White Coat Underground

OK, the title is inaccurate. Kirby is not bound by the same code of ethics as researchers and doctors, so perhaps he’s not unethical. But his latest rant in HuffPo encourages unethical behavior. Honestly, I’m getting tired of writing about this guy, but he just keeps bringing the stupid, and something about that just calls out for a response.

So what’s so horrible about his latest hunk of drivel? Well, first he starts with a blatant misinterpretation of the truth:

It is not accurate for members of the media to report that the link between vaccines and autism has been “disproven.”

Actually, it is quite accurate. Study after study, all well done, have failed to show a link between vaccines and autism (except that they both involve children and Kirby).

But where he really brings the pain is in his call for a study of “vaccinated vs. unvaccinated” kids. First of all, the study has essentially been done, in that we can compare our current statistics with pre-vaccination stats, and we can compare ourselves to countries with poor vaccination rates. Even more useful is the falling vaccine rate and rising disease rate in England, the U.S., and elsewhere, especially with regard to measles. Add that to the studies that show no causation or correlation between autism and vaccines, and it’s a done deal.

More important that that, however, is the horribly unethical nature of the suggestion. A study of vaccinated vs. unvaccinated children is almost certain to be an ethical nightmare. If you intentionally randomize children to an unvaccinated group, it’s ethically akin to assigning them to a no-seat belt group. If you simply try to enroll groups of vaccinated and unvaccinated children, there are still ethical problems, but also technical problems with validity. If validity problems can be overcome, the final problem will be this: if the results fail to show the results that Kirby, et al wish, they will simply dismiss the data as somehow flawed, just as they have with every other study that has refuted his claims.

His shameless self-promotion is a threat to public health. He should be ashamed.

But of course, he has no shame.

Comments

#1 MikeMa
March 4, 2009

He should be more than ashamed. He should be prosecuted and made liable for medical costs for the loss of herd immunity cases his insanity encourages. What a moron. Sadly he’s not alone.
#2 Catherine
March 4, 2009

Has anyone compiled a ‘cheat sheet’ for refuting anti-vaccinationist claims? An easily searched web reference would be useful.
#3 T. Bruce McNeely
March 4, 2009

Kirby may not be bound by a formal Code of Ethics, but there is ethical and unethical behavior that most of us can agree on.
In my opinion, Kirby crosses that line, so that your headline is indeed accurate.
#4 Heraclides
March 4, 2009

As a journalist/reporter he does have a code of ethics, one that he regularly breaches!

Catherine: The closest I know of are a number of FAQs put out my medical sources (e.g. CDC, Mayo Clinic, etc). Offit also has a relevant book chapter on the WWW: http://www.immunize.org/catg.d/4038myth.htm
#5 David
March 4, 2009

2 observations:

first, who the heck are the “salt lake city writing group?” As far as I can tell, they have no web site. They aren’t referenced on the NVAC website (www.hhs.gov/nvpo/nvac/index.html). NVAC didn’t list any meetings on 27Feb, the date Kirby indicated. Their last meeting was apparently 6Feb, and the agenda posted (http://www.hhs.gov/nvpo/nvac/agenda20090206.html) reads more as something supportive of vaccine use. Check it out.

second, Kirby’s call perhaps isn’t so much unethical as it is ignorant. He doesn’t understand that there are many different kinds of studies. There’s nothing wrong with “conducting studies on health outcomes in vaccinated vs. unvaccinated populations.” Note that he didn’t call for a concurrent, randomized, controlled, blinded study. That would be quite an undertaking. If the incidence of autism spectrum is 0.006 then detecting a 30% reduction (with the usual alpha 0.05 and beta 0.9) would require over 50,000 subjects. Maybe it’s unethical to deliberately not vaccinate 25,000 children. But there are other kinds of evidence than the gold-standard trial. Consider non-concurrent controls: in Japan, when MMR was halted, autism didn’t decrease. Consider non-randomized self-selected studies: in Denmark, a case-controlled population study compared vaccinated vs unvaccinated children and found no significant difference in autism rates (NEJM 2002 v347(19)p1477). And so on. Lots of studies out there comparing vaccinated and unvaccinated children. a few minutes with PubMed should satisfy Kirby’s hunger for knowledge.
#6 T. Bruce McNeely
March 4, 2009

David, I’m sure that Kirby knows about these studies that you refer to. I think that he chooses to dismiss them because they don’t support his meal-ticket delusion. Nothing short of a Tuskegee Syphilis-type study would satisfy this asshat (and even then, he would probably find some way to dismiss it).
#7 Donna B.
March 4, 2009

On Kirby, agreed. He’s at best, a jerk.

But, to state again, my question on one of the Harkin posts, why, oh why, do people want so much to join him in these delusions? There are no financial incentives for the people who self-enroll their children willingly into this massive vac v unvac trial, are there?
#8 Heraclides
March 4, 2009

David & Bruce:

I would be fairly certain Kirby does. If my memory serves me well, Kirby replied in a blog thread that included references to these.
#9 The Blind Watchmaker
March 14, 2009

He and others have penetrated the barber shops of middle America.

I was waiting to get a haircut today. The shop was busy. The 3 barbers were in a chatty mood. A guy in the chair complained that his son has allergies. The older, “wiser” barber then shared his observations.

(Paraphrased)”We never had all these problems before. If you ask me, it’s all these chemicals we are injecting into our kids. I mean, what the heck are doing? All them big companies who profit off of every baby born. Somethin’ ain’t right. I have a friend who is a doctor and he never had his 3 kids inoculated. They’re all grown up, gone to college and just fine. Now what does that tell ya?”

Lots of nods from the customers and other barbers.

My heart rate was high. What was going on? Are they blaming allergies on vaccines? Are they insane? Doesn’t anybody think rationally?

Then I calmed down. It is not the fault of “Joe Plumber” that people are misinformed. It is the fault of those of us who are informed. Those of us who understand the science, who have read the studies and who have not communicated the science to the people in the same, savvy way that the pseudo-scientists have communicated their message.

The anti-vaccinationists have the advantage. They “speak out to the little guy”. They oppose the big, nasty corporations. They snicker when scientists start talking about p values and statistics. They use logical fallacies to short-cut their way around facts. They speak in common language.

I felt the urge to speak up and start educating. Maybe I should have. I felt outnumbered. I looked over at the books and magazines provided for my waiting pleasure. I noticed a disproportionate number of Ann Coulter books. Not the right time. Not the right audience. I just wanted a haircut.
#10 The Blind Watchmaker
March 14, 2009

Kirstin Sanford makes our point.

http://skepticblog.org/2009/03/13/creating-a-science-sensation/