Paper finds mercury *does* cause autism?

Lest those who support the vaccine-autism link accuse me of ignoring this by not jumping on it immediately, I want to briefly point out a new study suggesting autism rates decline as thimerosal has been removed from childhood vaccines. From the press release:

A new study shows that autism may be linked after all to the use of mercury in childhood vaccines, despite government's previous claims to the contrary.

An article in the March 10, 2006 issue of the Journal of American Physicians and Surgeons (JPandS.org) shows that since mercury was removed from childhood vaccines, the alarming increase in reported rates of autism and other neurological disorders (NDs) in children not only stopped, but actually dropped sharply -- by as much as 35 percent.

Using the government's own databases, independent researchers analyzed reports of childhood NDs, including autism, before and after removal of mercury-based preservatives. Authors David A. Geier, B.A. and Mark R. Geier, M.D., Ph.D. analyze data from the CDC's Vaccine Adverse Event Reporting System (VAERS) and the California Department of Developmental Services (CDDS) in "Early Downward Trends in Neurodevelopmental Disorders Following Removal of Thimerosal-Containing Vaccines."

The numbers from California show that reported autism rates hit a high of 800 in May 2003. If that trend had continued, the reports would have skyrocketed to more than 1000 by the beginning of 2006. But in fact, the Geiers report that the number actually went down to only 620, a real decrease of 22 percent, and a decrease from the projections of 35 percent.

(More after the jump)

I've not read the study yet, but there's already some commentary here pointing out some flaws. I'll add another I can see just from the abstract: they again used the VAERS database. Actually, checking out the authors, I see it's again the Geiers, who Orac mentioned here have a history of mining VAERS for these sorts of connections, rather than carrying out careful epidemiologic studies (such as the oft-mentioned Danish study. So on the surface, this study looks bad in all sorts of ways, yet I predict proponents of the thimerosal-autism connection will herald it as a new study that "proves" that connection.

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As I looked over the ol' blog last night, I was shocked to realize that I haven't blogged about the antivaccine movement and its offenses against science in nearly three weeks. That's right! The last time I did a vaccine post was when I examined a particularly egregiously bad paper from a couple of…

I know nothing about this but is it in any way connected to the proposed link between the MMR vaccine and autism?

Thanks

By Mark Frank (not verified) on 05 Mar 2006 #permalink

Hi Mark,

Yes, it's all related. The MMR was the first vaccine singled out to play a role in the development of autism (in a study that has since been discredited, and several of the co-authors asked to have their names removed from it). Nevertheless, it triggered a number of subsequent studies, focusing on thimerosal, a preservative used in many vaccines. The CDC has all kinds of fact sheets that you can find here.

No, it is not. MMR has never contained thimerosal. Not that the antivaxers don't keep making the mistake of claiming that it did or does.

In any case, I was trying not to comment on this study, as I had been blogging a lot about this lately and wanted to try to avoid turning my blog into an all-autism all the time. Unfortunately, it's looking more and more as though I won't be able to escape. A couple of physicians (who should know better) are pointing to this "study," as is Wingnut Daily (WorldNet Daily, for those not familiar with the website).

Damn you, Mark and David Geier!

Heh. I should clarify, since Orac and I seem to be contradicting each other. It's related because the thimerosal "controversy" is due largely to follow-ups to the MMR study--not because, as Orac notes, MMR contained thimerosal.

It's worth emphasizing that for all practical purposes, the Geiers are the only group who find links between thimersol and autism. The only ones. No one else who looks finds a link.

They've long since exceeded their Kook Threshold.

All this time I thought the increase in autism was due to stressful, entrance-exam prep courses for 1-year-old candidiates for the best pre-pre-pre-K preschools in the larger cities.

By biosparite (not verified) on 05 Mar 2006 #permalink

There is an essay in PLoS medicine "Why Most Published Research Findings Are False" from John P. A. Ioannidis, with 6 corolaries, and some examples. I found the following near the end of the paper disturbing:

«[...] Such manipulation could be done, for example, with serendipitous inclusion or exclusion of certain patients or controls, post hoc subgroup analyses, investigation of genetic contrasts that were not originally specified, changes in the disease or control definitions, and various combinations of selective or distorted reporting of the results. Commercially available data mining packages actually are proud of their ability to yield statistically significant results through data dredging.»

You are not reassuring me.

What could possibly be the matter?

Since posting this earlier in the day:

"If it's Tuesday, it must be Belgium"

"If it's Thursday, it must be Nigeria"

So, since it's Sunday, it must be South Africa, si?

"I've written to both Anon II questions and I'll have a post up tomorrow.

Posted by: Tara | March 2, 2006 10:44 AM"

Posted by: bialy | March 5, 2006 10:59 AM

We have had several posts from dr. Smith regarding a variety of weighty matters (each surely as weighty as her vciuous attack on a *book* that began all of this an ice age ago), as well as a school marm irrelevant put down of poor Hank in which she displays her typical shallow and useless information, gleaned from undergraduate textbooks.

So what's the deal Smith? Are you ever going to keep your promise to Anon II and all the many readers of your nominated blog and provide ansers that match his questions in both civility and clarity?

Even your chairman is waiting to know.

PS / http://bialystocker.net/files/cancercult.pdf is up to 100+ downloads and

http://bialystocker.net/files/Pipedream.pdf is fast approaching 1500

and the Farber Harper's article has provoked a real panic among the Aids church parishoners like POZ and ActUp and Tac, although the BOD and principal shareholders have thus far wisely kept their mouths shut.

To:

Tara C. Smith and "Aetiology" blog:

This long post is offered to correct and clarify statements made on your blog that arebased largely on misinformation or incorrect assumptions.

The new study that you cite was not based on the VAERS database alone. Rather it compared three separate databases, VAERS, the California CDDS database, and the Department of Education database. The point of the study is that each database, independent of each other, found decreases in neurodevelopmental disorders and autism coinciding with the removal of thimerosal from vaccines, and each database validated the findings in the other. In addition, although your criticize the VAERS database CDC researchers have themselves published studies and used the VAERS for purposes similar to the use made of the database by the Geiers over the last several years.

As to the Geiers �failure� to conduct other kinds of epidemiological studies, rather than use the VAERS database, your comment is misplaced. First, let me repeat that there exists nothing improper with use of the VAERS in the way the Geiers have used it; the CDC has done the same � I can provide citations to CDC studies using VAERS. Second, the point of the Geiers new study is that they were not simply relying on VAERS but also on the two other independent databases, one of which, California, is especially highly regarded as it registers in its data only full blown diagnosed DSM-IV autism, and not the broader categories of autism spectrum disorders. Third, the Geiers have made serious and extensive attempts to analyze data from the VSD (Vaccine Safety Datalink), a database maintained by the CDC. The CDC has placed serious obstacles in the way of the Geiers� access to the VSD. The Institute of Medicine severely criticized the CDC�s handling of the VSD database in a report issued in 2005, citing lack of transparency, lack of access by outside researchers and going so far as to suggest there existed violations of law in handling the database. The CDC has �farmed out� custody of this database to a private corporation, placing further obstacles to access to it, despite the fact that this database is paid for by the American public. The Geiers preliminary look at the VSD has suggested there exist strong associations between thimerosal and neurodevelopmental disorders, including autism, in the data contained in the VSD. Next, careful epidemiological studies, as you describe them, are exceedingly difficult to conduct because they are very expensive, costing millions of dollars. That is why many people have been campaigning for Congress to allow outside researchers to conduct research using the VSD, and for epidemiological research comparing vaccinated vs. unvaccinated populations. There is legislation pending in both areas. If we are honest about this controversy we should all support legislation that will require studies both using the VSD and comparing the referenced populations.

If you read the Geiers new study you will note that the modest and reasonable conclusion they draw from their examination of the three databases is that their findings suggest that more research should be conducted, a finding contrary to the 2004 IOM study that discouraged any such research. Surely, since you advocate care epidemiological studies you should support this recommendation, as only through more research will we know the answer to the very important question of whether mercury in vaccines has caused some cases of the syndrome called �autism.�

You cite the Danish studies as �careful� epidemiological studies yet you fail to note serious shortcomings in those studies. The most glaring fact is that the rate of autism in Denmark is about 10% of the U.S. rate and that that Danish vaccine schedule never exposed children to as much mercury as early as did the U.S. schedule in the 1990�s. Denmark removed mercury from vaccines in 1993, as did most European countries in the late 1980�s and 1990�s. The reason for the removal was safety concerns.

While beyond the scope of this post, please also know that there are serious problems with data handling in the Denmark studies. In one, for example, outpatients were added to the data in the middle of the study, while before that only hospital inpatients were counted. Since most persons afflicted with autism are outpatients this late addition certainly makes the findings of that study suspect.

Yes, there should be a careful epidemiological statistical evaluation of the U.S. population. Why is the effort to get such studies completed being frustrated?

One poster on your blog asks whether this study and the thimerosal controversy have anything to do with the MMR controversy. The answer is that there is no direct connection because the MMR vaccine never contained thimerosal or mercury. It is a live virus vaccine that is incompatible with a bacteriostatic agent like thimerosal. That said, please understand that the same children who received thimerosal-containing vaccines also received MMR, many times at the same time in the same doctor�s visit. Some have theorized an interaction between the two, but the answer for now is that the MMR controversy is separate from the thimerosal controversy.

Contrary to the assertion of another poster the MMR controversy did not �trigger� the �subsequent� thimerosal studies. The concern about thimerosal was an independent development in the USA when, in 1997 the Congress mandated an inventory of all medical uses of mercury and it was discovered that mercury was used in vaccines. A 1998 study (Stajich) found mercury blood levels in babies given the birth dose of Hepatitis B vaccine to be excessive and this triggered concern. That is what triggered the concern in the US, not the UK MMR controversy. Also, Dr. Wakefield�s work on the MMR published in the Lancet in 1998 has never been �discredited.� His findings stand despite extreme pressure in the media and by the UK government and public health authorities. Dr, Wakefield found evidence of a unique intestinal disease, ileal nodular hyperplasia and characteristic inflammation in the guts of a small number of children with autism. This caused a furor even though Dr. Wakefield merely called for more research. Several US researchers have since confirmed the finding of intestinal disease in many US children. Dr. Wakefield and others have found vaccine strain measles in the cerebrospinal fluid (and brain) and in gut biopsies of autistic children. Studies that will be unveiled this year will likely confirm the same thing in a large group of children. No matter how devoted one is to public health (and I believe in public health) it must give one grave pause to discover that live vaccine strain measles inhabits the guts and brains of children with autism.

Unlike the assertion of one of your bloggers it is not �wingnuts� who are concerned about this issue, but many parents of children, some of whom have autism and others who simply want to keep their children healthy.

Another post suggests that the Geiers are the �only group� who find links between thimerosal and autism. �No one else who looks finds a link� is the assertion. Nothing could be further from the truth. There are many other epidemiologists who have reviewed the Geiers work and find it compelling. Many, many researchers have looked at the toxicological, immunological, endocrinological and metabolic effects on children with autism and believe there exists strong evidence of a link. This includes one scientist who edited the journal Environmental Health Perspectives at the NIEHS for many, many years. Researchers at George Washington University, Northeastern, Columbia, U. Kentucky, U. Nebraska, MIT, U. Arkansas, Baylor, Wake Forest, U. of Arizona and many other reputable institutions have found evidence of a link.

Please be careful whom you call �Kooks� as you may find the evidence showing that you are the kooks for unfairly doubting evidence of a major health problem for many children in our country.

Finally, the quote from Ioannidis�s article �Why Most Published Research is False� posted by one person on your blog is apt � the only published study based on the US population and published in Pediatrics was based on the VSD, mentioned above. This study is cited widely, by the 2004 IOM report and by the CDC as supporting the idea that there is no connection between thimerosal and vaccines. But the CDC�s handling of the VSD on which this study was based was subsequently severely criticized by an IOM report issued less than one year after the 2004 IOM denying the thimerosal � autism link. This calls the CDC's study into question as the product of data manipulation. Most importantly, the lead author of the US Pediatrics study, Thomas Verstraeten, stated in a letter to Pediatrics that his study should and could not be used to prove there was no association between thimerosal and autism; it was not a negative study as Verstraeten said, the study could only point the way to additional research. Thus, based on its lead author the CDC was misusing its own study.

So much for scientific and public health integrity.

I can cite to authority for every statement I have made above. I sincerely hope this clarifies some points and enhances the level of your discussion of the link between autism and thimerosal or autism and the MMR vaccine. It is not very helpful for you to simply dismiss the idea that mercury (it is after all a known highly potent neurotoxin) in vaccines may have caused problems in the developing brain as the product of KOOKS, nor is it helpful for you to dismiss Dr. Mark Geier, who has distinguished himself in the publication of more than 100 studies of vaccination over the past two decades or so. The subject of our children�s health, and you might ask why we have such an increase of chronic disease in our children, warrants serious consideration.

Robert J. Krakow, NY, parent and attorney

By RJ Krakow (not verified) on 05 Mar 2006 #permalink

I was not taking sides in this debate, I'm not qualified to do that (although I do understand statistics). My comment was about the fact that all of this is supposed to be peer reviewed work and I'd rather see people concentrating in the possible scientific flaws, like in the link provided by Tara, than in things like number of researchers behind each camp. This subject interests me and I'd rather not read a flame war like the one about the Padian paper.

Sorry, Tara. I won't post again, for me this thread is dead. Not being from the USA I wasn't aware that the Journal of American Physicians and Surgeons had let's say political "issues".

Also, Dr. Wakefield�s work on the MMR published in the Lancet in 1998 has never been �discredited.�

LOL! You've got to be kidding. Were you aware that 10 of the 13 authors of that study disavowed it?

Brian Deer eviscerated Wakefield's work.

It is not very helpful for you to simply dismiss the idea that mercury (it is after all a known highly potent neurotoxin) in vaccines may have caused problems in the developing brain as the product of KOOKS, nor is it helpful for you to dismiss Dr. Mark Geier, who has distinguished himself in the publication of more than 100 studies of vaccination over the past two decades or so.

Straw man argument. What is being contested is whether mercury causes autism, not whether it might cause neurologic problems (which has not been proven at the doses given in vaccines). The available evidence indicates that it doesn't. As for Dr. Geier, the only thing he's "distinguished himself in" is in dubious science and quackery. Let me ask you: Do you approve of his latest quackery: chemical castration of autistics with Lupron because he thinks testosterone binds to mercury and makes it more difficult to chelate, a concept that has no science behind it whatsoever? Even die-hard advocates of the mercury-autism link and chelation as the treatment for autism are having a hard time swallowing Dr. Geier's latest.

As well they should.

Finally, reading their latest paper, I see no mention of their using three databases, just VAERS and the CDDS database.

Finally, do you know why the Geiers couldn't use the Vaccine Safety Datalink? The CDC and their IRB shut them down because they tried to reconstitute the database in a way that could have compromised patient confidentiality and tried to take files that they were not supposed to take by intentionally renaming them. And, yes, I have citations for this allegation as well. In addition, they both make a considerable amount of money providing expert testimony and legal resources to parents suing VCIP.

With the Geiers, you're backing the wrong horse.

Tara and Orac thanks. Living in the UK, I am quite familiar with the MMR controversy but I had never heard of thimerosal.

By Mark Frank (not verified) on 05 Mar 2006 #permalink

"Another post suggests that the Geiers are the �only group� who find links between thimerosal and autism. �No one else who looks finds a link� is the assertion. Nothing could be further from the truth."

Papers then please....

You know, I thought it would have been simpler to demonstrate that thimerosol/mercury could do the specific kinds of neuronal 'damage' seen in autism first. Mercury tends to be a little like a nuclear weapon when it does damage to the nervous system and I would like to know the mechanism that causes it to suddenly perform brain surgery. After all, thimerosol seem to fail in causing a massive increase in disorders of the peripheral nervous system (which if it could damage the nervous system you would expect it to as well as the brain).

Why hasn't it?

You cite the Danish studies as �careful� epidemiological studies yet you fail to note serious shortcomings in those studies. The most glaring fact is that the rate of autism in Denmark is about 10% of the U.S. rate and that that Danish vaccine schedule never exposed children to as much mercury as early as did the U.S. schedule in the 1990�s. Denmark removed mercury from vaccines in 1993, as did most European countries in the late 1980�s and 1990�s. The reason for the removal was safety concerns.

No, the reason for the removal was that thimerosal wasn't necessary, and Statens Serum Institut has a principle of not including things that are not necessary. The flu vaccinations still contains thimerosal - had there been safety concerns, they certainly wouldn't.

Also, how is it a shortcoming that the numbers are different in Denmark? That would seem to validated the point that there is some other cause than thimerosal. Maybe genetic, as is quite often suggested these days?

While beyond the scope of this post, please also know that there are serious problems with data handling in the Denmark studies. In one, for example, outpatients were added to the data in the middle of the study, while before that only hospital inpatients were counted. Since most persons afflicted with autism are outpatients this late addition certainly makes the findings of that study suspect.

This is an interesting concept - could you perhaps explain to me what there differences between in- and out-patients are in Denmark? Where people are checked for autism? If people disagnosed at specialist clinics are considered in- or out-patient?
Actually, could you perhaps describe the Danish health system to me and others?

The reason why I am asking, is to see if you are just parroting talking points by SafeMinds - an organization that made cliams about liability without even checking the Danish laws.

By Kristjan Wager (not verified) on 06 Mar 2006 #permalink

Teaching and lecturing heavily today, so I won't be around until later this afternoon, but just wanted to point everyone to Orac's thorough takedown of the paper.

The Journal of American Physicians and Surgeons is more of a political publication than a medical one. It is not even indexed in PubMed.

Just read a few back issues to get a flavor of purpose. I've posted this elsewhere, but I remember when it changed from "Medical Sentinal" to the JAPandS...

That was very interesting. Especially their choice of publication.

One the benefits of being around this kind of discussion for almost a decade is that one can have a historical perspecitive.

I actually remember when AAPS changed their website journal (it used to be "Medical Sentinal"). Anyway, I posted this on Kevin Leitch's blog, but it bears repeating.

Okay, about that journal and its group. One of it members, Jane Orient (was an Executive Director) participated in the Healthfraud listserv for a while.

I spent more than a few minutes digging up some of her posts and responses to her in its archives:

Threads she participated in (click on the threads to read them), the healthfraud listserv archives are not user friendly.

A notice of her suspension.

And finally a notice of Jane Orient and her Antivaccination Gang , actually an announcement that AAPS is online.
...

This is the entire thread (she does respond, saying she is being gagged).

If you have time, it is sometimes fun to click through some of those older threads to see what has come and gone.

I wonder if I am unblocked now?

Let's see:

"What could possibly be the matter?

Since posting this earlier in the day:

"If it's Tuesday, it must be Belgium"

"If it's Thursday, it must be Nigeria"

So, since it's Sunday, it must be South Africa, si?

"I've written to both Anon II questions and I'll have a post up tomorrow.

Posted by: Tara | March 2, 2006 10:44 AM"

Posted by: bialy | March 5, 2006 10:59 AM

We have had several posts from dr. Smith regarding a variety of weighty matters (each surely as weighty as her vicious attack on a *book* that began all of this an ice age ago), as well as a school marm irrelevant put down of poor Hank in which she displays her typical shallow and useless information, gleaned from undergraduate textbooks.

So what's the deal Smith? Are you ever going to keep your promise to Anon II and all the many readers of your nominated blog and provide answers that match his questions in both civility and clarity?

Even your chairman is waiting to know.

PS / http://bialystocker.net/files/cancercult.pdf is up to 100+ downloads and

http://bialystocker.net/files/Pipedream.pdf is fast approaching 1500

and the Farber Harper's article has provoked a real panic among the Aids church parishoners like POZ and ActUp and Tac, although the BOD and principal shareholders have thus far wisely kept their mouths shut."

And I now add that we are almost back in Belgium. Or did the Rover break down in some AIDS decimated village between Lagos and Soweto where the mechanics were all at the local brothels with the lorry drivers making sure everybody was a victim of the deadly virus.

Bialy, can you stay on topic? This post has nothing to do with AIDS etc.

By Kristjan Wager (not verified) on 06 Mar 2006 #permalink

He's just avoiding the anthrax post. I notice both he and Hank are conspicuous by their absence there.

Bialy can spam that post with his pointless babble and the ego-inflating repetitious linking to his own website as well as he can any other random thread.

No, I ain't conspicuously absent, Hell, I got stuff to do! Is this an invitation to post re anthrax? I didn't want to make a pest of myself.

Barnes, Hank

p.s. Simple question re autism: After thimerosol was removed from vaccines, did autism rates decrease, increase or stay the same?

Should be very easy to answer, and I don't understand all the fuss.

By Hank Barnes (not verified) on 06 Mar 2006 #permalink

Sure, Hank. Consider it an invitation to answer *all* the questions posed to you that you've ignored.

Regarding thimerosal, I already pointed you to the Danish study. And while studies are never "easy" as you suggest, they do take time to plan and conduct when done correctly. I'm sure someone's probably already looking into your question with a study in the US; what the Geiers tried to do was take a shortcut, but as Orac pointed out, their results aren't worth the paper they're printed on.

And as others have pointed out already, if thimerosal is indeed essentially the cause of autism, then the incidence of diagnosed autism should over the next couple of years plummet dramatically in the U.S.

I probably won't, but this probably won't affect the anti-vaccine crowd either.