009

    Hi

    The definition of autism is so wooly that a ten fold increase is being argued as meaning nothing.

    Who can say who has what. All we know is they are developmentally delayed and following a dozen or more vaccines with the coincidence that the more vaccines given the greater the chance of some health problem.

    ADEM theoretically should improve for most and as it doesnt implies some toxicity resting in the body rather than organisms which can get disposed of by the bodies defence mechanisms.

  7. #7 PalMD
    February 26, 2009

    While word salad my have that certain dada-ist cool, it doesn’t really inform the discussion.

  8. #8 Alyric
    February 26, 2009

    Harold is a newly paid up member of EOH, the yahoo anti-vaxxers so he’s a bit gung ho and not worried unduly about accuracy of diagnosis.

  9. #9 The Blind Watchmaker
    March 1, 2009

    Science has already determined through numerous epidemiological studies that vaccines do not cause autism.

    The Omnibus trial represents a judges recognition of this.

    Clinging to a debunked idea is the hallmark of pseudoscience.

    When will our politicians and media learn this?

  10. #10 Chris
    March 2, 2009

    To add to what the Blind Watchmaker wrote:

    The science has been done, the link between vaccines and autism does not exist. It is a dead link… “It’s not pinin’! ‘It’s passed on! This link is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! If you hadn’t nailed it to the perch it’d be pushing up the daisies! Its metabolic processes are now ‘istory! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!! THIS IS AN EX-LINK!! ” (hat-tip to Monty Python and the dead parrot sketch)