Vaccines and autism--can we stick a fork in it now, please?

Last fall, I wrote about a new research paper which tried to replicate some of Andrew Wakefield's original results, which not only claimed a correlation between MMR vaccination and autism, but also the presence of measles virus in intestinal tissue. Wakefield had suggested that an inappropriate response to the presence of measles virus in this tissue may trigger conditions such as bowel disease and autism. The more recent study was unable to replicate any of Wakefield's findings--not surprising, since so many papers in the last decade have found no connection between vaccination and autism.

There are plenty of reasons why the study may not have been replicated. The design of the new study was a bit different from Wakefield's (case-control versus a case series); it had larger numbers; investigators were blinded to the status of the patients and so less likely to bring in bias. However, a recent investigation by the Sunday Times (London) has another reason why the results of the two papers differ: Wakefield made up his data. More after the jump...

From the Times Online:

Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients' data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children's conditions.

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

This is truly incredible. Even being familiar with Wakefield's statements over the past decade about his research, and his complete denial about studies that have contradicted his own findings, it's still pretty shocking that he completely made up data, and then pushed it for ten years as children around the world became ill and even died in light of his research. It's even more disgusting in light of the fact that I doubt this new information will change many minds when it comes to vaccination--the meme has already spread too far to let a little thing like atrocious scientific misconduct rein it in now.

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"Well, maybe this new info will fix the problem. The anti-vax crowd can move on other toxins and cause less problems."

Sadly I highly doubt it will.

By Poodle Stomper (not verified) on 08 Feb 2009 #permalink

The problem I have with the studies on vaccines is that MMR appears to be the only focus on both sides of this issue. In science, sides should not exist. What should exist is what consistently fits the data. Here is what I have gleaned so far, since I have a child with autism, I have a wife who is convinced that the vaccines are at fault, and I had to make a decision regarding vaccine exemptions and my daughter's school. There is a Dutch study that focused on MMR and autism. The study finds no relationship between autism and that particular vaccine.

Now, here's where I tear my hair out. I read that there is no known safe level of mercury for a child under six months. Before six months of age, my child had 26 or 29 vaccinations (I can't remember the number offhand). What if any of those had a mercury- or aluminum-based preservative?

Worse, the levels of mercury allowed at coal-burning power plants has been allowed to go up in recent years (my daughter is five, and it's within the time frame). A recent study linked rainfall to incidents of autism. Correlation isn't causation, but environmental mercury--which I told my wife could more easily be the culprit than the tiny amount of mercury in vaccines--is a possibility.

Furthermore, I heard just today that several samples of high fructose corn syrup, which is in just about everything sweet these days, contained unsafe levels of mercury when tested. It's in the juice boxes we give our kids sometimes (though we try to stick with organic and pure sugar, if my child consumes anything sweet). The damage could have been done during my wife's pregnancy. She laid off of anything with caffeine, but she still consumed soft drinks with high fructose corn syrup.

Everything I've read about autism tells me it is multi-causal. It's difficult to point to any one thing and say it's the cause. I'm becoming increasingly convinced that it's more environmental mercury than vaccines, but I think that if it is the vaccines, the damage is done well before MMR. People just point to it because that's when the symptoms appear, and MMR is one of those vaccines that usually comes in multi-dose containers and needs to be preserved.

I'd love to learn about any studies that rule out the vaccines that are given to children before six months. I haven't researched lately, but it always seems to be MMR, MMR, MMR. I'd love to turn the page on MMR and see what else we can rule out. In the meantime, my daughter needs help that I can't afford financially. I wish someone would find the cause so other people won't have to go through it needlessly.

I'm rambling, but I just want to throw one more thing out there: this sudden rise in autism could correspond with a shift in population genetics. Since a small amount more genetic information is added each time we reproduce, it's possible that part of our population is following an evolutionary path that is resulting in more children with autism. I've also heard that there's a correlation between older fathers and autism, so it's possible that all of the genetic information that's adding up every time new sperm is produced eventually results in autism. I need to explain what I mean a lot more for other readers, so I'm going to stop now.

Greg, this is the current vaccine schedule in the first 6 months (8 vaccines with 2 boosters of each)
Hep B x3
Diptheria x3
Pertussis x3
Tetanus x3
Pneumococcal x3
Polio x3
Rota virus x 3
Hib x3
There possibly would have been a flu vaccine. This is given to children of at least 6 months age between September and March of each year. This may have had some thimerosal in it, but there are mercury free versions.

For info about vaccines and constituents, see here:
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75744

You just absolutely cracked me up with that headline! How great to get a giggle related to autism. THANKS!

Lisa Jo Rudy
(autism.about.com)

Greg, while MMR was the focus of Wakefield's paper, most later studies did focus on other vaccines as well. Particularly when looking at thimerosal (the mercury-containing preservative), MMR isn't even included in those because as a live vaccine, the MMR never contained thimerosal. And studies carried out since the removal of thimerosal from vaccines (in the US and abroad) have not shown any decrease in autism--in fact, autism diagnoses seem to be rising still in spite of the fact that fewer children receive any exposure to thimerosal.

Paul Offitâs book on the vaccine hysteria points to some eerie similarities to AIDS denialism. Wakefield and Duesberg have more than a little in common. The cottage industry that grows around hysteria looks like the denialists. Pseudoscience is embraced over science. Selective reviewing and cherry picking. Conspiracy thinking. The harm caused is even the same - refusing the benefits of modern medicine. The parallels are striking and will undoubtedly be denied.
Seth Kalichman
http://denyingaids.blogspot.com

Lisa,

I enjoyed the headline too. The image of the autism-vaccine connection being "done like dinner" is a great one.

So, then, why did you put a "balanced" article about this on your about.autism blog? As you can see from the list posted on Liz's blog (she linked to it above), the weight of the response has been pro-Deer, anti-Wakefield. It would be nice if you added a few more links to this side of the story.

By Broken Link (not verified) on 09 Feb 2009 #permalink

I'm rambling, but I just want to throw one more thing out there: this sudden rise in autism could correspond with a shift in population genetics.

More likely it's mainly the result of diagnostic substitution, and not a real increase at all. IOW, some conditions which were once given other names (e.g. 'mental retardation') are now recognized as the more specific condition of 'autism', becuase of increased awareness both of physicians and of parents.

Tara writes:

It's even more disgusting in light of the fact that I doubt this new information will change many minds when it comes to vaccination--the meme has already spread too far to let a little thing like atrocious scientific misconduct rein it in now.

No doubt it will merely be seen as yet more confirmation of the persecution of poor Dr. Wakefield.

Absolutely, now that mercury has been discovered in HFCS, there is a new target.

on the issue of mercury contamination of high fructose corn syrup that Greg mentioned:
the samples, mostly from baked goods, were all very close to the lowest level of mercury the test was able to discern, and all were less than 1/1000 of the limit for mercury in fish (I don't know what the limits for mercury in baked goods is).

I read that there is no known safe level of mercury for a child under six months.

You need to understand science-speak to disentangle a statement like this.

Here's what it does not mean: It does not mean that "any amount of mercury is harmful to a child under six."

Here's what it does mean: Nobody has ever intentionally given known amounts of mercury to children under six to determine what level is harmful.

On the other hand, there have been cases of accidental exposure of populations, including children, to mercury. Mercury poisoning is bad, it causes neurological symptoms, but they don't much resemble autism.

There are good reasons to minimize exposure to heavy metals like lead and mercury, but the likelihood that they have anything at all to do with autism is very, very small.

It is certainly true that unvaccinated children get autism. The antivax group Generation Rescue did a telephone survey, expecting to prove that unvaccinated children did not get autism, but they actually found the opposite: Not only were unvaccinated children no less likely to have autism spectrum disorders, but unvaccinated girls were actually more likely to have ASD

Wow. So the best evidence that Mercury is safe comes from epidemiological studies after it's removal. Shouldn't the evidence for a potentially toxic substance, thats very toxic in very small amounts like mercury, come before it's in major use in pre clinical experiments?

Did the CDC have a crytsal ball and knew without any studies that in the future when the potentially toxic was taken out there would be not be a connection? They didn't.

Hypothetically using their Guinea pig way of proving safety, the FDA should not test drugs in pre marketing studies, they should just put it on the market, if people get more sick then they can blame the drug and remove it from the market, if they are just as sick or less sick than the drug is safe. Brilliant logic. Never mind the millions of people that could die using this protocol. The CDC cannot ever be in error.
You guys are weird. Seriously.

I'm not as familiar with this as the other commentors are, apparently, but how have Wakefield/anti-vaccine community responded?

You need to understand science-speak to disentangle a statement like this.

Here's what it does not mean: It does not mean that "any amount of mercury is harmful to a child under six."

Just to underscore the point, there's no such thing as zero mercury in the environment we live in. It's a naturally occuring element found at low levels everywhere. If you'be been swimming in the ocean, you'vr been swimming in 10 ng/ml Hg or thereabouts. I'm not saying any concentration is safe, just that zero concentration is not reality.

"Wow. So the best evidence that Mercury is safe comes from epidemiological studies after it's removal. Shouldn't the evidence for a potentially toxic substance, thats very toxic in very small amounts like mercury, come before it's in major use in pre clinical experiments?"

First Cooler complains that these vaccines cause autism, then when they are shown NOT to (thus supporting safety studies required by the FDA prior to using a product on people), what does he do? Does he admit he was wrong? Nope, he just complains some more. There is no making you happy, Cooler.

By Poodle Stomper (not verified) on 12 Feb 2009 #permalink

Cooler,

Have you heard anything about the dangers of DHMO, Dihydrogen Monoxide?

There is contradictory evidence now. There is only one Study that looks at the rate of Autism in America after removal, that was the California study in 2007 that didnt show a decrease, nevertheless, even the authors of the study cautioned about making sweeping statements about the results of the study.

The study was only epidemiological, other studies not based on a correlation have shown a connection, three studies have shown kids have higher urine rates of markers of mercury poisons(poryphrins), and 12 monkeys inoculated with the heavy thimerosal load showed signs of brain damage while controls didn't.

Most rational people would look at the data and say "I don't know, and it was a mistake to ever expose infants to 100 times the EPA's safe limit of methlymercury without any pre clinical testing" (Ethlymercury, contrary to the propaganda of the CDC is even worse, A scientist from the University of Washington injected both forms of mercury and found ethlymercury to be even more distributed in the brain)

Irrational and mentallly unstable people would say religiously that everyone that questions mercury is a nut, dismiss studies that show a connection, and embrace others that don't.

Rnb,
Ingest an equal amount of DMHO and mercury and see what's more toxic. Another fallacy from people who always claim to be "rational" and "scientific."

Two Forks.
The New York Times reports today that special masters (i.e., judges) appointed by the U.S. Court of Claims to hear cases for the federal Vaccine Injury Compensation Program have decided hands-down that there is no link between vaccines and autism.

Ha. DMHO is water. I'd give you credit for that joke, too bad you borrowed it from elsewhere, as usual. Have anything original? Doubt it.

Cooler,
Care to cite your studies? Not only has the link of vaccines to autism never been confirmed, the person who started the craze is found to have fudged his data to support his view (nevermind that he also had taken out a patent on his own version of the measles vaccine a few months before his paper hit the Lancet). I wonder why you were so quick to accept accept his findings as fact when you cite "financial motivations" as cause to doubt the integrity of HIV researchers. Can you do it Cooler? Can you admit that you were wrong? Can you admit that the man that started the whole vaccine-autism scare you buy into did so by manipulating data the way you've claimed HIV researchers did? Can you step up and admit you were wrong or will you simply play the part of the hypocrite?

"Ha. DMHO is water. I'd give you credit for that joke, too bad you borrowed it from elsewhere, as usual. Have anything original? Doubt it."

Give him at least a little credit since it took you two hours to figure it out ;-)

By Poodle Stomper (not verified) on 12 Feb 2009 #permalink

"The New York Times reports today that special masters (i.e., judges) appointed by the U.S. Court of Claims to hear cases for the federal Vaccine Injury Compensation Program have decided hands-down that there is no link between vaccines and autism."

While its nice that the courts have sided with science in this case I truly wish that science and not courts would be the deciding factors in such lawsuits. A judge or jury can be swayed or fooled by the right lawyers. Look at poor Charlie Chaplain who had to pay child support for a child that couldn't have been his at a time when the common public didn't understand the science behind blood-typing.

By Poodle Stomper (not verified) on 12 Feb 2009 #permalink

Cooler,

Are your claims about mercury something you came up with yourself,
or are you just parroting something you've heard from someone else?

Here is another thread where References for the studies I mentioned were posted.
http://scienceblogs.com/aetiology/2008/09/oh_lets_go_back_to.php

Anyways, I really don't feel like debating the same thing over again, especially when the position of most rational people is that they don't know for sure, and even if there is not a link, it's very dangerous to inject children with hundereds of times the EPA's safe limit of mercury without testing the thimerosal containing vaccines in combination beforehand.

You guys basically only have one study that looks at the rates of Autism in the United States after Thimerosal's removal, the California study. Correlations might not detect susceptible populations, these sensitive people might only be detected diagnosed properly in the labratory.

A new study from UC davis just came out that states that the increase in autism is environmental, not the result of genes or more diagnoses.

"it's very dangerous to inject children with hundereds of times the EPA's safe limit of mercury without testing the thimerosal containing vaccines in combination beforehand."

You do understand that mercury and thimerosal aren't the same thing, right? You do understand that the EPA limit for mercury is not going to be the same for ethyl mercury or methyl mercury or any other mercury compound? You do understand why none of these are mercury or the same as mercury don't you?

Anyways, I really don't feel like debating the same thing over again, especially when the position of most rational people is that they don't know for sure, and even if there is not a link, it's very dangerous to inject children with hundereds of times the EPA's safe limit of mercury without testing the thimerosal containing vaccines in combination beforehand.

The EPA's "safe" level for mercury is a level that is so very far below the levels that have been found to be harmful as to be considered safe for water--that is, it is considered safe to ingest that level of mercury every day.

What is more, that is not for the form of mercury that was used in the vaccines, but for another form that is eliminated from the body more slowly, and thus is more likely to accumulate.

Of course, the only ethical way to estimate a safe level of mercury for humans is from epidemiology. To do it experimentally, one would have to give increasing known doses of mercury to human infants until they started to exhibit toxic effects. Are you going to volunteer your own kids for that study, cooler? If not, isn't it a bit hypocritical to be outraged that it has not been done? Of course, even if you could find subjects, no scientist would do it; it would be quite unethical.

Those who are upset about the mercury that used to be in vaccines forget that it was not that long ago that mothers would paint mercurichrome (a halogenated organic mercury compound) on kids' scrapes and scratches. Of course, back when parents did that, the reported incidence of autism was much lower than today.

Hey, maybe the antivax crackpots have it exactly backwards! Maybe mercury protects against autism, and the reason autism diagnoses are rising is that kids aren't getting enough mercury. It's sort of a crazy hypothesis, but not nearly as crazy as blaming mercury for autism--at least it fits the epidemiological data. After all, as one country after another has reduced the use of mercury in vaccines, the autism rates have climbed.

I remember mercurichrome. Mom used to use it on my sister and I for cuts and scrapes. That could have direct contact
with body fluids.

You guys lie as usual, ethlymercury is worse than methlymercury when injected into monkeys it's deposited in the brain much more. But hey thats good, because ttrl says mercury is good for you and prevents autism!

"A newly-released primate study published in Environmental Health Perspectives (EHP), a NIEHS publication, is getting fluffy reviews today. The NIH-funded study, conducted by Dr. Thomas Burbacher, a University of Washington researcher, found that Thimerosal, best known for its use as an ethylmercury-based preservative in infant vaccines and pregnancy shots, is actually more toxic to the brain than methylmercury (MeHg).

MeHg has always been widely hailed as the greater of two evils, pushing ethylmercury out of the limelight as "most toxic." Burbacher's study, however, proves ethylmercury is more damaging because it crosses the blood-brain barrier at a quicker rate than MeHg. Once in the brain, ethylmercury converts to what's called "inorganic" mercury -- the more toxic form -- and is unable to be excreted.

In the actual study, Burbacher states: "There was a much higher proportion of inorganic Hg [mercury] in the brain of Thimerosal infants than MeHg infants (up to 71% vs. 10%). Absolute inorganic Hg concentrations in the brains of the Thimerosal-exposed infants were approximately twice that of the MeHg infants"

No, ttrl, no one is calling for human tests and using children as test animals like you did when you guys injected kids with high doses of ethlymercury with no knowledge of it's safety in the 90's.

They could have conducted a study like the one brubacher et al. did and this alone would warrant replacing mercury with another preservative.

The EPA's limit is based on the lowest dose people experienced an adverse effect to methlymercury divided by 10. Keep in mind most of these adverse events were recorded in adults not infants. So it does matter what the daily dose is, especially when the Thimerosal dose in the early 90's was at 10 times the effect at which adults experienced problems, of course the problem could be even more exacerbated in infants, since they weigh much less and their brains are not developed.

"Give him at least a little credit since it took you two hours to figure it out ;-)"

No. It actually took 5 seconds on google. It's pretty easy to figure out since the joke is 20 years old and borrowed from elsewhere, as usual.

Yes, Cooler, it took you 5 seconds... but of course your comments are TWO HOURS apart...

The rest of us just laughed when reading it.

Look, I'm sure you're well-intentioned (i'd like to believe it, at any rate) but a lot of the readership here has a scientific background. If you can believe it, some of us know what mercury does in the body, how it disrupts disulfide bonds... some of us actually have background in bioinorganic chemistry!

Your comments come across as conspiracy-theory-esque.

So, to summarize for yourself as well as other readers:
cooler lifted this summary from: http://monkeydaynews.blogspot.com/2005/04/study-shows-ethylmercury-used…

the actual article is available for free from pubmed central: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1280342&blobtype=…

So what is all the commotion about, you may wonder?
Burbacher's study, however, proves ethylmercury is more damaging because it crosses the blood-brain barrier at a quicker rate than MeHg.
*blink blink*
No such conclusion can be drawn from this publication.

Look, the half-life for thimerosal is a lot faster than MeHg. Brain concentrations were lower with thimerosal.
In fact, it says so: Brain concentrations of total Hg were significantly lower by approximately 3-fold for
the thimerosal-exposed monkeys when compared with the MeHg infants...

Notably, this trend is not followed in the blood, so if anything one might suppose that the Hg is spending less time in the brain. And as we read the paper, we see this is indeed the case.

The kicker for me is this gem:
In the actual study, Burbacher states: "There was a much higher proportion of inorganic Hg [mercury] in the brain of Thimerosal infants than MeHg infants (up to 71% vs. 10%). Absolute inorganic Hg concentrations in the brains of the Thimerosal-exposed infants were approximately twice that of the MeHg infants.

While this is true, this was a kinetics paper! And the half-life of the mercury is so... much... faster... for thimerosal! The very next paragraph explains this point:

The results of these studies indicated that damage to the cerebellum was observed only in MeHg treated
animals that had much lower levels of inorganic Hg in the brain than animals comparably treated with ethylmercury.

Someone else here is free to correct me if I'm mis-reading this bit of conclusionary data, but what they're saying is that the damage incurred from inorganic mercury from MeHg is worse than that incurred via inorganic mercury from ehtylmercury not because there's a difference in the inorganic mercury in the brain (there isn't), but because the half-life for thimerosal is so much faster for the ethylmercury than it is for MeHg. If the body is more efficient at clear the Hg, than it has less time to do damage in the brain.

The conclusion from this paper is the exact opposite of what you/the people you lifted this from are suggesting.

No, ttrl, no one is calling for human tests and using children as test animals like you did when you guys injected kids with high doses of ethlymercury with no knowledge of it's safety in the 90's.

They could have conducted a study like the one brubacher et al. did

You'll have to explain to us how a study that did not find any toxic effects of mercury could be used to determine a toxic dose for mercury.

The EPA's limit is based on the lowest dose people experienced an adverse effect to methlymercury divided by 10.

Actually, EPA standards are based upon analysis of epidemiological studies of prenatal damage due to long-term exposure of pregnant mothers to methylmercury, and include an additional safety margin related to concerns that levels of mercury too low to hurt people directly could result in concentration in fish to toxic levels. They are not applicable to single exposures such as vaccines.

http://children.webmd.com/vaccines/news/20080130/vaccine-mercury-leaves…
Web MD January 2008

Burbacher says that just because ethyl mercury is gone from an infant's blood soon after it receives a dose of thimerosal -- a half-life of just 3.7 days in the Pichichero study -- doesn't mean it's gone from the body.

"Just because it came out of the blood doesn't mean it is excreted from the body. It could have gone to the brain," Burbacher tells WebMD. "Although total mercury levels in the blood are lower following thimerosal exposure [than following methyl mercury exposure], mercury in the blood from thimerosal has an easier time getting to the brain than methyl mercury."

Cooler, you never did answer my above post (copied below in case you can't find it).

"Not only has the link of vaccines to autism never been confirmed, the person who started the craze is found to have fudged his data to support his view (nevermind that he also had taken out a patent on his own version of the measles vaccine a few months before his paper hit the Lancet). I wonder why you were so quick to accept accept his findings as fact when you cite "financial motivations" as cause to doubt the integrity of HIV researchers. Can you do it Cooler? Can you admit that you were wrong? Can you admit that the man that started the whole vaccine-autism scare you buy into did so by manipulating data the way you've claimed HIV researchers did? Can you step up and admit you were wrong or will you simply play the part of the hypocrite?"

By Poodle Stomper (not verified) on 12 Feb 2009 #permalink

No because Wakefield didn't found the antivax movement, he only dealt with the thimerosal free mmr. Besides Dr. Wakefield has responded to the hit peice, anyone who speaks out against the establishment is bound to be attacked sooner or later.

http://www.ageofautism.com/2009/02/dr-andrew-wakefield-responds-in-the-…

I don't know who is right in this case the reporter or Wakefield, but it's very telling how you guys mindlessly assume the reporter is right. Two words. Confirmation bias.

"I don't know who is right in this case the reporter or Wakefield, but it's very telling how you guys mindlessly assume the reporter is right. Two words. Confirmation bias."

Ah yes, the hospital records of the children in question contradict Wakefield's story and we are to assume he is just assume he is being attacked by the "establishment"? Sounds to me like you are the one who has blindly accepted this theory already. So lets look at this:

1) Wakefield was being paid by a lawyer for the antivax group (Jabs) seeking to sue vaccine manufacturers (had this situation been reversed and about HIV you would have cried "conflict of interest" by now. Strange that it doesn't bother you in this case).

2) No one unrelated to Wakefield has been able to reproduce his research (this should be VERY, VERY, VERY telling right here...VERY!).

3) The children's medical histories shows that the majority had symptoms PRIOR to the vaccinations, not after, and yet Wakefield claims they are linked to the MMR vaccine. Vaccines don't time-travel, Cooler!

None of this sounds strange to you? Are we to assume that Wakefield's dismissal of evidence against him as nothing more than an attack by the establishment is correct? Give me a break!

By Poodle Stomper (not verified) on 13 Feb 2009 #permalink

Can someone do a study on Maschosism and use cooler as subject? Seeing how often he/she just keeps on coming back for his/her ass whoopin', they must really be in to that kind of thing.
Keep it up, cooler. I gotta say, you are entertaining!
Thanks,
J. Todd DeShong

No, I just have fun exposing you guys as frauds and liars. The CDC says ethlymercury is so much safer because it leaves the body within a few days! Read the study the half life was 24 days for ethlymercury in the brain! Multiply the half-life by 5 and thats how long the entire toxin stays in the brain. 24 days x 5 is 4 months!

It takes 4 months for each thimerosal shot to leave the brain! And Offit for profit and you guys said its quickly gone in a few days! One can only imagine how much it can build up with multiple vaccines.

The CDC says ethlymercury is so much safer because it leaves the body within a few days! Read the study the half life was 24 days for ethlymercury in the brain!

Typically, you neglect to mention that, according to your own much-beloved Burbacher study, only a third as much ethylmercury gets into the brain in the first place, because it is eliminated from the blood so much faster than methylmercury. Considering that the methylmercury standards are set so low as to be safe for pregnant women being exposed to methylmercury for months on end (rather than a single brief exposure), there is no rational basis to expect any harm from thimerosal in vaccines. Which of course fits with the extensive evidence from multiple countries showing that the incidence of autism has gone up, not down, as exposure to mercury has decreased. If anything the evidence is more consistent with the hypothesis that mercury prevents autism.

Long time, no response to cooler.
Sorry.

Cooler, it is ironic that you QUOTE Burbacher in your response to my comment, where you parrot his criticism, CONSIDERING he is the author for the first study you call in to question.

It's also interesting that you went and shopped for another study because the first one didn't say what you said it was claiming.

You agree with the guy when he makes points about others studies in mercury, and then say his own study is crap.

The truth is that you don't understand the science and you're cherry picking / quote mining. Now, I've read the webmd site as well as the primary study that is being discussed in the webmd link. I can reply, but you're just going to cherry pick again.

For good measure, it's noteworthy what the response was to Burbacher's claim:
"There is a direct relationship between the amount of mercury in the blood -- and how long it stays in the blood -- and the ability of mercury to get into the brain to produce developmental problems," he says. "We did not prove there was not deposition of mercury in other parts of the body, but we prove that the half-life of ethyl mercury from thimerosal is low, excretion is high, and the kidneys -- an organ very sensitive to the effects of mercury -- were not damaged."

Wow, a non-scientific editorial-type piece from a biased anti-vax group like "Homefirst" must surely hold more water than actual scientific research...right?

By Poodle Stomper (not verified) on 18 Feb 2009 #permalink

Interesting, Stomper, that you would present the NEJM as your best effort to reassure us that because something is printed in it, it surely must be factual and unbiased. So lets look at it again and see who paid for the study, and see if they are biased or unbiased...

"Supported by grants from the National Vaccine Program Office and National Immunization Program, Centers for Disease Control and Prevention; and the National Alliance for Autism Research.

Well, first glance, and just a bit of common sense says the financiers are far from unbiased. But how about it being in the NEJM?

Pood, the former editor of the NEJM rag assures us that NEJM iteself is not to be trusted. Particularly older issues such as the 2002 issue you presented.

In 2002, Marcia Angell was the NEJM editor, Marcia Angells own words:

"This is an industry that in some ways is like the Wizard of Ozâstill full of bluster but now being exposed as something far different from its image. Instead of being an engine of innovation, it is a vast marketing machine.

"As the entrepreneurial spirit grew during the 1990s, medical school faculty entered into other lucrative financial arrangements with drug companies, as did their parent institutions. One of the results has been a growing pro-industry bias in medical researchâexactly where such bias doesn't belong".

and...

"As their profits skyrocketed during the 1980s and 1990s, so did the political power of drug companies. By 1990, the industry had assumed its present contours as a business with unprecedented control over its own fortunes. For example, if it didn't like something about the FDA, the federal agency that is supposed to regulate the industry, it could change it through direct pressure or through its friends in Congress".

Hmmm. So should we listen to Mr. Stomper? Should we listen to the big pharma interests who were, and still are controlling the media and government or groups such as homefirst who have no bias one way or the other?

But, lucky for big pharma, they still have their die hard supporters and pill pushers like you.... Oh, I forgot. You are not just their supporter. You are just one more of their minions who is supported by them and relies on their profit engines to make your own living.

By Joe's Mama (not verified) on 19 Feb 2009 #permalink

Joe's Mama

Your reply, if I ignore the vitriol, boils down to summarizing some of the concerns Marcia, as editor for the NEJM, has about pharma-sponsored research.

This point is a worthy of consideration.

It is, inherently, a conflict of interest. Even if the study is perfectly well-designed, that a party that stands to profit is funding the research presents as an issue.

However, there are methods to deal with this (e.g. a double-blind study in which the organizers of the study are not affiliated with the pharma) and full disclosure of funding must be made with the publication of the results.

This isn't a perfect fix, but it does tell you that it's a potential issue and how people attempt to ameliorate the situation.

Marcia does do a good job of highlighting problems in her book.
http://books.google.com/books?id=5DKwxAnhTygC&pg=PA8&lpg=PA8&dq=As+the+…

But let's get back to the issue at hand.

What if I told you that Marcia is ardently pro-vaccine?

What if I told you that medical studies about the effects of vaccines are doable and fundable without pharma because SO many people are vaccinated that one can make comparisons between a population given 1 type of vaccine, and another population given another?

Neither of the studies that I've already read in responding to comments in this thread have bizzaro funding issues; the kinetics and data speak for themselves.

I study drug resistance evolution as a phd student - I'm not funded by a drug company - I'm only interested in understanding how drug resistant fungus in AIDS patients comes about and how can it be prevented; does that make me one of these minions?

To others who are scientists/researchers - how do you respond to claims like this? I make nothing as a grad-student and this ranting and character-assassination makes me want to leave the computational biology research I do to become a software engineer.

The Vaccine Court's release of its opinion on Darwin's 200th birthday was fortuitous, seeing as the vaccine-autism faithful have a good deal in common with religious fundamentalists. They are so invested in their ideas that they ignore or attack any evidence to the contrary, and treat gaps in the opposing evidence as further proof in their favor.

The obscenity of the "anti-vax" movement is stupefying-- a campaign to reinstitute open sewers or ban refrigeration could scarcely threaten greater violence to the public health.

I have much more to say on this topic here.

"Interesting, Stomper, that you would present the NEJM as your best effort to reassure us that because something is printed in it, it surely must be factual and unbiased"

I find it more interesting that you consider this to be my "best effort". Many epidemiological studies have in fact refuted the link between vaccines or thimerosal and autism. I need not make an effort to prove it, it has been done for me. The problem is that vax/mercury-autism people like you want so much to believe its true that you don't give a rat's ass about what science truly consists of. You look past epidemiology and blindly follow the Wakefields and Geiers of the world. You claim that researchers are in the pocket of "big pharma" but fail to even glance at the exorbitant amount of money being made by the "alternative" autism "treatments" which are not only unproven in efficacy but also in safety. You fail to even consider that Wakefield's lab received a combined total of approximately 800 thousand dollars (or at least the British equivalent) to prove the link between MMR and autism for a lawyer wanting to sue vaccine manufacturers. While Wakefield initially lied about the sum he was paid, the financial documents were obtained and made public, forcing him to admit how much his lab had actually received. Of course I don't expect you to be bothered by this. You will simply discount this and apply a double standard, claiming true and REPRODUCIBLE science to be compromised and Wakefield and his ilk to be the only true voices of fact.

"But, lucky for big pharma, they still have their die hard supporters and pill pushers like you.... Oh, I forgot. You are not just their supporter. You are just one more of their minions who is supported by them and relies on their profit engines to make your own living."

Sorry, but the company for which I work is a specialized company that makes blood-derived therapies such as the ones used by hemophiliacs. I personally have nothing to do with vaccines, AIDS, thimerosal, or autism. However, before I worked here I worked in R&D for a nutritional supplement company and quickly left due to ethical issues I had with what I saw as the industry's use of half-truths and untruths to try to convince people to buy products that didn't work. I took a pretty big pay cut to do so precisely because I couldn't stand the idea of an industry that offered false hopes to people.

By Poodle Stomper (not verified) on 20 Feb 2009 #permalink

"To others who are scientists/researchers - how do you respond to claims like this? I make nothing as a grad-student and this ranting and character-assassination makes me want to leave the computational biology research I do to become a software engineer."

Just ignore it. It's the feeble, desperate jabs of a person who knows deep down they have an unsupported position but want it to be true anyway. When the evidence doesn't support what they want, the dismiss it and everyone associated with it by convincing themselves we're lying for money. If anything it reveals the shakiness of their position instead of strengthening it.

According the the trial on Cedillo's autism, Nicholas Chadwick, the research assistant who did the PCR for Wakefield's original paper stated that the results had all come out negative, with a few false positives. He had brought this to Wakefields attention. However, when Wakefield wrote up his paper, the results mysteriously changed to positives, causing Chadwick to request his name be removed it. This is reminiscent of Wakefield's older claims that Crohn's patients had higher levels of measles antibodies. When he made this claim at a national meeting, a member of the audience, David Brown stood up and refuted the results. David Brown, as it turns out, was the one who had performed the very tests that Wakefield was citing. Wakefield had to retract his statement but obviously his standard of science didn't improve. Sad

By Poodle Stomper (not verified) on 20 Feb 2009 #permalink

There's a lot of good information here (though there are more than a few personal attacks thrown in, and I'm not sure what they have to do with science). I'm a layman, but I do love science, I read a lot of literature, and I try not to jump to conclusions. That said, I want to make a few points on the responses to my post.

First, I never came to a conclusion about vaccines and autism because when I researched it, all I found was the study on MMR. I'm probably not looking in all of the right places, and I'm glad for the links posted in a few of the responses here.

Second, I have my daughter's shot records, and she received twenty-seven shots before she was six months old. I said "vaccines", but it was shots with boosters. I should dig them out and list them, but I think that point is probably moot, anyway, given my research and some of the information here. I can't find evidence that any sort of mercury-based preservative was in these shots. I heard something somewhere about how aluminum-based perservatives are used now, and that they have the same effect, but I can't fathom how that works when we drink out of aluminum cans all the time. I'm thinking it's based on rumor and conjecture.

Third, someone commented that we ingest mercury all the time, and that it occurs naturally. Yes, I know that. What I also know is that coal-burning power plants pump out more mercury than they should, have made fish unsafe for pregnant women to eat when it comes from certain bodies of water, and can cause the mercury levels in an area to become unsafe. I also know that the Bush Administration was working hard during the last few years of their regime to relax the standards on mercury emissions, and they succeeded in lifting some regulations. That bit of information does not sit well with me.

Fourth, the point about no known safe levels of mercury for children under six months came from a study regarding children under six montha and mercury poisoning. It is not the same as a study where children are injected with mercury to determine what levels are safe, but the fact that they haven't found a level that is safe in children under six months caused them to take action and swith preservatives. I'll have to find that study and post it, too. I don't expect people to take my word for it; I know that's not how science works.

Finally, I just wish someone would figure out once and for all what actually causes autism so the rumors and speculation would go away. Parents get really emotional about this issue because they want to help their children, and they don't think rationally about it. They want to look for someone or something to blame--and they often blame themselves.

Greg,
There have been several studies that have suggested very strongly that autism is mainly genetic in nature (with the possibilities of environmental triggers as well). Identical twin studies have shown that if one twin has an autism spectrum condition that the second has a 90% chance of developing it as well as opposed to 10% in fraternal (non-identical) twins. Unfortunately the studies also show that ASDs are affected by more than one gene which makes it difficult to pinpoint which ones are to blame. While certain things have been linked to a higher rate of autism, thimerosal, MMR, and other vaccines are not. While you are correct that ingesting and injecting mercury are two different things, the epidemiological studies exonerating thimerosal were done on vaccinated and unvaccinated children or children vaccinated with thimerosal-containing vaccines versus thimerosal-free vaccines. In either case, thimerosal and vaccinations have been shown not to cause Autism Spectrum Disorders.

I agree with you that parents of ASD children seek someone to blame. This is a very human response and I would hope that they do not blame themselves but at the same time as they seek out a culprit they need be vigilant for those who would prey on their vulnerability. Wakefield did just that. The lawyers (just my opinion...seriously, don't sue me, too, guys!) representing the parents in court against the vaccine manufacturers did that as well. Science is working out the causes and triggers of autism but to waste time and energy on disproved theories based on fraud and shoddy science only diverts attention, funding and manpower from seeking out the real cause.

By Poodle Stomper (not verified) on 22 Feb 2009 #permalink

The media and the pharmaco-petrol-military-industrial complex say one thing and at times blatantly print one thing and do another! Just because thimerosol or mercury is supposed to be out of the vaccine doesn't mean you can run with that info! Dr. Sherry Tenpenny states that since the announcement of discontinuing thimerosol/mercury from vaccines there is still vaccines that have been tested at random, and they still have the thimerosol/mercury. How are we to know unless we test anything ourselves. The scientific method teaches us to not have blind allegiance to info. we use to launch an investigation. Make sure there is no thimerosol/mercury in the vaccines "literally" to this day at this second you are reading this! Then move on with your hypothesis.
Another interesting note, is why a newborn or any baby for that matter, needs a hepatitis B vaccine? Off hand there are two major ways to get Hep. B... unsafe sex with contaminated persons, and blood contamination through blood transfusion or sharing of contaminated needles! Are these babies at the age for this behavior risk? And as if that wasn't enough they need a booster in less than the age of seven? Are they now at the behavioral risk age? Seems like the sheeple get scared into accepting vaccines under the phony guises of public health so these corporations that make vaccines can fatten up their wallets while they get in line for bailout money... Pharm. companies fund both sides of the political scene and then when their "bought and paid for" officials take office they make mandatory rules for vaccines to support the big pharm. giants. The FDA officials frequently are appointed on the basis of which firm gave the most in contributions and they get to control which drugs pass and which fail... If a small pharm. company makes a drug with real value the large Pharm. Company with FDA ties tries to buy it before it hits the market. If the small company won't sell the patent then the FDA will not approve it. We live in a world of legal mafia... sorry about the rambling...

By Trauamacowboy (not verified) on 22 Feb 2009 #permalink

Trauamacowboy,

Here is what gets me. You talk about "big pharma" and how they are doing everything for money, ect... but then you cite Dr. Sherry Tenpenny as an authority!? First, she is by no means unbiased. Not only is she very much biased on the anti-vaxer side but she is also very much into the woo of alternative medicines such as osteopathics.
Here, let me quote you from her website:

"Vaccination is built around a "belief system." We believe vaccines are safe; we believe vaccines are important to health; we believe the stories we've been told about vaccines being responsible for the elimination of smallpox and polio. "

Does that sound unbiased? Apparently the good "doctor" doesn't understand immunology, virology, history, or for that matte science in general. She certainly does not understand the scientific method if she believes that vaccination is based on faith. She is also very much financially involved in her BS as is obvious if you bother to go check out her "products" and books, DVDs, CDs and ect...that she sells.

Sorry, but if you want to be taken seriously you should maybe find some serious sources of information instead of rantings from someone as unqualified as her.

You say "The scientific method teaches us to not have blind allegiance to info" and I say this is very true; please applied it to yourself. Her arguments against vaccines are nothing more than scientific illiteracy and a complete lack of understanding of the scientific method. Don't believe me? Go back to the link at the top of this post and read the crap she posts toward the bottom of her page under "What facts do we know about vaccines?" with a scientific mind. If you can't find it I can always point it out later. Enjoy.

By Poodle Stomper (not verified) on 22 Feb 2009 #permalink

To cooler: This morning I had a couple olives. They get approximately 85% of their calories from fat. The FDA recommends I get no more than 30% of my calories from fat. Not only do I feel fine, olives are considered a health food. Perhaps this has something to do with the fact that we don't eat an all-olive diet. Do you get the point I'm making?

By Ace of Sevens (not verified) on 22 Feb 2009 #permalink

Poodle Stomper,

You think everything I said relating to Hep. B, the stock market, the FDA etc. comes from Dr. Tenpenny? I just made mention to the one thing of mercury still being in the vaccines even though the companies say they don't. What are you some government/corporate sponsored blogger looking to point thought somewhere else? Thats what spooks do for a living... Anyway be nice and think if babies being immunized with Hep. B and corporate crooks has anything to do with Tenpenny?! Whether vaccines work or not is irrelevant in the point I was making concerning neonates. If a mom tests negative for Heb B. which we do standard for all moms that come to our hospital (all OBs have this standing order in the corporate systems I'm familiar with) and the baby has a normal work up prior to birth by history from mom, dates, ultrasound and lab work, why does the child need the Hep. B shot then a booster before the age of 7. This is not Tenpenny, this is my observation! Do you think a neonate needs protection from unprotected sex and blood transfusions with a normal history and medical jacket! So, back to your favorite Tenpenny discussion, whether you feel she understands vaccines or not is irrelevant. Unless you still don't get my point.

By traumacowboy (not verified) on 22 Feb 2009 #permalink

Thoughts Regarding Autism Spectrum Neurodevelopmental Disorders

Of these rare neurological dysfunctions, Autism is the most common of these passive developmental disorders. Autism is a disability that is suspected to be caused possibly by a brain development disorder of unknown cause, yet some suspect the cause is some sort of neurological dysfunction- possibly with a genetic predisposition. Autism is about 3 times more common in males than females as well.
Usually, symptoms of the disease present themselves before the toddler reaches the age of three. Before Autism was more understood, others inaccurately labeled autistic people as childhood schizophrenia or as having a psychosis or mental retardation.
Symptoms of the autistic patient included limited or dysfunctional social and personal or intimate relationships with others, their intelligence is affected, and the autistic person typically is adverse to change. Also, the autistic person tends to be compulsive and prefers to be alone. They lack eye contact as much as physical contact with other people.
Out of over two dozen diagnostic criteria utilized for these disorders, eight must be present to be considered autistic, according to the DSM. As with all passive developmental disorders, the person expresses language, social, and behavioral difficulties.
Treatment includes what are called psychotropic medications that delay the progression of the disorder, as well as relieve some of the symptoms of one who is autistic. Behavioral therapy is common as a treatment regimen as well. Boys get Autism much more than girls.
Then there is the controversy between many who claim that thimerosal- a preservative containing mercury, which is a neurotoxin that was used in vaccines until 2001, was the catalyst for autism in children.
Over 5000 lawsuits have been filed because of this belief, and some have been successful for the plaintiff. Yet most agree the correlation between thimersal and autism is void of scientific merit. Furthermore, the cases of autism have not decreased since the preservative was discontinued in 2001.
Aside from Autism, the other four passive developmental disorders are known as autism spectrum disorders.
Aspergerâs Syndrome is more common than autism, and the symptoms are milder, as there is minimal delay in language abilities, if at all. What is expressed with Aspergerâs syndrome is mild autistic symptoms. In time, the patient may express atypical personality disorders, though.
While intelligence is within normal limits with the Aspergerâs patient, social interactions and abilities preset difficulty for such a patient. As with Autism, medications and behavioral therapy are treatment regimens with one with this syndrome
Rettâs Syndrome or disorder presents with not only atypical behavior, but also suffers from restricted physical growth and movement. There is cognitive and social impairment as well. The disorder affects mostly girls, and the cause is due to a gene mutation.
Childhood Disintegrative disorder is rare, and is 10 times less common than autism. The disorder has a late onset with mild autistic symptoms. The disorder affects mostly boys, and regression is sudden and possible with this disorder. Skills lost with this disorder may be language, social, self-care, as well as play or motor skills. Decreased function or impairment with this disorder may include social skills and behavioral flaws. Central Nervous System pathology is a suspected cause of this disorder.
Finally, there are passive development disorders that are not otherwise specified. This may include atypical autism, for example. Yet as with the rest of types of these disorders, the symptoms vary in their frequency and intensity, as well as the range of abilities of these developmental disorders vary widely as well.
Medicinal treatment is believed to be not necessary for the management of the autistic person. However, cognitive and behavioral therapy prove to be most beneficial for all the different types of Passive Development Disorders that unfortunately exist for unknown reasons, yet further research should be done to discover both the etiologies as well as more effective treatment for the Autism Spectrum.
www.autism-society.org
http://www.medicalnewstoday.com/articles/139183.php
Dan Abshear

Traumacowboy,
"You think everything I said relating to Hep. B, the stock market, the FDA etc. comes from Dr. Tenpenny?...whether you feel she understands vaccines or not is irrelevant. Unless you still don't get my point."

Actually I do get your point. Now here is mine:
If you are capable of accepting someone like Tenpenny, with her skewed view on biology and very obvious misunderstanding of vaccines, as an authority on...well...anything really, then I would have some serious doubt as to the quality of research you have done on this and any related subject. This is not meant to be an insult mind you but in my experience people who take the word of those such as Tenpenny, who peddle woo to the masses, tend not to be discerning in what they accept as fact unless, of course, it runs contrary to what they believe. In this case you have a very notable preset belief that pharmaceutical companies are âcorporate crooksâ. You ask why children receive the HepB vaccine so young but I wonder if youâve ever tried to research why other than by reading anti-vax sites on the internet. This is why I bring up your citation of Tenpenny. Get my point?

âWhat are you some government/corporate sponsored blogger looking to point thought somewhere else?â

And now you have just crossed the line into the realm of wearing tin foil hats. Just in case you donât get my point from the above (which I suspect will be the case) the answer to what I do has already been posted.

By Poodle Stomper (not verified) on 22 Feb 2009 #permalink

Poodle Stomper,

My last posting had nothing to do with Tenpenny? But, you still keep coming back to her as if she has the only research in the world you are familiar with? Since you stated that you got my point on neonates receiving HepB Vacc., what is your view on it? You ran through the "stop" sign without pondering on the idea, except to point on and ramble about Tenpenny?

By traumacowboy (not verified) on 23 Feb 2009 #permalink

traumacowboy (probably cooler),

You still miss my point. My point is that your choice of sources of information are not what people would consider credible or scientific. This typically extends beyond just one subject and thus I would suspect that you delve only in the anti-vax sites for information both on mercury and also on the reasons for HepB in children. If you believe that "corporate/government" would bother or even need to "sponsor" bloggers to debunk you then you obviously need to get a better grip on reality. I honestly don't think you have enough of a grip on science to be taken seriously by anyone, much less the uber-secret-shadow-government-reptilloid-run-nessie-concealing pharmaceuticals you seem to believe in.

Tell ya what. Look up HepB on something other than an anti-vax site. Look up statistics on the disease, look up how preventable it can be. Research all of these things on your own (not from some hokey anti-vax-OMG-teh-Manz-is-trying-to-killz-us" site and you will have your answer on the rationale for vaccinating children against hepB. Until then, all I can assume is that no matter how thorough the science, you will refuse to accept anything that doesn't support what you already believe and that is a waste of anyone's time.

By Poodle Stomper (not verified) on 23 Feb 2009 #permalink

Poodles,
Boy something really got under your "reptilloid"?? skin... I can tell you have a wealth of priori logic in your thinking. It is based on fraudulent junk science and your little CDC academy will have you believe that guns and bullets follow Koch's Postulates of Pathogenicity therefore a menace that needs to be eradicated right? Hypothesis are being tested, but not rejected, selected (cherry picked) facts are being selected, valid info. is being omitted and statistics are being concocted, hell they'll even describe a textbook methodology to "their science" but they don't follow it and it is based on skewed biased population samples so the sacred cow (cdc) can proclaim yes, indeed a ten minute newborn needs the HBV. You believe in "politicized" science research, along with all the alphabet government agencies, and tv stations out there hyping the media blitzkrieg. Do the world a favor and when you are involved in some "science project" and you see something not right, blow the whistle and stand up for Christ's sake, don't just stand there and collect your allowance.... I'll close with that you never had an explanation for a ten minute newborn's need for HBV. Something I asked of you in the last post. Instead you went with some science fiction stuff... It's been interesting poodles.

By traumacowboy (not verified) on 23 Feb 2009 #permalink

traumacowboy,
Your use of...alternative...grammar and punctuation has left me baffled as to what you are trying to say. I will comment on what little was intelligible. First, I have, in fact stood up and spoken out when I saw data being fudged. However this has not been at the pharmaceutical company where I now work (you get fired fudging even the littlest thing, believe it or not) but at my previous place of employment which was a nutritional supplement company. You see, the supplement industry like to not only fudge data but also make very strongly implied claims (just outside of an actual legally viable claim) about their products to get people to buy their useless junk. I not only spoke out about it but I took a pretty significant pay cut to work where I am now. Since you seem to think that all us pharma-employees are basking in ill-gotten gains I will have to burst your bubble here. The pay I am getting now is substantially less than what I made at my prior job but I consider it worth it because I don't have to deal with lack ethics I observed in the supplement industry. I'm not sure what any of the "guns and bullets" but it is obvious that you have neither knowledge of science, nor the desire to actually learn as it would demand you turn away from your preconceived notions. In that, you and Tenpenny are a perfect match. If you ever break out of your paranoia feel free to look up stats on HepB. Maybe one day you'll be able to answer your own question.

By Poodle Stomper (not verified) on 23 Feb 2009 #permalink

trauma,
Because you do not like the CDC, is it any better if the information comes from the World Health Organization?

This article pulls down the recommendations made by the WHO and offers an explanation for vaccinating infants.

Programmatically, it is usually easiest if the three doses of hepatitis B vaccine are given at the same time as the three doses of DPT. Administering the vaccine earlier in life makes it easier to achieve high immunization coverage. This schedule prevents infections acquired during early childhood, which accounts for most of the HBV-related disease burden in countries with high endemicity. However, this schedule does not prevent perinatal HBV infections because it does not include a dose of hepatitis B vaccine at birth.

Then there's a table that diagrams a possible vaccine schedule based on age/climate/etc

For preventing perinatal transmission the first dose of hepatitis B vaccine should be given as soon as possible after birth, preferably within 24 hours. In most countries the most feasible strategy for preventing perinatal hepatitis B transmission involves giving a dose of Hepatitis B vaccine to all infants at birth, as a program to screen HBV-infected mothers will require extensive resources.

This leaves us with the question: how serious/endemic is perinatal HBV? If it's not so common, why bother, right? And that other article was from India, so of what use is it in America?

From the New York Department of Health.

On October 17, 2001, the Advisory Committee on Immunization Practices (ACIP) voted to recommend giving the birth dose of hepatitis B vaccine to all newborns prior to hospital discharge. This ACIP recommendation concurs with the American Academy of Pediatrics (AAP) policy that recommends a birth dose for all infants. The New York State Department of Health Immunization Program supports these recommendations and urges your hospital to adopt a universal hepatitis B birth dose policy if you have not already done so.

Approximately 19,000 women with chronic hepatitis B infection give birth in the United States each year. Ninety percent of perinatal infections can be prevented by postexposure prophylaxis given within 12 hours of birth. Tragically, many babies are exposed to HBV at birth but do not receive appropriate postexposure prophylaxis. Because thimerosal has been removed from all pediatric hepatitis B vaccines in the United States, concerns about thimerosal should no longer be an obstacle for practitioners in enacting a universal birth dose policy.

Melanie Phillips' scientific education stopped at o level. (age 16). Although an elegant writer she is a carpet chewing evolution and global warming denier and as abour as qualified to comment on complex science as my cat.

I once sat next to Dr Wakefield at dinner. I could have stuck a fork in him.

Severe autism is an extremely distressing phenomenon for parents, and even mild autism can disrupt normal expectations in painful ways. Parents are faced with a great burden, emotionally and financially, often with little help from the state or other resources. They have a lifetime of care to look forward to, and intense anxiety about what will happen when they are no longer able to support their child.

Parents are often stigmatised by their friends and families, partly because the complex nature of the probable genetic components is not fully understood by researchers and is completely strange to most members of the public.

Family physicians are often ill-informed about diagnosis and current ideas about best practice for therapy, so that they are sometimes very far from helpful. In the worst cases, however, no amount of the currently available therapy is likely to make a substantial difference.

Few members of the public or the medical profession ever see these worst cases, or recognize milder cases when they do see them in a non-medical context. This is one of those unseen ailments, ignored or dismissed in most contexts. "Oh, that's just a fashionable diagnosis," people say. "Where have all these cases suddenly come from?" Asperger's and ADHD are examples of other dismissed diagnoses, misunderstood even by physicians.

Under such circumstances, it is hardly incomprehensible that parents should seek a single external cause which they can blame, and perhaps even use to obtain some financial support. A large range of environmental factors has been proposed as perhaps implicated, although without any clear proof as yet, but it is MMR that gains all the attention.

No amount of scientific debate is likely to shift those who have a strong emotional commitment to using MMR as their explanatory mechanism, and casting doubt on Wakefield is unlikely to make any difference, as it does not conclusively prove the safety of MMR. Indeed, the structure of scientific debate within society is little understood, not least by those scientists who trumpet a need for The Public Understanding of Science.

Perhaps what the rest of us should take away from this is not a condescending attitude towards those who seek a simple explanation for their children's severe disabilities and all the co-morbidities that often accompany autism.

Rather, we should seek better education in the complex character of scientific practice, better use of clear explanation rather than didacticism on the part of scientists, and a great deal more compassionate care from the communities around those who suffer from a wide range of disabling conditions.

In most instances, it is we ourselves who transform an ailment into a disability, by failing to make enough effort to understand its personal effects or to make provision and allowances for those suffering from it. It is we ourselves who stigmatize those suffering from inexplicable or unseen ailments. It is we ourselves who do not put sufficient pressure on governments and the medical profession to help sufferers and their families.

We live in an individualistic and uncaring society, in which care for children, the sick, the poor and the elderly receives a very low priority. Most of us do little or nothing ourselves, expect parents or government to do everything necessary, and oppose providing the public resources. We are responsible, indirectly, for the fervour of the anti-MMR movement, by failing to alleviate the plight of the autistic and their families.

By David Harley (not verified) on 27 Mar 2009 #permalink