The new strategy of the antivaccination movement: Autism is a "misdiagnosis" for mitochondrial disease

I should have seen this one coming a mile away in light of the concession of vaccine injury in the case of one child that led to the incredibly shrinking causation claim when it comes to vaccines and autism. Having had it conclusively demonstrated through several large studies in multiple countries that mercury in vaccines does not cause autism (nor do vaccines themselves), the mercury militia are rapidly changing course. No longer is autism a "misdiagnosis for mercury poisoning."

Now it's a "misdiagnosis for mitochondrial diseases."

Or it soon will be. Just wait. The new propaganda from the mercury militia will be that autism is a result of mitochondrial diseases plus vaccines, just as they claimed before that it was due to the mercury in vaccines plus a "sensitivity" to mercury. (Of course, they only started to claim the sensitivity to mercury after studies failed to find any link between thimerosal and vaccines in large general populations.) Don't believe this will happen? Think again:

Is Miss Hannah Poling patient #1 in the new paradigm for "The disorder formerly known as autism?" Perhaps we'lll come up with a really funky sign like Prince did? Was Hannah misdiagnosed with autism, when she actually had a mitochondrial disorder that was triggered by her childhood vaccines? If so, there may be tens of thousands of children who have been misdiagnosed. That opens up rather a large can of wigglers, doesn't it?

Now that's a really concentrated hunk o' hunk o' burnin' stupid, but it really does show that everything old is new again, just this time with mitochondrial diseases. Indeed, the mercury militia is cranking up the propaganda mill with a press conference about this "concession" that "vaccines cause autism" (that is not any sort of admission that vaccines cause autism) to take place as this post shows up and an appearance of the parents on Larry King Live.

Personally, I'm looking forward to the press conference. Googling the phone numbers of the listed contact Todd Scott produces some rather interesting results in terms of the hits that it produces.

Unfortunately, this is not going away. As I have predicted many times, now that mercury in the thimerosal preservative in childhood vaccines is increasingly being exonerated by science as a cause or contributor to autism, antivaccinationists have latched on to another cause--a cause that involves vaccines of course. Never mind that mitochondrial diseases are very rare. Indeed, there are only a handful of patients reported in the medical literature with mutations in the same gene in which the child above has a mutation. Never mind that it could well be that mitochondrial diseases alone might be implicated in a small number of autism-like conditions without needing to invoke the involvement of mercury or vaccines. To the antivaccinationist, it's not so much about the autism as it is about the vaccines. It's all about the vaccines. It's always been all about the vaccines. It will always be all about the vaccines.

I hazard a new prediction: Just as the antivaccinationists pivoted on a dime to start invoking other "toxins" in vaccines as a cause of autism when studies consistently failed to find a link to mercury in vaccines, overnight, a veritable cottage industry of quackery related to mitochondrial diseases will pop up, just as chelation therapy and other "biomedical interventions" designed to "detoxify" mercury poisons were the quackery of choice for autism a couple of years ago. Indeed, chelation therapy will now be viewed as so 2005. It'll be time to get with the program and entere 2008, when "treatments" for mitochondrial disorders will be the big "in" thing for autism quackery. I also can't resist hazarding another prediction: As science, as seems quite likely, increasingly shows that this "vaccines plus mitochondrial disease" has no more validity than the mercury claim, antivaccinationists will find another condition to latch on to as the One True Cause of autism. The only thing it will share in common with previous One True Causes of autism like mercury (and now mitochondrial disorders) is that somehow, some way, it will have as part of its hypothesis that it's vaccines that cause autism.

That's because it's all about the vaccines--period.

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I can just see what's next: autism as a "misdiagnosis" for ear infections.
Autism as a "misdiagnosis" for hot water burns.
Autism as a "misdiagnosis" for being punched in the face.
I wouldn't put it below these people.

By Laser Potato (not verified) on 06 Mar 2008 #permalink

Autism as a "misdiagnosis" for being punched in the face.

From the people who claim shaken baby syndrome as a vaccine reaction, that would be positively sane.

Given that it is, indeed, all about the vaccines, I wonder how long autism will remain the condition of choice. Will they continue shopping around for a vaccine-related cause, or will they eventually pick some other condition whose cause is poorly understood and start all over again?

Or maybe they'll just find another condition to latch onto as the One True (Side-)Effect of Vaccines... Tense, nervous headache? Vaccines. Can't get laid? Vaccines. Incurably stupid? Vaccines.

Oh, they're already retargeting, and this time, they're going to start blaming aluminum! Or any other adjuvants. Or the "pus" or "aborted fetal tissue" or *any* ingredient in vaccines.

The first salvos have already been launched over on Usenet in misc.health.alternative. But I think we can look for "highly toxic aluminum" as the next culprit.

It would be nice if these people woke up and realized that their efforts and money would be better spent on actually helping people with autism, rather than running around like headless chickens searching for the cause.

I'm just curious what "minor" intervention will be touted as the treatment for "mitochondrial disease". What will they do to make money off distressed and naive parents now? I hope it will be less harmful than what they're doing now. Should we be hoping for something homeopathic? (After all, drinking water or rubbing wax on your forehead shouldn't kill children.)

On CNN they just said two things which maybe interesting:

1) The father of the girl who settled this case is a neurologist.

2) The family will be on Larry King Live tonight.

We shall see...

It is quite obvious from your ignorant commentaries that none of you idiots have had to speak with a doctor (who is subsidized by the pharmaceutical companies) and your "scientific" evidence of harm is purely based on "quackery", and there is no possible evidence that the worst nightmare of the drug companies, CDC, etc is to have actual proof of the harm caused by these injections containing heavy metals ... of course not, it would be the largest class action in the history of law. Parents of children with Autism are not in the business of reintroducing Polio, Mumps, Rubella, etc ... what we are heavily invested in is acknowledgement from the drug induced government of their stupidity in throwing levels of toxic materials into a baby that doesn't way 20 pounds. Do any of you "know it alls" have a child with Autism ... I thought not.

By Gary Myers (not verified) on 06 Mar 2008 #permalink

It is quite obvious from your ignorant commentaries that none of you idiots have had to speak with a doctor (who is subsidized by the pharmaceutical companies) and your "scientific" evidence of harm is purely based on "quackery", and there is no possible evidence that the worst nightmare of the drug companies, CDC, etc is to have actual proof of the harm caused by these injections containing heavy metals ... of course not, it would be the largest class action in the history of law. Parents of children with Autism are not in the business of reintroducing Polio, Mumps, Rubella, etc ... what we are heavily invested in is acknowledgement from the drug induced government of their stupidity in throwing levels of toxic materials into a baby that doesn't way 20 pounds. Do any of you "know it alls" have a child with Autism ... I thought not.

By Gary Myers (not verified) on 06 Mar 2008 #permalink

Do any of you "know it alls" have a child with Autism ... I thought not.

Here we go again. I do have a classically autistic son.

The notion that all parents of autistic children would necessarily have to be pro-quackery and government conspiracy mongers boggles the mind. I'm not sure where people get these ideas. It's totally contrary to my experience. Many if not most parents online don't buy the anti-vax stuff.

Pulls up chair...grabs popcorn...waits patiently for Gary Myers to have his empty little head handed to him...starting...

I have nothing but admiration for the overwhelming majority of parents who struggle to bring up a child with ASD. I know a couple of them myself, and what amazes me is their down-to-earth attitude and the fortitude with which they cope with the curve ball that life has thrown them, without resorting to hysterical delusional ramblings about vaccines and invoking big pharma conspiracies lurking in every corner of the doctor's surgery.

I think this new strategy just shows how scientifically incompetent they are. All mitochondrial disorders are 100% genetic. The only way you can get a mitochondrial disorder is by not having the right genes to make the appropriate proteins to make the appropriate mitochondria.

You can have things like mitochondria depletion from some drugs that inhibit mitochondrial protein synthesis (for example chloramphenicol) or DNA replication (HART therapy will do it), but those do not cause mitochondrial defects. Low NO will cause mitochondria depletion too, but not mitochondrial defects.

Mitochondrial defects are straightforward to diagnose, and the diagnosis is unambiguous. There is no possibility of a misdiagnosis by a competent clinician. It is usually done by sequencing genes. If the person has the genetic defect, they have the mitochondrial defect and vice versa. If they don't have one, they don't have the other. There is no possibility of a "cure", no possibility that vaccines caused the mitochondrial defect.

I hope you guys enjoyed the press conference as much as I did. Now you can give up your obfuscation of the truth and engage in other pursuits. You put up a decent battle but the good guys just won!!!

Let us know if you ever want to engage in another battle of wits. We'll give you a bigger head start next time.

actual proof of the harm caused by these injections containing heavy metals

That's the rub isn't it. Show the actual proof of harm by the vaccinations.

Go ahead. Show us.

must proof tags

That should look like this

actual proof of the harm caused by these injections containing heavy metals

That's the rub isn't it. Show the actual proof of harm by the vaccinations.

Go ahead. Show us.

"Do any of you "know it alls" have a child with Autism ... I thought not."

I am not a "know it all". Apparantly, neither are you. Many people who discuss the vaccine/autism connection (including myself) have children with autism. Some are autistic themselves.

Orac--since this family appears to be big into chelation (at least in their past) one wonders if chelation will be seen as "so 2005".

First off, I agree with the scientific evidence against there being a link between autism and vaccines, I'm not certain that the comment by daedalus2u is correct about inheritance and mitochondrial disease.

I pulled the following discussion of the etiology of mito disease from this link:
http://www.umdf.org/site/c.dnJEKLNqFoG/b.3042179/

"Sporadic Cases -- Where There Are No Affected Relatives
In the "real world", in the majority (perhaps about 75%) of cases the patient is the only family member affected with mitochondrial disease. These cases are called "sporadic", and present much difficulty in answering the questions posed about regarding inheritance.

The first question is whether the problem is due to genetics, environment, or some combination of the two. Certainly, the genetic aspects of mitochondrial disease are well known and were briefly summarized above. However, not all mitochondrial disease is primarily genetic. For example, anti-retroviral medications used to treat HIV/AIDS can damage mitochondria and cause symptoms due to resultant energy failure. Removal of these drugs reverses the process and the symptoms resolve. There are other environmental causes of mitochondrial disease, and likely many that we do not know about.

In the opinion of this author, most mitochondrial diseases are probably both genetic AND environmental in origin. Even in the case of anti-retroviral medications, thousands of individuals have no problem on these drugs while only a handful do. Likely, there are genetic reasons for the high susceptibility to these drugs in an unlucky few - a genetic predisposition of an "environmental" disease. On the other hand, in MELAS, which clearly is primarily genetic in origin, neurological deterioration often occurs during a viral illness and/or fasting - an environmental trigger of a "genetic" disease.

The second question is: If genetic, was the mutation inherited? The answer is usually yes, but not always. New mutations do exist. In particular, deletions (missing areas) of mtDNA tend to be new mutations not present in the mother or siblings. However, deletions with duplications are often inherited, and some duplications are hard to detect.

What this all means is that there are very few answers in most cases where only one person in a family has mitochondrial disease. The condition probably is genetic, and it may or may not be inherited. Either the nuclear or mitochondrial DNA could be involved. Inheritance is probably autosomal recessive, maternal or sporadic (no inheritance), but not necessarily.

Based on many families, some groups give an estimated recurrence risk for mitochondrial disease (chance that each additional child of the same two parents will be somehow affected) of 10-15%. This is probably a reasonable rough estimate, but you should discuss the probability of recurrence for your family with a genetics counselor familiar with mitochondrial disease.

- Written by Richard Boles, M.D. and Terri Mason

I'd appreciate comment by those with medical expertise.

Orac (or anyone more knowledgeable in this are than me),
How does the fact that the brain in an immune priveleged organ, fit in with "vaccinations cause autism" hysteria? From my understanding, wouldn't any immune response ellicted by a vaccination outside the CNS have no bearing on an immune repsonse in the brain? or can the materials in the vaccine cross the blood-brain-barrier?

From what I've read, it appears that mitochondrial disease is genetic, but sometimes doesn't manifest until a few years after birth. It can manifest after some stress, like a fever or an infection. In that sense I guess there's an "environmental trigger" if you will, but not in the sense that it might be preventable.

I can see, though, why some people might hypothesize that *regressive* autism has some relationship with mitochondrial disease. The main reason I'd be skeptical is that autism is not fatal.

"I'm just curious what "minor" intervention will be touted as the treatment for "mitochondrial disease"."

That's easy: look no further, I predict, than our old friend dichloroacetate (originally tested as a therapy for mitochondrial disorders, remember).

Of course, given the aversion of the mercury nutjob fringe to "chemicals" perhaps it will have to be homeopathic dichloroacetate.

The Poling dad thinks Hannah's vaccines created her mitochondrial disorder. That's a new one.

I listened to the CNN reports. That mom is quite the harpy.

Thanks Joseph. I have no suspicion that autism = mitochondiral disease. I work with children with autism (and other developmental disorders) and they don't tend to present with some of the signs of mito. disease. However, given the coming onslaught of questions from parents and others I work with, I'm trying to understand as much about mito. disease as I can.

Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.

Mitochondrial disorders are genetic, but usually they are sporadic, that is a de novo mutation in that individual. There are a number of reasons for this, a major one being that mitochondrial diseases are often fatal, so they are not transmitted through the germ line.

Any environmental influence on any DNA disorder would cause different mutations in different cells. For all cells to have the same mitochondrial disorder, the disorder had to occur before the cells divided. If every blood cell has the same mitochondrial disorder, then it had to occur in utero or before in a germ cell before conception.

If all muscle cells have the same mitochondrial defect, that defect occurred before those muscle cells divided during early fetal life. The child has a point mutation in a mitochondrial gene. It is simply not possible for the same mitochondrial defect to occur in multiple muscle cells due to an environmental exposure unless that exposure was before the muscle formed in utero.

Doesn't matter what the dad thinks, it simply shows his ignorance, and the ignorance of his handlers. In their zeal to blame vaccines and mercury, they are pushing nonsense.

This whole vaccine award is purely legal. And the award should not have been given when considering what has been admitted the facts of the case...this is a confusing and weird case.

From everything I've read, which has been on-line and in newspapers, the child showed "autistic" signs at three months old, far earlier than the supposed affects of the vaccine. The child is also described as being mildly affected, which if such is the case, where's my damn money?

How does the this fund work? What the parents have to say doesn't really illuminate this issue, and the fact Larry King is going to talk to this coupld only goes to show that whether you love her or not, Rosie O'Donnell was right and maybe he should hang up his microphone. I want to know the reasons, especially as what the child supposedly has is not considered autism.

And an example of another doc who has been emotionally manipulated, either by himself or his "handlers," into a state of denial.

And so Dr. Jon Poling joins Prof. Peter Duesberg in the lexicon of whackjobery. It's not at all surprising that Larry King is hosting this clown. This is the same Larry King who once famously asked why there will still monkeys if humans descended from monkeys.

Rjaye - I think the news report that said 3 months was in error. Nothing else I've seen has indicated she had problems before starting to get ear infections at about 6 months.

I do think it's important that, as you point out, she is apparently only mildly affected - which was borne out in the CNN video aired today. If that is a child who needs 24-hour one-on-one supervision (at least more so than any 9-year-old), I am Queen Elizabeth. The published case report says that she has not scored in the autism range on a standard metric since she started kindergarten. So, wtf?

First it was MMR that supposedly caused autism. Research ruled that out. Then it was thimerosal. That was ruled out when the rates of autism went up rather than down as thimerosal was removed from most childhood vaccines. As evidence accumulated against these hypotheses, yet another emerged. Now it is giving too many vaccines at the same time.

All the while real research, (as opposed to parental speculation), has improved our ability to diagnose autism at younger and younger ages which completely negates the significance of the correlation between 15-18 month vaccines. But there is no news commodity to be sold with that story.

Do you suppose anyone in the news media will ever report on the unvaccinated child who dies as a direct result of the irresponsible choice to sell the news rather than report the actual facts? Or will we ever see a story about the delay in finding the real cause of autism as we waste our limited research resources chasing parental convictions rather than the actual evidence?

Science needs a voice that is as loud as a heartbroken and/or angry parent. We need a story that is as marketable as perseverance prevailing over the establishment. Until we find that voice or that story, it's going to be a long struggle with these issues.

By Skeptigirl (not verified) on 06 Mar 2008 #permalink

Do any of you "know it alls" have a child with Autism ... I thought not.

I do, you arrogant jackass. And if you and the rest of the mercury militia are not in the business of reintroducing polio, mumps, rubella, etc., you're sure doing a damn good job of pretending to be.

(By the way, dipshit, thimerosol's been removed from the vast majority of childhood vaccines. What was that about heavy metals? Do you even understand what the term means?)

How does the this fund work?
Posted by: Rjaye

The National Vaccine Injury Compensation Program is described here:
http://www.usdoj.gov/civil/torts/const/vicp/about.htm

"Individuals who believe they have been injured by a covered vaccine can file a claim against the Department of Health and Human Services (HHS) in the U.S. Court of Federal Claims seeking compensation from the Vaccine Trust Fund. The Department of Justice (DOJ), which represents HHS, consistently works to ensure that fair compensation is awarded in every case that meets the eligibility criteria. If found eligible, claimants can recover compensation for related medical and rehabilitative expenses, and in certain cases, may be awarded funds for pain and suffering and future lost earnings. Often, an award is more than $1 million. By protecting the Trust Fund against claims by those who have not suffered a vaccine-related injury, DOJ helps to preserve the Fund for future deserving claimants. Regardless of a claimant's success under the Program, reasonable attorneys' fees and costs are paid."

Among the reasons the fund was established was to remove the disincentive drug manufacturers had from entering the vaccine market. In addition, just as many worker's compensation programs do, it removes the claims from the tort system. In doing so, the vaccine manufacturer and health care providers do not have to fight frivolous lawsuits and the claimants do not have to prove the facts of their case in they same way they might have to in a tort case.

The real tragedy here is the incompetent way the news media is reporting on this case. And I doubt that damage will be undone even if Larry King has someone on with this family to talk about the scientific evidence regarding vaccine risks and benefits.

By Skeptigirl (not verified) on 06 Mar 2008 #permalink

The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.

It's ALREADY clear there isn't a connection. It's as clear as the fact that there isn't a total absence of transitional fossils. The people who lead the movement denying one of these claims have the same basic motives and mindset as the people who lead the movement denying the other, and it is highly unlikely that any evidence up to and including the stars moving around to spell "It's Not the Vaccines, Stupid!" could possibly convince them otherwise.

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.

By skeptigirl (not verified) on 06 Mar 2008 #permalink

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.

And of course some studies end up suggesting this (one out of the UK, for example) just because the numbers work out that way. But I think it's just as mistaken as suggesting that because thimerosal exposure and autism diagnoses increased simultaneously in the first half of the 1990s, then there's a causation effect. We're clearly looking at coincidence. The California trends are very telling in this regard. They are completely unaffected by removal of thimerosal. There's no discernable change in the previous increasing trend, upward or downward.

Carlie said: "Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. "

Actually there is... one of the biggest problems is pertussis. The protection for pertussis wears off after a few years and it is still goes through the population. For adults it is often mistaken for a nasty cold, but for babies under a year old it is often fatal. Herd immunity is the only thing that protects newborns from pertussis. Because of the efforts of the antivax bunch (Barbara Loe Fisher for one), that herd immunity has been significantly reduced and pertussis is still around and from http://www.cdc.gov/vaccines/vpd-vac/pertussis/dis-faqs.htm, "In recent years, 15 to 21 infant deaths from pertussis are reported to CDC annually."

Recently a pertussis vaccine has been approved for older children and adults. All three of my teenagers have had the Tdap (and for the 19 year old it was the first time he had ever been vaccinated for pertussis... he had to depend on herd immunity due to his neonatal seizures, at a time when our county was having a pertussis epidemic --- we had to be very very careful who he had contact with during his first couple of years).

Also when the Hib vaccine first came out it was only for older toddlers/preschoolers. It turned out that was not an effective timing, and the rates of Hib (a truly nasty disease that had a very high rate of death and disability) weren't substantially reduced until it was approved for babies. My younger son was the first to get that vaccine, he is 17 years old (and at a mom/baby group that I took him to I met a woman whose first child had died of Hib just a couple of years before).

If you look at vaccine studies you will see that there are lots of research into finding appropriate timing of the vaccines and their boosters. Unlike the propaganda one finds in several anti-vax websites, there is lots of research in vaccines from safety to effectiveness. Just go to www.pubmed.gov and put in a disease with vaccine to get a list of papers.

Gary Myers wrote "stupidity in throwing levels of toxic materials into a baby that doesn't way 20 pounds. Do any of you "know it alls" have a child with Autism ... I thought not."

I have never claimed to "know it all". I would not have even thought of vaccines and safety until my firstborn had seizures as a newborn. He spent his first year on anticonvulsants. But after he was weaned from the medication he became ill from now vaccine preventable disease, which caused him to have a very very bad seizure which required him to be taken by ambulance to the hospital. My oldest son's severe speech and language disability may be due to that last seizure. He might be a "disease damaged" child.

You guys seem to forget that the actual diseases cause harm and disability. The little girl would have also had serious ill effects if she actually had measles, pertussis, chicken pox or just a high fever. I'm not sure it was even wise of them to put all the catch-up vaccines for one day (even 1968 when my family was preparing to move to South America I got several vaccines, but not as many as Ms. Poling, and they were spread out over two months)

Please, Mr. Myers, answer my question: Which vaccine in the present pediatric schedule is more dangerous than the actual disease? Be sure to include verifiable documentation, for example, if you claim that the DTaP is more dangerous than pertussis, diphtheria or tetanus show us the study that show the large number of children harmed by DTaP versus the numbers of children harmed by the disease (see link above). Thank you.

Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.
Posted by: Carlie

First, autism is diagnosed before these vaccines are given. Some very clever research was undertaken looking at the abundant videotapes of children's first birthday parties. Researchers identified behaviors that were diagnostic of autism. Prior to that, the diagnosis was most often made when toddlers reached a stage of more social interaction after 12 months of age. The original suggestion vaccines were related to autism had to do with the coincidence vaccines are given at the same age socialization increases. The original research has been discredited, by the way.

Now autism can be diagnosed even younger than one year. It's pretty apparent that the root of autism is either in utero, perinatal, or genetic. The medical community has been unable to get the news media as excited about those discoveries as they have been about the vaccine misinformation.

As for the ideal age for vaccinations and the reasoning and safety of administering them together, in the US that is determined after very careful review and continual monitoring undertaken by the public health service's Advisory Committee for Immunization Practices (ACIP). They meet twice a year to review the research and the Vaccine Adverse Event Reporting System (VAERS) data. Their findings are public as well as the documentation of their rationale and the hundreds of citations they based their decisions on.

They also alert providers to any problems with vaccines that show up in between the April and October meetings.

Criticism the ACIP is simply an extension of the pharmaceutical companies couldn't be more ignorant. Their decisions are completely transparent, and contrary to the big pharma conspiracy theorists, there is abundant research out there which is not funded by drug companies. There is also a very large and very diverse medical community out there who are capable of and do read the research for themselves, and who are capable of and do evaluate the bias of the source or funding of the research. In fact, it should be rather obvious the medical community is by far better at evaluating the bias and significance of medical research than any layperson conspiracy theorist.

Vaccine age recommendations are based on actual data as to the risk of the specific infections. The earliest given, hepatitis B vaccine, is given just after birth because there are cases of infants contracting hepatitis B at that age. Pertussis and tetanus are risks to infants. It would be dangerous to delay those vaccines. Herd immunity is irrelevant when it comes to tetanus, the bacteria come from dirt not other people. And you need both herd immunity and individual vaccinations to protect infants from pertussis because the vaccine is not good enough without both.

Also, you cannot usually achieve sufficient herd immunity in older populations to protect younger populations because the pool of unvaccinated younger kids would be too large.

Vaccines are given in combinations, one, to decrease the discomfort in giving a child numerous injections, and two, because the data shows if you can give them all together, kids are more likely to get them. If you spread vaccines out, they inevitably get delayed, duplicated (when records of past shots cannot be found) and sometimes missed altogether. Again, we know this from experience, not from guessing or assuming.

Other countries have similar public health systems to evaluate and make vaccine recommendations. There is more consistency in the recommendations between countries than there are discrepancies. Again, for vaccine recommendations to be a big pharma conspiracy it would have to involve the majority of researchers and scientists all over the world, the majority of health care providers all over the world, and all the world's public health systems. Either the entire medical community is in on the scheme or they are a bunch of dupes. You trust them to perform neurosurgery but not to figure out if a vaccine is safe?

There is one more typical antivaxer misinformation I haven't addressed here. That is the notion that 'herd immunity' is somehow the sole objective of the public health system. Nonsense! The objective of this country's public health system and the world's public health systems is to decrease disease burden. The idea herd immunity trumps individual risk is a contradiction in logic. If individuals were somehow sacrificed for herd immunity, you would have by simple analysis, a vaccine risk greater than vaccine benefit.

By skeptigirl (not verified) on 06 Mar 2008 #permalink

But I think it's just as mistaken as suggesting that because thimerosal exposure and autism diagnoses increased simultaneously in the first half of the 1990s, then there's a causation effect. We're clearly looking at coincidence. The California trends are very telling in this regard. They are completely unaffected by removal of thimerosal. There's no discernable change in the previous increasing trend, upward or downward.
Posted by: Joseph

I am not suggesting this is an evidence based conclusion. I am suggesting it is an evidence based hypothesis. Why would I attack an unproven hypothesis, "vaccines cause autism", with another unproven hypothesis?

BTW, you've merely added some evidence to the contrary. I wouldn't want to form a research direction with a bias against a thimerosal benefit anymore than I'd want to bias it against a thimerosal risk. The health care community did not dismiss the thimerosal risk out of hand, we did the research.

By skeptigirl (not verified) on 06 Mar 2008 #permalink

"Science needs a voice that is as loud as a heartbroken and/or angry parent. We need a story that is as marketable as perseverance prevailing over the establishment. Until we find that voice or that story, it's going to be a long struggle with these issues."

Science (or at least the American Academy of Pediatrics) is looking for parents of children injured or killed by vaccine-preventable diseases to tell their stories. Similarly, it may be desirable for the parents of such children to sue the pants off the irresponsible and sociopathic antivaxers who assured them that vaccines were useless and gave them advice on how to dodge vaccination requirements. The antivaxers obviously don't have pockets as deep as those of vaccine makers or the government, but it's another place to start.

"This is the same Larry King who once famously asked why there (were) still monkeys if humans descended from monkeys"

Actually, the burning question is, if human descended from monkeys, why is John Best still around?

By Dangerous Bacon (not verified) on 06 Mar 2008 #permalink

daedalus2u:

Thanks for that clarification. The interaction between gene and environment you seem to be identifying is prenatal environmental influence. That makes the different etiologies of mitochondrial disease easier to understand.

Well, it sounds like the press is far worse than I could imagine. I just watched the newscasts in Seattle, and Channel 5 just reported that the vaccine caused the child's autism. AAAAGH!

Thanks, Isles, on the vaccine fund info. I thought the ball was dropped, but reading the Academy of Pediatrics press showed that the fever the vaccine may've caused might've aggravated her mito, and not caused autism. It was a probability-not a certainty...I guess that fifty percent and a feather? Actually, the fund makes better sense now that I've read that, but wow! I can't believe how the press has bungled this one.

Ouch.

And kids do die from pertussis. I worked for several years in a NICU and it happened several times over that period. There would also be babies come in with whooping cough, and never go home. That was so heartbreaking. And it would only be a blurb or two in the paper, the usual "the signs and symptoms of," and that was it. On to the next story.

Well, it sounds like the press is far worse than I could imagine. I just watched the newscasts in Seattle, and Channel 5 just reported that the vaccine caused the child's autism. AAAAGH!

Thanks, Isles, on the vaccine fund info. I thought the ball was dropped, but reading the Academy of Pediatrics press showed that the fever the vaccine may've caused might've aggravated her mito, and not caused autism. It was a probability-not a certainty...I guess that fifty percent and a feather? Actually, the fund makes better sense now that I've read that, but wow! I can't believe how the press has bungled this one.

Ouch.

Thanks to people like Barabara Fisher, we now use the DTaP, rather than the DTP, a much safer vaccine, that has had far fewer adverse reactions.

Thanks to parents of immune deficient children who contracted polio from the vaccine, we now use a safer vaccine, an inactivated virus vaccine.

How is it we successfully eradicated polio, smallpox, etc, without vaccinating infants? These vaccines were given to older children, not infants.

To think we cannot strive to improve safety is ignorant.

I do ask you this, can anyone find a study that shows how many children produce antibodies to the vaccines they received in our current schedule?

I am very interested because my child's immunologist stated that it is NOT abnormal for a child to not respond to vaccines, as the immune system is not mature until age 2. If this were true, then our vaccination program would be faulty, correct?

My child suffered an adverse reaction to either the MMR, or Varicella vaccines. She had encephalitis, seizures, fever, bulls eye rash.

We also discovered she didn't create antibodies to these live virus vacines, and may have some sort of immunodeficiency. That is where it gets tricky, one immunologist said immunodeficiency, based on the lack of antibody response to vaccines. The other said that the lack of antibosy response is typical, but I just don't feel this is true...

Monica said "Thanks to people like Barabara Fisher, we now use the DTaP, rather than the DTP, a much safer vaccine, that has had far fewer adverse reactions."

Au contraire... further research showed that the DTP did not cause more seizures than what would normally happen. And the DTaP is less effective. Go figure:
http://content.nejm.org/cgi/content/full/345/9/656

Barbara Fisher is directly responsible for my oldest son not getting vaccinated for pertussis at a time when my county was having a pertussis epidemic (which she most likely helped create). It was also the same time that 120+ Americans died from measles. She is part of the problem, not the solution.

She continued "How is it we successfully eradicated polio, smallpox, etc, without vaccinating infants? These vaccines were given to older children, not infants."

That is pure bullshit. I was vaccinated for both smallpox and polio as an infant. All of my children were vaccinated for polio as babies.

From http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdf ... "A primary series of IPV consists of three doses. In infancy, these primary doses are integrated with the administration of other routinely administered vaccines. The first dose may be given as early as 6 weeks of age but is usually given at 2 months of age, with a second dose at 4 months of age. The third dose should be given at 6-18 months of age."

From my shot record (I was born in October of 1957):
Smallpox:
23 Jan 58 (no take)
20 Mar 58
13 Aug 59
30 Mar 68
6 Apr 68
7 Sep 71
20 Jun 74

Check it out, three smallpox vaccines before I was two years old.

Monica continued "I do ask you this, can anyone find a study that shows how many children produce antibodies to the vaccines they received in our current schedule?"

I am at my limit of two URLs, (which is why I did not post the JREF posting where I listed my entire vaccine schedule in response to a homeopath challenging us on our own vaccine histories)... but if you go into PubMed you will find lots of studies that show the studies on the effectiveness of vaccines. You'll also find the studies that debate the schedule.

By the way, my oldest son also had seizures a week after his MMR vaccine. But he also happened to be sick with another illness (which is now vaccine preventable). Guess what? Seizures happen, and sometimes no one knows why. His last seizure was blamed on the illness... but his first at the young age of 48 hours (before any vaccines, this was in 1988) were for "unknown etiology". Crap happens.

Dangerous Bacon,

Thank you for the insult. That's another victory for my side today. What a wonderful day! I think I'll go listen to Louis Armstrong now. ...I see skies so blue, red roses too....the good guys win...what a wonderful world!!!!!

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.

And of course some studies end up suggesting this (one out of the UK, for example) just because the numbers work out that way. But I think it's just as mistaken as suggesting that because thimerosal exposure and autism diagnoses increased simultaneously in the first half of the 1990s, then there's a causation effect.

Yes, that's the point: it's as sound as the conclusions the Mercury Militia are drawing.

Dangerous Bacon,

Thank you for the insult. That's another victory for my side today. What a wonderful day! I think I'll go listen to Louis Armstrong now. ...I see skies so blue, red roses too....the good guys win...what a wonderful world!!!!!

Let's have a poll: at what point do anti-vax loonies make themselves so loathsome that it is no longer productive to give them the benefit of the doubt and ascribe their behavior to something other than a sadistic desire to see children crippled or killed by disease?

Posted by: Monica Thanks to people like Barabara Fisher, ... Thanks to parents of immune deficient children who contracted polio from the vaccine, ...

Why would the medical community need a suffering child or parent to lobby those health care providers to evaluate risks and benefits of a vaccine and choose the safest most effective options? Why would we not act when safer vaccines became available? What makes you think the medical community only acts when some suffering person brings something to our attention?

I've spent 8 years at a university and 30 years in practice. Do you think people like me sit around on our asses not caring in the least about our patients or the care we provide? Why would I spend so much time learning my profession and providing health care and then need a suffering person to lobby me to act responsibly? Do you trust a neurosurgeon to cut into your brain yet think that same medical provider would not evaluate the research on the safety of vaccines?

Why do you, with no medical education from the sound of your comments, think you have looked at vaccine safety but the the medical community hasn't? Do you think that we want to cure cancer and heart disease but while we are at it make a few bucks on the side hawking vaccines which result in needless misery for children and parents? Are you serious?

Posted by: Monica How is it we successfully eradicated polio, smallpox, etc, without vaccinating infants? These vaccines were given to older children, not infants.

You could not be any more ignorant of the facts here than this.

Posted by: Monica To think we cannot strive to improve safety is ignorant.

No, Monica. To imagine the medical community has no interest in improving care and safety is where the ignorance lies.

Posted by: Monica I do ask you this, can anyone find a study that shows how many children produce antibodies to the vaccines they received in our current schedule?
I am very interested because my child's immunologist stated that it is NOT abnormal for a child to not respond to vaccines, as the immune system is not mature until age 2. If this were true, then our vaccination program would be faulty, correct?
My child suffered an adverse reaction to either the MMR, or Varicella vaccines. She had encephalitis, seizures, fever, bulls eye rash.
We also discovered she didn't create antibodies to these live virus vacines, and may have some sort of immunodeficiency. That is where it gets tricky, one immunologist said immunodeficiency, based on the lack of antibody response to vaccines. The other said that the lack of antibosy response is typical, but I just don't feel this is true...

So you've taken your personal experience, the failure of the medical community to provide answers or treatment for your child and decided that every one of us are to blame? You have no answers so we must all be at fault? They didn't help your child so we all must not have tried hard enough?

I'd like to offer you empathy for your tragedy, whatever it is. But I'm not in the mood to take the blame you want to heap on me and my 30 years of dedicated practice doing the best job I could. I am a nurse practitioner and I am not making tons of money by any stretch. But I take great pride in my work and I, like most of my colleagues, feel an obligation to providing the best care we can.

Medicine has only been in the business of serious evidence based practice for the last 100 years. Of course we can't cure every patient and of course we don't understand every disease process. But to accuse us of not giving a sh*t is as ignorant as it gets.

By skeptigirl (not verified) on 06 Mar 2008 #permalink

it. If Hannah's mom and dad has been into autism quackery (DAN) since shortly after she was diagnosed as having encephalopathy way back in 2001, they sure must know about Andy Cutler. How come Andy baby hasn't cured their Hannah by now? How come chelation didn't cure her? How come she's still so disabled she can't be left alone for a minute? Your son looks like he has a genetic disorder. Maybe Sotos syndrome?

By John best is losing (not verified) on 06 Mar 2008 #permalink

Askyroth,
Thimerosal has not yet been removed so your conjecture is premature.

John Best Just Won,
Good job, insult my son's appearance when you have nothing intelligent to say.
Perhaps the Poling's child has not been cured yet because they have to deal with the mitochondrial thing that most of us aren't dealing with. Why don't you "scientists" figure out how to help her?

skeptigirl, you ask Why would the medical community need a suffering child or parent to lobby those health care providers to evaluate risks and benefits of a vaccine and choose the safest most effective options? Why would we not act when safer vaccines became available? What makes you think the medical community only acts when some suffering person brings something to our attention?

The reason the antivaccinionists believe the medical community doesn't care about suffering people is because the antivaccionists are projecting. They are projecting their own values, their own beliefs, and how they themselves would behave in that situation onto the medical community. The antivaccionists are all about "me, me, me". They don't consider the adverse consequences of their actions, they believe that no one else does either.

David Kirby doesn't care if parents stop vaccinating and their children are then harmed by preventable diseases. He makes a lot of money fanning these flames and selling torches to the mob trying to destroy the vaccine industry.

First and foremost, I am NOT here to blame anyone, I don't recall stating this was YOUR fault skeptigirl, perhaps you inferred that because you feel guilty? Have you administered vaccines to a child who had a severe reaction?
I am not sure what to make of your attack. I never accused anyone of not giving a "sh*t". In fact, quite the opposite is my experience. My daughter's pediatrician, and her entire team of doctors have been very compassionate, and determined to learn why my daughter had such a reaction. I have never once blamed them, as they could not have known the outcome. You could not be further from the truth.

Secondly, I am NOT antivaccine. I hate when people draw conclusions that are not valid.

We CAN create safer vaccines, we have in the past, and we need to continue to do so. The first step towards that is a more accurate, accessible and well known adverse reporting system.

I find it sad that the ARNP and 2 pediatricians that have been treating my daughter did not know of VAERS, or how to report a reaction. My congressman suggested I do such a thing, and I provided the practice with the correct information.

Thirdly, I have real skepticism with our current state of affairs at the FDA. Let us not forget Ketek, Zelnorm, Oxycontin, Heparin and Vioxx. Let us not forget who funds the FDA.

I would also like to remind everyone that for every congressman in the US, there are approximately 40 pharmaceutical lobbyists. Pharmaceutical companies have more lobbyists in the US than any other industry.

Currently, the only countries that allow direct to consumer advertising of pharmaceutical preperations is the US and New Zealand. Recently, congress asked these corporations to suspend such marketing, until a product has been available for 2 yrs, to allow for a smaller sample size and moniter adverse reactions more efficiently.

Last yr, $48 billion was spent on direct to consumer advertising in the US.

Pharma's lawyers said "no way, we have freedom of speech", which by laws of our constitution, trumps our safety.

Currently, members of our congress are asking that the commissioner of the FDA, Andrew von Eschenbach, resign. Congress has lost confidence in officials over the handling of investigations and oversight by the agency.

Former employees of the FDA often wondered who the client was, the American people, or the companies funding the studies. You can read about it in the NEJM.

The tides are turning, our congress is demanding answers from these corporations, and the FDA, not just about vaccines. I say it is about time.

First and foremost, I am NOT here to blame anyone, I don't recall stating this was YOUR fault skeptigirl, perhaps you inferred that because you feel guilty? Have you administered vaccines to a child who had a severe reaction?
I am not sure what to make of your attack. I never accused anyone of not giving a "sh*t". In fact, quite the opposite is my experience. My daughter's pediatrician, and her entire team of doctors have been very compassionate, and determined to learn why my daughter had such a reaction. I have never once blamed them, as they could not have known the outcome. You could not be further from the truth.

Secondly, I am NOT antivaccine. I hate when people draw conclusions that are not valid.

We CAN create safer vaccines, we have in the past, and we need to continue to do so. The first step towards that is a more accurate, accessible and well known adverse reporting system.

I find it sad that the ARNP and 2 pediatricians that have been treating my daughter did not know of VAERS, or how to report a reaction. My congressman suggested I do such a thing, and I provided the practice with the correct information.

Thirdly, I have real skepticism with our current state of affairs at the FDA. Let us not forget Ketek, Zelnorm, Oxycontin, Heparin and Vioxx. Let us not forget who funds the FDA.

I would also like to remind everyone that for every congressman in the US, there are approximately 40 pharmaceutical lobbyists. Pharmaceutical companies have more lobbyists in the US than any other industry.

Currently, the only countries that allow direct to consumer advertising of pharmaceutical preperations is the US and New Zealand. Recently, congress asked these corporations to suspend such marketing, until a product has been available for 2 yrs, to allow for a smaller sample size and moniter adverse reactions more efficiently.

Last yr, $48 billion was spent on direct to consumer advertising in the US.

Pharma's lawyers said "no way, we have freedom of speech", which by laws of our constitution, trumps our safety.

Currently, members of our congress are asking that the commissioner of the FDA, Andrew von Eschenbach, resign. Congress has lost confidence in officials over the handling of investigations and oversight by the agency.

Former employees of the FDA often wondered who the client was, the American people, or the companies funding the studies. You can read about it in the NEJM.

The tides are turning, our congress is demanding answers from these corporations, and the FDA, not just about vaccines. I say it is about time.

skeptigirl, I would also like to add that when you speak for the entire medical community, as it seems you want to be their spokesperson, you are speaking for the medical community that treats patients.

That is not where the problem lies.

You see, most physicians truly care for the patients they treat, and want to see them healthy.

The individuals at the core of this issue never even see patients! They sit in a lab, or behind a desk, and are very profit driven.

Thankfully congress had ensured that I no longer have to see Dr Robert Jarvick hawking his pills on the air.

Skeptigirl, this is much different from what drives you to care for your patients. You see them, face to face. Corporations see them as dollar signs, and increased revenue.

Trust me, I am all for doctors, nurses, and practicing physicians who treat patients. They have a rough job these days. They are often fed even more b*llsh*t than us patients are.

skeptigirl, I would also like to add that when you speak for the entire medical community, as it seems you want to be their spokesperson, you are speaking for the medical community that treats patients.

That is not where the problem lies.

You see, most physicians truly care for the patients they treat, and want to see them healthy.

The individuals at the core of this issue never even see patients! They sit in a lab, or behind a desk, and are very profit driven.

Thankfully congress had ensured that I no longer have to see Dr Robert Jarvick hawking his pills on the air.

Skeptigirl, this is much different from what drives you to care for your patients. You see them, face to face. Corporations see them as dollar signs, and increased revenue.

Trust me, I am all for doctors, nurses, and practicing physicians who treat patients. They have a rough job these days. They are often fed even more b*llsh*t than us patients are.

sorry bout the duplicate posts, each time I try to post I receive an internal server error, go back and then I am able to post, yet my post appears twice...

Neither "greening" vaccines nor changing the schedules for vaccination is not going to reduce rates of autism, because there is no causal link between vaccines and autism. To believe that there is to also believe that there is a vast conspiracy going on involving our governmental agencies, medical associations, and the governmental agencies of foreign countries.

If you want to continue a fight against vaccines, you will have to do it without autism as an issue.

Lastly I would like to answer one more question that was posed,

"Why would the medical community need a suffering child or parent to lobby those health care providers to evaluate risks and benefits of a vaccine and choose the safest most effective options? Why would we not act when safer vaccines became available? What makes you think the medical community only acts when some suffering person brings something to our attention? "

Vioxx was a wonder-drug, and prescribed heavily, until people started DYING, only then it was found unsafe and pulled from the market. Why wasn't it removed BEFORE people died? Why did it take someone having an adverse reaction to see the problem with Vioxx? Because, we don't fix things that aren't broken.

The "medical community" that you refernce is comprised of physicians treating patients. The "medical community" is not responsible for the development and production of medication and vaccines.

I am certain that most of the medical community WOULD use safer vaccinations once they were made available.

It does not make sense to change a product if it is safe, and works. Again, why fix something that is not broken?Unfortunately, it often does take injury to even know that injury can occur, that is why we have adverse event reporting systems. When injury occurs, the individuals responsible for proucing and maintaining the safety of medication and vaccines also share the reponsibility in creating safer alternatives.

That is not your job, nor my doctor's job, nor my daughter's pediatrician's job.

That is up to the FDA and pharmaceutical companies.

If children were not contracting polio from the OPV, we would still use it. Before the switch to the IPV in 2000, the OPV was primarily the ONLY option, so that is what was used. Once a safer vaccine was available, doctors used it!

I am sure if "the medical community" had access to inactivated measles, mumps, ruebella and varicella vaccines, they would use them too, but sadly, they are not in production.

Lenora, who is fighting against vaccines? There truly are few who feel we DON'T need vaccines, and they are generally NOT the autism parent crowd.

Most of us just think we need safer vaccines.

Monica said "I find it sad that the ARNP and 2 pediatricians that have been treating my daughter did not know of VAERS, or how to report a reaction. My congressman suggested I do such a thing, and I provided the practice with the correct information."

This is very odd. Since you claimed earlier that your child suffered from either the MMR or varicella vaccine, the year was after 1995 (when the varicella was introduced). Now each and every time my children have been vaccinated (starting in 1988), I have been handed a sheet of paper explaining the risks of the vaccine with information about VAERS and how to file a claim with VICP. Example here:
http://www.immunize.org/vis/varic07.pdf (see second page)

You also have three years to file a claim. So if you went shortly after the adverse reaction to give that information to the doctors, you were still within the time limit.

You also claimed that polio is not given to infants, yet there is easily available information showing that is not true. If you had been diligent about your child's vaccines until she got her MMR after her first birthday, you would have known that (or at least have a copy of her vaccine record available, given that varicella was not available until 1995, your child may not be older than 12 or 13 years old).

Monica, there are some serious holes in your anecdote.

I do want to share with you, my daughter was dx'd by a developmental pediatrician as severely autistic, as her BEHAVIORS met certain criteria for the dx. No labs or tests were ordered, which is par for the course with autism. They say autism, and look no further.

I insisted that we rule out possible other conditions, and consulted many specialits, including immunology, infectious disease, neurology and endocrinology.

My daughter was found to not have responded to many vaccines, and had some "immune dysfunction" at time of vaccination, allowing one of the 4 live viruses to replicate, and cause infection. Too bad they can't check a child's immune status before vaccinating, huh?

Upon referral to a neurologist, she was diagnosed with encephalopathy, based on her MRI and vaccine reaction. This is an accepted sequelae of a live virus reaction of an immunocomprimised individual.

But that pesky autism diagnosis, which is based soley on a set of behaviors, has prevented us from seeking compensation from the NVICP.

Gee, you guys really like to argue, huh?

I claimed that the polio vaccine WASN'T given to infants. My parents remember standing in line at school to receive their OPV in a cup. We were successful in eradicating these diseases while vaccinating at a much older age.

My daughter WAS immunized with the IPV as an infant, and I have never inferred otherwise, as it is part of our current pediatric vaccination schedule. The CDC should be commended for reccomending the change to the IPV, as it is inactivated, cannot replicate and cause VPDV in an abnormally functioning immune system. It is a SAFER vaccine.

Let me tell you about that vaccine information statement.

My child's pediatrician did not hand these out. I was given a laminated copy to review while awaiting a nurse to administer the vaccines. Usually, you are trying to console a baby who is already upset that someone just shoved things in their ears and mouth, and do not have a chance to fully absorb the information contained in the VIS. This has become standard practice with MANY pediatricians, and needs to change. Parents should be able to review the VIS PRIOR to vaccination, and I don't mean simply 5 minutes prior, like before the next appointment prior.

My daughter's pediatrician now makes copies of these to be sent home with the parent at time of vaccination.

As incredulous as it sounds, many pediatricians are unfamiliar with filing a VAERS report.

Do not assume that because you have knowledge of filing with VAERS, that everyone in practice does. Sadly, we have not put enough effort in educating physicians regarding VAERS.

Again, I ask the question I came here to ask- does anyone know where I can find a full scale study of children that shows they have postive antibody response to ALL the vaccines they receive? I have searched google scholar and come up with many that study the MMR, DTP, etc. response, but nothing that takes a group of children and looks at the entire picture.

What I am more afraid of than an epidemic of autism, is the statement the immunologist made- that a child's immune system is not mature until age 2, and a negative vaccination response is typical. If this statement is true, and children are vaccinated by 18 months, then we are in very serious danger of widespread epidemics in coming years.

That is what I need answered. I do not need to argue, or go into detail about the link between autism and vaccines, nor defend statements that I have made concerning vaccines. I don't enjoy arguing, did not come here to do so. I would rather simply have a question answered by individuals who seem mildly intelligent, which, I had thought, many here were.

Monica:

"The individuals at the core of this issue never even see patients! They sit in a lab, or behind a desk, and are very profit driven."

Do you understand the the overwhelming vast majority of basic science research regarding the mechanisms of disease and understanding normal bodily mechanisms/functions occurs in non-profit academic, research institutes and government labs. Do you have any understanding of how poorly academic scientists get paid relative to industrial scientists. I find it extremely laughable that you would call us profit-driven. Another thing, physicians would be no better than snake oil salesmen/women if they couldn't fall back on the research of non-physician scientists to guide their diagnoses and provide clarity as too why certain treatments or diagnoses are biologically plausible. That's why quacks/alties have an utter disregard for basic science research because time and time again the basic research flies in the face of their snake oil.

Monica -

From the CDC, all the references are there if you want to look them up:
http://www.cdc.gov/MMWR/preview/MMWRhtml/00053391.htm

Live attenuated mumps virus - 97% develop measurable Ab

Live attenuated measles vaccine - 95% at age 1, 98% at age 2

Live attenuated rubella vaccine - 95% at age 1 or older

Think of immune system development as analogous to neurological development. The current understanding, of what I'm aware, is that brain is not fully developed until sometime during early 20's. So maybe we should not teach children until their brain is fully developed, wrong. All vaccines are doing are training the developing immune system to recognize certain pathogens so then upon subsequent exposure you get a quicker and more robust response to them than you would if it was the first time you recognized that pathogen.

I sympathize with your daughter's plight. Nothing is 100% effective and everything has side effects. The problem is that when you deal with public health issues you have to take the perspective of what is best for the population in general.

Monica, you seem to be under the mistaken impression that the only antigens that the immune system has to deal with are those in vaccines. This is simply not the case. Every child is exposed to thousands of times more antigens every day than those from vaccines. Essentially every bacterium a child is exposed to is a potentially lethal infection. That includes thousands of bacteria in the child's mouth and gut (which are absolutely necessary for good health). The reason (and the only reason) that essentially every bacterium a child is exposed to doesn't cause a LETHAL INFECTION is because of the immune response that child produces.

Every single little infection, cold, runny noses, etc is caused by some sort of immune response. There are vastly more immune responses that "catch" the infection before it causes any symptoms.

If a child doesn't live in a bubble and is still alive at age 5, is excellent evidence that the child has a reasonably good immune system.

I don't know where you are coming from. You say "we can make safer vaccines, we have in the past", and then go on a diatribe about non-vaccine pharmaceuticals. Do you have a scrap of evidence to back up your statement about vaccines? It is my impression that vaccines today are safer than they have ever been. In other words there is no time in the past when vaccines were safer than they are today.

To Azkyroth:

I have used the term anti-vac liar sociopath and, more recently, Merchant of Disease, Disability and Death, to describe these beings. Neither gets across just how loathesome they are.

Has anyone ever seen *J*ohn *B*est and *J* *B* Handley at the same time? Could they actually be the same person?

Now, for the next question. Which one did I insult?

:)

Daedelus2u said: Monica, you seem to be under the mistaken impression that the only antigens that the immune system has to deal with are those in vaccines. This is simply not the case. Every child is exposed to thousands of times more antigens every day than those from vaccines. Essentially every bacterium a child is exposed to is a potentially lethal infection. That includes thousands of bacteria in the child's mouth and gut (which are absolutely necessary for good health). The reason (and the only reason) that essentially every bacterium a child is exposed to doesn't cause a LETHAL INFECTION is because of the immune response that child produces.

Every single little infection, cold, runny noses, etc is caused by some sort of immune response. There are vastly more immune responses that "catch" the infection before it causes any symptoms.

If a child doesn't live in a bubble and is still alive at age 5, is excellent evidence that the child has a reasonably good immune system.

I don't know where you are coming from. You say "we can make safer vaccines, we have in the past", and then go on a diatribe about non-vaccine pharmaceuticals. Do you have a scrap of evidence to back up your statement about vaccines? It is my impression that vaccines today are safer than they have ever been. In other words there is no time in the past when vaccines were safer than they are today."

Excellent! Right on target.

Monica said: Gee, you guys really like to argue, huh? I claimed that the polio vaccine WASN'T given to infants.

Me: That may have been true during the early trials. However, it did change, as you said.

Monica: My parents remember standing in line at school to receive their OPV in a cup.

Me: I recall getting the shots, and then the cup. I was a Salk/Sabin kid.

Monica: We were successful in eradicating these diseases while vaccinating at a much older age.

Me: You do not really know, do you? You are inferring that solely from your parents story. If you really know, how do you really know?

Monica: My daughter WAS immunized with the IPV as an infant, and I have never inferred otherwise, as it is part of our current pediatric vaccination schedule. The CDC should be commended for reccomending the change to the IPV, as it is inactivated, cannot replicate and cause VPDV in an abnormally functioning immune system.

Me: Actually, it could cause polio in a normally functioning immune system.

"Let's have a poll: at what point do anti-vax loonies make themselves so loathsome that it is no longer productive to give them the benefit of the doubt and ascribe their behavior to something other than a sadistic desire to see children crippled or killed by disease?"

I'd call it "reckless indifference" rather than "a sadistic desire", when it comes to the consequences of children seriously ill, crippled or killed by a vaccine-preventable disease. And as with other ideologies, the element of sociopathy is proportional to the extreme vehemence with which antivax theories are promulgated.

When one's response to the reality of a child being harmed (by anything) has degenerated to the level of "so what?" and sneering about "sob stories", it's time to address one's basic decency and humanity.

By Dangerous Bacon (not verified) on 07 Mar 2008 #permalink

Monica,

Save your sanity, don't engage with these people. They have no interest in what happened to your child... none whatsoever. Don't bother with them. They are a bit desperate right now as I'm sure that you can understand.

By Anonymous (not verified) on 07 Mar 2008 #permalink

John Best sadi: "I hope you guys enjoyed the press conference as much as I did. Now you can give up your obfuscation of the truth and engage in other pursuits. You put up a decent battle but the good guys just won!!!"

Great word John, obfuscation, you use it quite a bit according to Google.

So does this mean you will be filing a lawsuit claiming your son suffers from a mitochondrial disorder? You've always claimed it was thimerosal, and thimerosal alone, that causes autism. All autism. You have more integrity than to switch gears just to try to capture a big pay out from Uncle Sam, right?

By notmercury (not verified) on 07 Mar 2008 #permalink

Monica wrote

I am very interested because my child's immunologist stated that it is NOT abnormal for a child to not respond to vaccines, as the immune system is not mature until age 2. If this were true, then our vaccination program would be faulty, correct?

As any neuroscientist will tell you, the brain is not mature until adulthood. Does that mean that our education program of sending children to school is faulty?

Askyroth,
Thimerosal has not yet been removed so your conjecture is premature.

What vaccines has thimerosol not been removed from, and do you have a single documented source to back that up?

Monica: ...perhaps you inferred that because you feel guilty? Have you administered vaccines to a child who had a severe reaction?

As a matter of fact, in 30 years of giving thousands and thousands of vaccinations, I have yet to even see a single serious reaction. Besides a few people fainting, one person in all that time had an irritated brachial nerve after a flu shot. It eventually resolved. He still gets flu shots every year.

Monica: We CAN create safer vaccines, we have in the past, and we need to continue to do so. The first step towards that is a more accurate, accessible and well known adverse reporting system.
I find it sad that the ARNP and 2 pediatricians that have been treating my daughter did not know of VAERS, or how to report a reaction. My congressman suggested I do such a thing, and I provided the practice with the correct information.
Thirdly, I have real skepticism with our current state of affairs at the FDA. Let us not forget Ketek, Zelnorm, Oxycontin, Heparin and Vioxx. Let us not forget who funds the FDA.
I would also like to remind everyone that for every congressman in the US, there are approximately 40 pharmaceutical lobbyists. Pharmaceutical companies have more lobbyists in the US than any other industry.

You prove my point. You trust the medical community, you don't trust the medical community. You know stuff about the FDA you think we don't know. Your provider didn't know about VAERS so the entire medical community must not know. And you think I speak of the collective "we" as just care providers or whatever parameters you put on that "we" which allows you to discount vaccine information that is inconsistent with your beliefs.

The collective "we" includes all providers, all medical researchers, all countries, all medical universities, all government organizations involved in medical practice oversight from each state's board of pharmacy to the CDC, from the FDA to the ACIP to the WHO.

The overwhelming consensus in all these people and organizations is that vaccines are safe, they don't cause autism, and the misinformation which swirls around the anti-vaccine crowd regardless of whether or not you view yourself as one of them has been looked at and discarded as misinformation by that collective "we", the medical community. There is no debate within the medical community with the exception of a few oddballs one has to wonder how they ever passed their licensing exams. Dr Cutler, by the way, the 'doctor' who touts mercury in dental fillings as causing autism is a chemist, not a medical doctor. Having a college degree is no guarantee of having reliable opinions.

Monica: The individuals at the core of this issue never even see patients! They sit in a lab, or behind a desk, and are very profit driven....
Skeptigirl, this is much different from what drives you to care for your patients. You see them, face to face. Corporations see them as dollar signs, and increased revenue.
Trust me, I am all for doctors, nurses, and practicing physicians who treat patients. They have a rough job these days. They are often fed even more b*llsh*t than us patients are.

Again proving my point. For this to be the problem, the part of that collective "we" in the medical community who provide care would have to be duped, stupid or in on it. And you, in your infinite wisdom would then be able to see what those of us with years of experience and education cannot see. You have that special ability to figure this all out while the rest of us are fooled.

Monica: Vioxx was a wonder-drug, and prescribed heavily, until people started DYING, only then it was found unsafe and pulled from the market. Why wasn't it removed BEFORE people died? Why did it take someone having an adverse reaction to see the problem with Vioxx? Because, we don't fix things that aren't broken.
The "medical community" that you refernce is comprised of physicians treating patients. The "medical community" is not responsible for the development and production of medication and vaccines.
I am certain that most of the medical community WOULD use safer vaccinations once they were made available.
It does not make sense to change a product if it is safe, and works. Again, why fix something that is not broken?Unfortunately, it often does take injury to even know that injury can occur, that is why we have adverse event reporting systems. When injury occurs, the individuals responsible for proucing and maintaining the safety of medication and vaccines also share the reponsibility in creating safer alternatives.
That is not your job, nor my doctor's job, nor my daughter's pediatrician's job.
That is up to the FDA and pharmaceutical companies.
If children were not contracting polio from the OPV, we would still use it. Before the switch to the IPV in 2000, the OPV was primarily the ONLY option, so that is what was used. Once a safer vaccine was available, doctors used it!
I am sure if "the medical community" had access to inactivated measles, mumps, ruebella and varicella vaccines, they would use them too, but sadly, they are not in production.

Here you are simply poorly informed as are many people. Perhaps I can actually help you understand these issues a little better.

Our system of medical care includes corporations, profit motives, more advertising than it should, market forces which encourage copycat drugs to take existing market share rather than incentives to make a better product and few incentives to make unprofitable drugs that are needed such as new antibiotics. These are extremely complex issues and it is naive to draw black and white, good and evil conclusions about them.

Let's just take the VIOXX example. You can only study a drug on so many people before you release it for use. It isn't practical to test a drug on a million people before marketing it. But if side effects are rare, then they are not always going to show up in testing. As a prescriber, I know that. So I use older treatments when they work and save newer drugs for people with no other options. After the newer drugs are on the market, more safety data is collected. And if the drug is truly superior, then I might switch it to being a first line prescription.

Companies do bad things. They decide to not release research they should have. But if this was the over ridding theme of prescription drugs, you'd have a lot more dead people than we do. We have people surviving terrible cancers, heart disease, trauma, infections, and so on. Medical care is successful. Because the system isn't perfect does not make me incompetent in assessing medical research. Because a company was unethical does not discount the fact the medical community detected the problem and corrected it. You can trust the VAST MAJORITY of the medical system.

And you can trust that when the vast majority in the medical community has looked at vaccine research, at decades of use, at public concerns, and have come to a general consensus identifying the valid information and the invalid information. Your imagination has run wild. Medicine is successful. The collective "we" are efficient at getting to the evidence and drawing the right conclusions.

The collective "them" as in anti-vaxers are not seeing something the rest of us can't. It is the other way around. We see where their logic fails. We see how they drew a false conclusion because they didn't understand something. We see how they overgeneralize single wrongdoings into an entire evil corporate world.

Monica: Most of us just think we need safer vaccines.

Vaccine safety is incredibly good. Vaccines prevent infections that would otherwise kill millions. I'd like to see an investment in research figuring out how to communicate that fact to people as much as research producing a safer flu vaccine for example. There are many things competing for scarce research and development dollars. If those resources were infinite maybe we'd have that cure for aging along with absolutely safe vaccines. Thinking vaccine safety is a pressing priority makes one lose sight of the real risk here, that of the actual diseases vaccines prevent.

Vaccine safety is continually monitored. The rotovirus vaccine was tried, stopped, reformulated and in use again. We switched to killed polio vaccine when the number of cases of vaccine associated polio exceeded wild viral polio. But there was a reason to use the live vaccine and there still is in parts of the world polio is still endemic. The killed vaccine is not as effective and takes longer to cover large at risk populations. That decision was not made lightly. It was made after careful evaluation of the risks and benefits of using each vaccine.

Couple other misconceptions in your posts:

We could not possibly eradicate polio without vaccinating infants. I believe I already addressed this. The pool of susceptible people would be too large.

The vaccinated person getting the live polio vaccine is not the usual victim of vaccine related polio, it is an unvaccinated person infected from viral shedding in the stools of the vaccinated person. The vaccine virus mutates back into a disease causing virus but only after passing through at least one host.

The reason for delaying live vaccines is not because the immune system is not mature. Either your doctor was misinformed or he/she oversimplified the explanation as a matter of expedience. Neither is a big deal since the recommendations of when to vaccinate comes from those who do know. Maternal antibody protects newborns to varying degrees for varying length of times. Live vaccines work by giving the person a mild infection rather than the risk of a severe infection with the real organism. So if the baby does not get the mild infection because the mother's antibodies protect it, then no permanent immunity occurs either.

You wait until 15 months to give live vaccines because maternal antibody is mostly gone by then. But we actually give MMR vaccines to 6 month and older kids during outbreaks. We just repeat the vaccine again at 15 months. It is not dangerous to do that.

We give more doses of the initial series of some vaccines to infants because their immune system is less mature. So 4-5 doses might be required when an unvaccinated adult might only require 3 doses in the initial series. Again, this does not endanger the younger children.

By Skeptigirl (not verified) on 07 Mar 2008 #permalink

Correction: After re-reading what you posted, Monica, about what your doctor said about immune system maturity, it sounds like it was correct and you drew incorrect conclusions about what it meant. The information in bold above should still explain the problem for you.

By Skeptigirl (not verified) on 07 Mar 2008 #permalink

Monica said "Gee, you guys really like to argue, huh?

I claimed that the polio vaccine WASN'T given to infants. My parents remember standing in line at school to receive their OPV in a cup. We were successful in eradicating these diseases while vaccinating at a much older age.

My daughter WAS immunized with the IPV as an infant, and I have never inferred otherwise, as it is part of our current pediatric vaccination schedule."

It is not so much that we like to argue, but I for one like to see a bit more accuracy and consistency. You said that the polio vaccine was not given to children, that was very very wrong. There is also a precedent in the veracity of some of the information being put out by a certain factions:
http://scienceblogs.com/insolence/2006/11/has_it_really_been_a_whole_ye…
http://www.pathguy.com/antiimmu.htm

So you are going on what your parents on about the polio vaccine as far the 1950s vaccine schedule? Perhaps they got as school children because they were born a few years before Sabin and Salk developed their respective polio vaccines.

I got it as an infant, and all of my three children received the OPV as infants. The youngest did get the IPV for her last dose. The switch from OPV to IPV occurred between 1996 and 1999, starting with IPV for infants to OPV for older children. The IPV only schedule was put into effect about 1999, so that would make your daughter less than 10 years old.

It would seem that if you did not get a printout of the vaccine information sheet then your medical care practitioners were sub par. I have held crying babies, had more than one vaccinated at a time, and each and every time I received information, plus Tylenol drops and time in the exam room for the child after the vaccine.

Also, if your child and seizures and encephalitis then the personnel at the hospital might have informed you of the possibility. Since my oldest son has had several hospitalizations (starting with his first week of life), I know that I have been given lots of information, and even received phone calls from our family doctor during those times. I have read the long long reports from the neurologists, the speech therapists and more recently the cardiologist. He is twice your daughter's age, and the standards of reporting and informing have not changed that much (except now you have to sign a sheet before the child is vaccinated). I would suggest that if you are not receiving these reports that you change medical care practitioners.

Oh wait, you clarified by saying "Upon referral to a neurologist, she was diagnosed with encephalopathy, based on her MRI and vaccine reaction. This is an accepted sequelae of a live virus reaction of an immunocomprimised individual."

Umm, encephalopathy is not the same as encephalitis. My son has a diagnosis of "Static encephalopathy"... which is neuro talk for "something is wrong, we don't know what, but it is not changing". You need to read those doctor reports a bit more carefully.

Now you continued: "But that pesky autism diagnosis, which is based soley on a set of behaviors, has prevented us from seeking compensation from the NVICP."

Then how do you explain the Autism Omnibus?

Maybe I didn't ask the question correctly, is it typical for children to NOT respond to vaccines???

If what my daughter's immunologist mentioned is true, then perhaps our vaccination system is faulty, but I have a hard time beleiving that. I am curious as to why my daughter, who is otherwise extremely healthy (she did have this nasty explosive GI problems after the reaction, and lost 5 lbs, stopped growing for a yr, etc) but otherwise, she NEVER gets sick, she is 4, and has only had a fever 3 times (including the reaction).

She did not respond to components of Prevnar (although she had 1 too many doses, "clerical mistake" they said), or Varicella (I believe it was the varicella she reacted to, as she had erythema multiforme, commonly associated with herpes-virus infection, also the leading cause of encephalitis)

Perhaps the OPV could cause VDPV in a sick person, if they are sick while being vaccinated, but a healthy person? That goes against all the literature I have found so far.

Could other live virus vaccines cause infection and replication in an otherwise healthy person?

TheProbe- could you find a history of the vaccination age of the Polio vaccine? It is something I am greatly interested in, as the end game strategy for global polio eradication could be a good model to follow for other vaccine preventable diseases, especially the ones we still use live viruses for.

Askyroth, the flu vaccine still contains thimerosal. Autism aside, it's just not smart to inject babies with mercury, to remove it is a step towards safer vaccination.

btw, for all you naysayers, If your child suffered a reaction to a live virus vaccine, had encephalitis, and was consequently dx'd with autism, all while this debate rages, you would be searching for answers for your child, too. It is difficult to know what to believe when you have seen something with your very eyes that science tells you is impossible. And to be attacked when asking honest questions is simply disturbing.

HCN, I could not join the "autism omnibus" because my daughter did not have thimerosal containing vaccines, no lawyer will touch the case, it's mercury, or nothing...

the burden of proof with the NVICP is with the patient's family, and it is exhaustive...

I had thought encephalopathy was the outcome of encephalitis? The neurologist feels my daughter had encephalitis based on the reaction, and the MRI findings. What would the sequelae of encephalitis be called?

Monica said "Maybe I didn't ask the question correctly, is it typical for children to NOT respond to vaccines???"

It is not typical, but it does happen.

and continued "btw, for all you naysayers, If your child suffered a reaction to a live virus vaccine, had encephalitis, and was consequently dx'd with autism, all while this debate rages, you would be searching for answers for your child, too."

So you child is back to having encephalitis, and not just encephalopathy.

So what to you say to a parent (like me) whose child suffered seizures and ensuing static enchephalopathy, with the severe speech disorder with subsequent learning disability... from an actual disease?

Do you think that it would be better for children to go unvaccinated until age two? How would you deal with the increase of Hib, pertussis, and rotavirus? Right now, even with a fairly high number of babies being vaccinated for pertussis several infants die per year from pertussis (see my first comment above). How many more babies will die from pertussis if we stopped vaccinating them... how do you deal with more of this: http://www.pertussis.com/see.html .

Then there is Hib, a horrible disease that use to kill several hundred babies and toddlers per year, http://www.hibdisease.com/parents_faq.html . So you want us to wait on that, and let only the strong survive?

Oh, the day of the reaction, we went to the ER, the doctor said "hand foot and mouth", although Jade didn't have anything on her hands, feet, or mouth. That, and I have seen HFM a few times teaching preschool, and it never appeared as a bulls eye rash, or with seizures.

I asked if it could be related to the vaccines, and the doctor in the ER assured me that a vaccine reaction could only happen within 5 days. This was 3 weeks after the MMR and Varicella. Oddly I believed that statement from him, in retrospect, if I questioned the HFN, I should have questioned the possibility of a vaccine reaction.

I didn't feel comfortable with the dx of HFN, my daughter was arching her back, screaming, and unresponsive, so we went to another ER, and after waiting in the lobby 5 hours without being seen, and considering the fever broke, we went home before seeing a doctor.

That is a decision I will always regret, as it was that day that my daughter was forever changed. Something about the way her eyes would not focus, and she would look right through me. For months, she was simply vacant.

She is not so "vacant" anymore, happy, and energetic but still is not able to communicate. She is only 4, and it is too early yet to tell what the future holds for her.

Some information on vaccine schedules from http://www.cdc.gov/vaccines/pubs/pinkbook/pink-chapters.htm (much better than Google Scholar, though in the future you should start your medical issues research with www.medlineplus.gov )

From the Hib chapter:
Incidence is strikingly age-dependent. In the prevaccine era, up to 60% of invasive disease occurred before age 12 months, with a peak occurrence among children 6-11 months of age. Children 60 months of age and older account for less than 10% of invasive disease.
In 1998-2000, approximately 44% of children younger than 5 years of age with confirmed invasive Hib disease were younger than 6 months of age and too young to have completed a three-dose primary vaccination series. Fifty-six percent were age 6 months or older and were eligible to have completed the primary vaccination series. Of these age-eligible children, 68% were either incompletely vaccinated (fewer than 3 doses) or their vaccination status was unknown.
Thirty-two percent of children aged 6-59 months with confirmed type b disease had received three or more doses of Hib vaccine, including 22 who had received a booster dose 14 or more days before onset of their illness. The cause of Hib vaccine failure in these children is not known.

.... Note that young children still got Hib even when older children were vaccinated, and they admit there is vaccine failure.

From the pertussis chapter:
During 2001-2003, the highest average annual pertussis incidence was among infants younger than 1 year of age (55.2 cases per 100,000 population), and particularly among children younger than 6 months of age (98.2 per 100,000 population). In 2002, 24% of all reported cases were in this age group. However, in recent years, adolescents (11-18 years of age) and adults (19 years and older) have accounted for an increasing proportion of cases....
...
Of the 10,650 children 3 months to 4 years of age with reported pertussis during 1990-1996 and known vaccination status, 54% were not age-appropriately vaccinated with DTaP.
.....

Still that means that the vaccine does not always work, and it wears off.

And if you read the measles chapter about the outbreak in 1990 or so you will come upon this paragraph:
"1989-1991 was low vaccination coverage. Measles vaccine coverage was low in many cities, including some that experienced large outbreaks among preschool-aged children throughout the early to mid-1980s. Surveys in areas experiencing outbreaks among preschool-aged children indicated that as few as 50% of children had been vaccinated against measles by their second birthday, and that black and Hispanic children were less likely to be age-appropriately vaccinated than were white children"

It seems that waiting to vaccinate children until they are older will not work.

HCN, I think you have me confused with anti-vaccine. I believe I stated before, no, I am not.

I do feel we need to determine if a child's immune system is strong enough before certain vaccines. We should not take a "lets throw em all to the wall and see what sticks" approach.

I am terribly sorry your child suffered a severe reaction to a disease. That is why we NEED vaccines, but we do need safer vaccines, and greater oversight of adverse reporting.

In doing much late night research, I was astonished to learn how many Primary Immunodeficiencies are now identified, double what we knew about in 2000. Many of those kids could never have a chance in hell of creating an antibody response. Not only can they suffer an adverse reaction to certain vaccines, but they are part of the very population we need to protect with herd immunity.

If you don't mind my asking, was it a vaccine preventable disease that cause your child's reaction?

HCN, I think you have me confused with anti-vaccine. I believe I stated before, no, I am not.

I do feel we need to determine if a child's immune system is strong enough before certain vaccines. We should not take a "lets throw em all to the wall and see what sticks" approach. That is dangerous, and if your child was not one that "stuck", you would agree.

I am terribly sorry your child suffered a severe reaction to a disease. That is why we NEED vaccines, but we do need safer vaccines, and greater oversight of adverse reporting.

In doing much late night research, I was astonished to learn how many Primary Immunodeficiencies are now identified, double what we knew about in 2000. Many of those kids could never have a chance in hell of creating an antibody response. Not only can they suffer an adverse reaction to certain vaccines, but they are part of the very population we need to protect with herd immunity. They are the ones that you hear about that DIE from the measles, and Varicella, as their immune systems are too weak, or do not respond properly.

If you don't mind my asking, was it a vaccine preventable disease that cause your child's reaction?

Thanks for the info - I had forgotten about pertussis. I know there's quite enough information that there's no link, I was just speculating about making a more sociological way around it since so many of those people won't be convinced by reality. But, of course, that would only be feasible if there were no bad effects from delaying immunizations.
I've seen the question raised of how much of the increase in autism rates is because of better/more sensitive diagnostics, but I've never been able to find a solid answer. That has to be part of it; my son has a high-end autism spectrum diagnosis and I know 20 years ago he would have just been labeled a "difficult" child. I doubt that's all of it, but I hate that the anti-people use the total increase as a scare number without adjusting.

Monica,

I would say that it is not typical for children to not respond to vaccines using the MMR vaccine as an example. Once again I will point you to the CDC website:
http://www.cdc.gov/MMWR/preview/MMWRhtml/00053391.htm

Live attenuated mumps virus - 97% develop measurable Ab (3% don't respond)

Live attenuated measles vaccine - 95% at age 1, 98% at age 2 so at age 1 you have a 5% non-response rate and by age 2 you have a 2% non-response rate.

Live attenuated rubella vaccine - 95% at age 1 or older (5% non-response rate)

I hope this answers your question.

Having a seizure three weeks after the MMR vaccine does suggest it was NOT the vaccine. There are other illnesses that cause problems, and seizures.

My son got his seizures two weeks after his MMR, but it was not the disease, but the very nasty (possibly rotavirus) gastrointestinal disease that was the cause. He had no fever but was dehydrated. I also had the same bug, I was also suffering... yet I have never had the MMR (just the real diseases, including having mumps twice!).

How would you know it was the MMR versus a form of influenza that caused the seizures? (sorry, we don't get much hand and foot around here, just looked it up, yes it can cause febrile seizures) Or how do you know it was not a form of bug bite? How did you know the rash was where the vaccine was given? Or even a strep infection (our family went through a period of repeated strep infections, and some did include rashes... it turned out one child had the infection but no symptoms and he kept re-infecting his siblings!) Did you remember the exact spot when you could not even remember reading the Vaccine Information Sheet.

The MMR has been used in the USA since 1971, and has never contained thimerosal. It can cause seizures, but usually within the first few days. There are lots of other pathogens floating around that are more likely to cause an illness several weeks after the vaccine.

Also, you say "In doing much late night research, I was astonished to learn how many Primary Immunodeficiencies are now identified, double what we knew about in 2000. Many of those kids could never have a chance in hell of creating an antibody response."

If you look at that right, it is because research is identifying more kinds, and finding better and more treatments. There is not an increase in cases, but better identification:
http://www.nichd.nih.gov/publications/pubs/primary_immuno.cfm

and it is true that they should not receive live virus vaccines... from:
http://www.aafp.org/afp/20031115/2001.html ... "Most patients with primary immunodeficiencies should not receive live virus vaccines, including live oral poliovirus vaccine (OPV). Because of the risk of infection, OPV also should not be given to persons in close contact with these patients.14 In addition, most patients with primary immunodeficiencies should not receive measles, bacille Calmette-Guérin, and varicella vaccines. One exception would be patients with B-cell deficiency, who should receive varicella vaccine."

But it also says "Severe combined immunodeficiency is characterized by severe opportunistic infections, or by chronic diarrhea and failure to thrive in infancy." ... so they should know the child has the problem before they are a year old. The paper lists steps to identify those with problems. And it is fortunate that the IPV is the polio vaccine in use now (as it turns out, that is what I was vaccinated with as a baby, the OPV came out when I was four years old).

Anyway, it says that up to half a million people in the USA have Primary Immunodeficiencies. In a country with a population 300 million, in incidence is less than 0.2% --- schizophrenia is more common than that! Though it is twice as common as my son's genetic heart condition, hypertrophic cardiomyopathy.

By the way, I got the references from MedlinePlus and PubMed. I plugged "vaccine failure" into PubMed and found lots of papers addressing that issue, mostly on vaccines being developed. If you go back you will find that there are studies on MMR effectiveness based on age (I know I've seen ones where the issue of giving the vaccine before the child turned one in Africa for wider coverage versus effectiveness due to remaining immunity from the mother, but I can't find them amongst all of the vaccine studies, hundreds of pages!).

Carlie, you ought to read:
http://www.amazon.com/Unstrange-Minds-Remapping-World-Autism/dp/0465027… ... the author is an anthropologist with an autistic daughter. He goes to Korea, India and Africa to compare the cultural difference in identifying and treating autism, plus a bit about the changes in diagnosis.

And this book (also by a father of an autistic child):
http://www.amazon.com/Not-Even-Wrong-Fathers-Journey/dp/1582344787/ ... it goes into more historical examples.

As far as changes in diagnosis... When my now 19 year old son was first in special ed. preschool in 1991, the teacher told us (parent group), that only fifteen years before many of our kids would have been institutionalized and considered mentally retarded because of their inability to speak. My son was and is not a difficult child, and he learned sign language to communicate. By the way, in a classroom of kids just like himself he finally started to use his voice. He does speak now (ten years of speech therapy!), but it is not "normal", and is sometimes hard to understand.

The neurologist kept telling us he was NOT autistic. He was sweet, engaging, but could not speak. This was before the DSM was changed to expand the autism criteria in 1994 (it is discussed in Unstrange Minds). Fast forward to his senior year in high school, where the school psychologist suggested that he might have Asperger's. Sigh.

Askyroth, the flu vaccine still contains thimerosal. Autism aside, it's just not smart to inject babies with mercury, to remove it is a step towards safer vaccination

Why? Thimerosol has been repeatedly demonstrated not to be harmful in the doses used in vaccines. If anything, removing that preservative seems to have made vaccines less safe by increasing the risk of contamination; I recall reading in passing about a string of cases recently. Insisting that the tiny amount of mercury in that form is harmful is like insisting that you would never allow your child to consume "a poison used as a chemical weapon in World War I".

Carlie: I've seen the question raised of how much of the increase in autism rates is because of better/more sensitive diagnostics, but I've never been able to find a solid answer.

From what I read recently the initial rise in rates of autism could have been explained as increased reporting. But the rates continue to rise and increased reporting should have tapered off by now.

So it's probably a little of both.

By Skeptigirl (not verified) on 08 Mar 2008 #permalink

Suggesting thimerosal should be removed from all vaccines for kids based solely on the fact the word, "mercury" conjures up the thought of toxins is foolish. We use toxins to our benefit all the time. The tetanus vaccine is actually tetanus toxoid, IE it is a toxin we derive a great benefit from.

You don't make medical decisions based on "better safe than sorry". You make the decisions based on risk/cost and benefit/risk of not intervening. We have > 50 year history of using thimerosal as a preservative in medications as well as vaccines and a whole host of other products such as contact lens solutions. It has an excellent track record and is extremely useful in preventing bacterial contamination in multidose vials and other products.

And multidose vials save needed medical resources. Single dose vials add cost so there is a trade off in taking the thimerosal nonsense too far.

Keep the thimerosal, eat a few less tuna sandwiches over the year.

By Skeptigirl (not verified) on 08 Mar 2008 #permalink

Vioxx was a wonder-drug, and prescribed heavily, until people started DYING, only then it was found unsafe and pulled from the market. Why wasn't it removed BEFORE people died? Why did it take someone having an adverse reaction to see the problem with Vioxx? Because, we don't fix things that aren't broken.

This is a completely untrue account. In fact, Vioxx was widely used, without anybody "noticing" any problem of people dying. Most likely, nobody would have ever noticed a problem, because the elevated risk of cardiovascular complications from Vioxx is very small, so small that it was only detected--by Merck, the drug's manufacturer--in a large, carefully controlled double-blind study carried out by Merck. Merck voluntarily withdrew the drug from the market, probably more for liability than for medical or scientific reasons.

It is still unknown whether Vioxx caused more deaths than it prevented. Vioxx was developed as a safer substitute for older anti-inflammatory drugs such aspirin, which are estimated to kill more than 7,000 people per year, because they increase the risk gastrointestinal bleeding.

I've had many people with arthritis tell me that they wish that they could still buy Vioxx because it worked for them much better than any other drug they'd tried--they feel that the pain relief more than justifies the slight risk. I know of people (including some at Merck) who retained a personal stash of the drug after it was withdrawn (voluntarily, by Merck). Unfortunately, our litigious legal system makes it impossible for Merck to provide it, even to those people who understand the risks and choose to accept them.

HCN, I think you have me confused with anti-vaccine. I believe I stated before, no, I am not.

Monica, anti-vaccine people almost always deny being opposed to vaccines. But they can be recognized because, when one aspect of vaccines is disproved as a cause of autism, they simply shift to blame something else associated with vaccines.

It is hard to imagine anybody who is not anti-vaccine advancing an argument so obviously irrational as the "immature immune system" argument that you are making. As others have pointed out, even the most minimal research will tell you that the vaccines do indeed produce an immune response in the vast majority of children vaccinated, proving that their immune system is sufficiently mature for the vaccination to "take."

trrll, to follow up on your comment, if someone's immune system is so "immature" that a vaccine won't produce a sufficient immune system response, then they likely wouldn't produce a sufficient immune response to the disease itself, which would likely kill them.

skeptigirl has come up with the T-Shirt for pro-vaccine rationality:

"Keep the thimerosal, eat a few less tuna sandwiches"

The "science free" antivaccination has no clue about either the dosages of "toxins" in vaccines or the abundance of the same toxins in the food supply, environment etc..

They are like the people I see in the parking laot of the natural food store who light up a cigarrete after they have packed their organic fodd in the trunk of their car.

By Freddy the Pig (not verified) on 08 Mar 2008 #permalink

This will be my last post. I came to ask a couple questions, not rehash what happenned to my daughter, nor defend what I feel and have learned from her doctors, and the CDC.

HCN, my daughter also received the Varicella vaccine with the MMR. I have never stated that my daughter reacted to the MMR.

In fact, due to the erythema multiforme being commonly associated with Herpes viral infections, it is most likely she reacted to the Varicella. She also had an adequate response to all components of the MMR, but no antibodies to Varicella.

In the document I received from an MPH at the CDC, titled "Post Licensure Safety Surveillance for Varicella Vaccine" under the section "possible immune mediated syndromes" it states "Among 42 cases reported as EM (erythema multiforme), 16 patients described symptom onset within 1 week after vaccination, and disease developed in 23 patients 1 to 5 weeks post vaccination, 3 reports lacked dates"

I was sent the full report from the CDC, but you may be able to access it through another source. It was printed from JAMA Septemper 13, 200 Vol 284, No 10. Page 1271

Honestly, HCA, from a parent who also has a disabled child, you show a complete lack of compassion.

btw HCN, the rash was NOT at the injection site. My daughter had about 30 target shaped lesions covering her face, trunk, upper arms and legs. Opun follow up, her pediatrician read the ER report, and saw what was left of the lesions, and said "erythema multimforme".

Please read what was written before spouting off garbage.

Now THAT is my final post.

Take a look at:-

Herbert, M.R., Russo, J. P., Yang, S., Roohi, J., Blaxill, M., Kahler, S. G., Cremer, L & Hatchwell, E. (2006)
"Autism and environmental genomics"
Neurotoxicology. 27, 671-684.

Now amongst the high risk genes that have been identified as positive for Autism more than 20% are involved in antioxidant defenses, oxidant repair pathways, inflammatory pathways, oxygen delivery by the vasculature and, most surprisingly, in the biotransformation of xenobiotics.
These gene products can be divided into seven groups that may be directly involved in a RO/NS induced neurodegeneration pathway. Anti- and Pro-Apoptotic factors, Antioxidant enzymes, Pro-inflammatory proteins, Vasculature factors and finally enzymes which are involved in the oxidation of xenobiotics.

Anti-Apoptosis.
DNA cross-link repair 1B
Ligase I
Excision repair cross-complementing rodent repair deficiency, complementation group 4
X-ray repair complementing defective repair in Chinese hamster cells 1
Replication protein A complex
Insulin-like growth factor 2 (somatomedin A)
Serpine1 (Serine/cysteine proteinase inhibitor, clade E)

Pro-Apoptosis.
Cytosolic:- Tumor necrosis factor receptors 11b (osteoprotegerin) and 17.
Phospholipase A2
Mitochondrial:- BCL2-associated X protein
BAK1 (BCL2-antagonist/killer 1)

Antioxidants.
Biliverdin reductase B
Heme oxygenase 2
Microsomal glutathione S-transferase 3

Pro-inflammation.
Arachidonate 5-lipoxygenase-activating protein
Fibroblast growth factor 9 (glia-activating factor)
Interleukin 13 receptor, alpha 2
PPARG (proliferator-activated receptor G)

Vascalature.
Catalase (principle peroxide scavenging antioxidant)
Nitric oxide synthase 3 (eNOS)
Paraoxonase's 1, 2 and 3.
Endothelin receptor type A
Fibrinogen, A alpha polypeptide

Xenobiotic transformation.
Diamine oxidase (Amiloride binding protein 1 (copper-containing)
Flavin containing monooxygenase genes 1 to 5
Microsomal glutathione S-transferase 3

What these 32 genes and their products point to suggests that at least 20% of autism sufferers may be pre-poised to undergo apoptosis, have excessive RO/NS levels, have lowered systems to detoxify RN/OS, have poor DNA repair function, have inappropriate oxygen delivery and changes in the manner that xenobiotics are detoxified.

With regards as to if antigens get into the brain from vaccination, oh yes they do. Thisis the basis for anti-amyloid vaccination against alzheimers.

I think we may be over looking something very obvious; hyperthermia. When you vaccinate, especially babies who have been brought up in a sterile environment, you get fever.
Could we be pushing them over the edge? Hypothermia saves neurones in ischemia/reperfusion injury (blue baby syndrome); couldn't hyperthermia be doing the opposite?

By DocMartyn (not verified) on 08 Mar 2008 #permalink

Monica said "btw HCN, the rash was NOT at the injection site. My daughter had about 30 target shaped lesions covering her face, trunk, upper arms and legs. Opun follow up, her pediatrician read the ER report, and saw what was left of the lesions, and said "erythema multimforme".'

Still doesn't mean it was a reaction to either the MMR or varicella vaccine after three weeks. It could have been any number of infections, including a strep type. Check out the green box of this explanation of fifth disease, it explains that there five major diseases that cause rashes, Scarlet fever (strep), measles, rubella, a fourth disease and fifth disease (also called erythema infectiosum):
http://kidshealth.org/parent/infections/bacterial_viral/fifth.html ... though there is also roseola.

According to this: http://www.nlm.nih.gov/medlineplus/ency/article/000851.htm ... a rash like that can be caused by lots of things. You just seem to key on the "herpes simplex" note. Maybe you think it was the varicella vaccine because of the rash, but I sincerely doubt that, since as you can see above lots of different kinds of infections cause rashes.

My kids never got he varicella vaccine because they got the actual disease. One was six months old, and trust me... this is not something you want to deal with. The oldest child had poxes all down his back, and it was exasperated because he was so sick he would wet his bed, and the urine would further irritate the pox.

Monica continued "Please read what was written before spouting off garbage.

Now THAT is my final post."

But I did read what you wrote, and you only finally cleared up the inconsistencies when I pointed them out to you. You finally admitted that your child had a rash and seizures three weeks after the vaccine. I'm not so sure if you now understand that the polio vaccine has historically been given in infants.

Too bad that is your final post, because you get a special mention by Orac in Saturday's round-up post.

Neurotoxicology. 2005 Apr 30; [Epub ahead of print]

Mitochondrial Mediated Thimerosal-Induced Apoptosis in a Human Neuroblastoma Cell Line (SK-N-SH).

Humphrey ML, Cole MP, Pendergrass JC, Kiningham KK.

Department of Pharmacology, Joan C. Edwards School of Medicine, Marshall University, 1542 Spring Valley Drive, Huntington, WV 25704-9388, USA.

Environmental exposure to mercurials continues to be a public health issue due to their deleterious effects on immune, renal and neurological function. Recently the safety of thimerosal, an ethyl mercury-containing preservative used in vaccines, has been questioned due to exposure of infants during immunization. Mercurials have been reported to cause apoptosis in cultured neurons; however, the signaling pathways resulting in cell death have not been well characterized. Therefore, the objective of this study was to identify the mode of cell death in an in vitro model of thimerosal-induced neurotoxicity, and more specifically, to elucidate signaling pathways which might serve as pharmacological targets. Within 2h of thimerosal exposure (5muM) to the human neuroblastoma cell line, SK-N-SH, morphological changes, including membrane alterations and cell shrinkage, were observed. Cell viability, assessed by measurement of lactate dehydrogenase (LDH) activity in the medium, as well as the 3-[4,5-dimethylthiazol-2-yl]- 2,5-diphenyltetrazolium bromide (MTT) assay, showed a time- and concentration-dependent decrease in cell survival upon thimerosal exposure. In cells treated for 24h with thimerosal, fluorescence microscopy indicated cells undergoing both apoptosis and oncosis/necrosis. To identify the apoptotic pathway associated with thimerosal-mediated cell death, we first evaluated the mitochondrial cascade, as both inorganic and organic mercurials have been reported to accumulate in the organelle. Cytochrome c was shown to leak from the mitochondria, followed by caspase 9 cleavage within 8h of treatment. In addition, poly(ADP-ribose) polymerase (PARP) was cleaved to form a 85kDa fragment following maximal caspase 3 activation at 24h. Taken together these findings suggest deleterious effects on the cytoarchitecture by thimerosal and initiation of mitochondrial-mediated apoptosis.

PMID: 15869795 [PubMed - as supplied by publisher]

oooh, thimerosal is dangerous in a test tube!

Ads94, Your post shows the problem of lay persons drawing conclusions from research they do not have the education to interpret. I can also kill you with water if I give you enough of it.

http://www.sciencedirect.com/science/article/B6T1B-47CPX66-B/2/3e9fd9c9…
"Mean mercury doses in infants exposed to thiomersal were 45·6 μg (range 37·5-62·5) for 2-month-olds and 111·3 μg (range 87·5-175·0) for 6-month-olds. Blood mercury in thiomersal-exposed 2-month-olds ranged from less than 3·75 to 20·55 nmol/L (parts per billion); in 6-month-olds all values were lower than 7·50 nmol/L. Only one of 15 blood samples from controls contained quantifiable mercury. Concentrations of mercury were low in urine after vaccination but were high in stools of thiomersal-exposed 2-month-olds (mean 82 ng/g dry weight) and in 6-month-olds (mean 58 ng/g dry weight). Estimated blood half-life of ethylmercury was 7 days (95% Cl 4-10 days).
Interpretation

Administration of vaccines containing thiomersal does not seem to raise blood concentrations of mercury above safe values in infants. Ethylmercury seems to be eliminated from blood rapidly via the stools after parenteral administration of thiomersal in vaccines. "

http://pediatrics.aappublications.org/cgi/content/abstract/121/2/e208
"The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30.

CONCLUSIONS. The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines."

http://www.immunizationinfo.org/immunization_science_detail.cfv?id=134 (link links to original article but subscription required)
"The prevalence of children with autism born from 1989 through 2003 increased each year (and for each age up to 10 years). This was true whether the data were examined by year of birth or age group. Specifically, the prevalence at ages 3 to 5 years increased for each birth year since 1999, during the period when exposure to thimerosal preservative in vaccines began to be reduced.
The relevance/bottom line

If thimerosal in vaccines were a major cause of autism, the prevalence of autism would be predicted to fall as exposure was reduced. These data show no decrease--in fact they show a continued increase--in cases of autism in California since the reduction of thimerosal in pediatric vaccines."

http://content.nejm.org/cgi/content/full/357/13/1281
"The weight of the evidence in this study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins administered prenatally or during infancy and neuropsychological functioning at the age of 7 to 10 years. The overall pattern of results suggests that the significant associations may have been chance findings stemming from the large number of statistical tests that we performed."

And that is the bottom line. There are volumes of research on this matter. The overwhelming consensus is the data supports no thimerosal risk.

I wonder if anyone who fears the 'unnatural' injection of a substance has anywhere near the same obsession with 'natural' eating of tuna fish?

By Skeptigirl (not verified) on 08 Mar 2008 #permalink

Monica, once you accept that you are an anti-vaccinationist, a Merchant of Disease, Disability and Death, you are one step closer to healing.

Do not be afraid to take that step. You will be on the path to the light of truth.

I am unsure that mercury has the same half-life in all individuals. mercury cycles between organic and inorganic due, in large part to the flora of the gut. Mercury, inorganic and organic, excretion is very complex because of enterohepatic recycling. Organic mercury leaves the body slowly with a half-life of weeks to months, typically in the urine. Inorganic mercury is excreted in the feces and to a lesser extent, in the urine. The microflora in the intestine can demethylate/deethylate organic mercury allowing inorganic mercury to be eventually eliminated through the feces or they can methylate inorganic mercury and this (re)enters the general organomercury pool. In the brain, both ethyl and methylmercury are converted to inorganic mercury by the astrocytes.
Intestinal diamine oxidase, which shows a link to Autism, is an enzyme closely involved with the maturation of intestinal mucosa of humans, and changes in diamine oxidase function/levels could alter the intestinal microflora, and hence mercury recycling and also the bodies relative ratio's of organo/inorganic mercury. A link between the elimination/recycling of toxins, like mercury, by the gut and associated mircoflora and Autism is an attractive hypothesis; as many children with autism also have gastrointestinal disorders

By DocMartyn (not verified) on 09 Mar 2008 #permalink

DocMartyn, you have your mercury physiology a little wrong. Mercury gets into the gut via being attached to glutathione and excreted in the bile which is ~10 mM in glutathione. That is both organic and inorganic mercury. Lots of compounds (hundreds) are detoxified by being attached to glutathione and then excreted in the bile. That is a major detoxification pathway for normal products of physiology (catecholamines) and for xenobiotic organic compounds as well as for mercury. There is no evidence that the glutathione pathway is seriously disrupted in autism. The (quite bogus) result touted by the anti-mercury crowd only looked at plasma levels of glutathione which are unimportant in physiology, and are normally 3 orders of magnitude lower that glutathione levels inside of cells (where it actually matters and which they didn't report). In the gut, organic mercury can be demethylated into inorganic mercury. The inorganic mercury can then attach to something else and be excreted. This is the major excretion pathway for mercury.

There is nothing about mercury physiology that makes it an "attractive" hypothesis regarding autism. A can of tuna has more mercury than a vaccination ever did. Excess mercury has never been associated with autism. What about mercury makes it "attractive", other than quacks can make a lot of money duping gullible parents into harming their children with chelation and that vaccine manufacturers have deep pockets and so if a court can be tricked into finding for the plaintiffs they can win the legal lottery? There certainly is no science behind the "mercury causes autism" idea.

The most common symptom of autism is a larger brain with more neurons. How does a larger brain get caused by a "neurotoxin"?

Orac does not seem to really grasp the complex issues of this case. The poling case has really made me think about autism, mitochondria, and heavy metals. This post unfortunately will fly over the heads of most bloggers commenting on the hannah poling case who cannot understand the J Child Neurol paper nor the comments dr. poling made. For those docs out there reading this though I found out from Dr. Poling's press conference that:

GENETIC TESTING OF HANNAH AND HER MOTHER DEMONSTRATES THAT BOTH HANNAH (AUTISTIC PATIENT) AND MOTHER (NORMAL CARRIER) ARE HOMOPLASMIC FOR THE mtDNA T2388C MUTATION. THIS MEANS THAT EITHER THIS NEVER BEFORE DESCRIBED MUTATION IS JUST A BENIGN POLYMORPHISM OR SEPARATE NUCLEAR GENETIC INFLUENCE CAUSES IT TO BE PATHOGENIC.

In other words, the parents looked as hard a possible for a genetic cause and came up empty. To quote the poling zimmerman J Child Neurol article re Hannah--"It is unclear whether (hannah's) mitochondrial dysfunction results from a primary genetic abnormality, atypical development of essential metabolic pathways, or secondary inhibition of oxidative phosphorylation by other factors. If such dysfunction is present at the time of infections or immunizations in young children, the added oxidative stresses from immune activation on cellular energy metabolism are likely to be especially critical for the central nervous system, which is highly dependent on mitochondrial function."

This really is a nice triple hit hypothesis that could apply to many other cases of autism (remember there are many 'causes' and 'autisms'). The triple hit is #1genetic susceptibility, #2environmental trigger, and #3timing during brain development.

Zimmerman and poling didn't say 'mercury poisoning' in their paper. So, now let me translate for the non-docs out there what "secondary inhibition of oxidative phosphorylation" means. This refers to blocking biochemical pathways involved in generating the curency of energy, ATP, ie mitochondrial poisoning. This is a primary mechanism of how heavy metals such as lead and mercury exert there toxic effects upon biological organisms. Food for thought and further discussion. Cheers!

By anonymous MD and PhD (not verified) on 09 Mar 2008 #permalink

The most common sources of inhibition of oxidative phosporylation are competely natural and occur all the time.

The multiple organ failure that occurs during sepsis is caused by a failure of oxidative phosphorylation. That has nothing to do with heavy metals.

Oxidative stress by itself causes depletion of mitochondria by destroying nitric oxide, the agent that triggers mitochondria biogenesis.

Zimmerman didn't mention heavy metal poisoning because there was no reason to suspect it, there is no data to suggest it was present, and so it would be nonsense to bring it up in an otherwise useful paper.

There is a third possibility, that the T2388C mutation is not completely benign, but that sometimes it doesn't matter. Any kind of immune system stimulation puts mitochondria under metabolic stress. If you don't have enough mitochondria to survive the immune system stimulation, then you die. Which organ fails first is a detail. In this child's case, it was her brain, causing a neuropathy. In the multiple organ failure of septic shock, the organs fail one at a time due to mitochondrial depletion.

The CNS is the organ most sensitive to mitochondria depletion because the turnover time of mitochondria is the longest there, and mitochondria are generated in the cell body and then transported out to the tippy end of the axons (which can take a long time). There is ongoing protein synthesis in those mitochondria as part of their ongoing regulation. This mutation (T2388C) is in the mitochondria protein synthesis pathway. It would be expected to have the largest effect in mitochondria where ongoing protein synthesis is the most important. That would be in the CNS. The CNS only gets ATP from mitochondria. If you don't have enough mitochondria in the CNS, you will get neuropathy.

Virtually all cases of autism don't have the slightest bit of neuropathy. What does neuropathy in this case have to do with the vast majority of cases of autism? Absolutly nothing.

Dear daedalus2u, please do not be offended, I am new to the mercury/autism story and am collecting background. I don not believe that mercury toxicity is the cause of Autism; any more than there is a single cause for cancer.
However, the detoxification of mercury is very complex. It is indeed true that glutathione does form a conjugate; GS-Hg-SG; but this can be (not is, can be) broken down to Cys-Hg-Cys. This is a bit of a problem as it is taken up by the neutral amino acid transport that typically takes up Cys-syC.
Bacteria/fungi have a very rich biochemistry in dealing with Hg and its thiol/organo species.
Being as dispassonate as I can, I can easily envisage recycling of Hg in the body.

By DocMartyn (not verified) on 09 Mar 2008 #permalink

I am not offended that you are not up to speed on mercury phsyiology and the failed "mercury causes autism" idea. I have written a blog about some of the physiology behind mercury.

http://daedalus2u.blogspot.com/2007/03/discussion-of-false-mercury-caus…

There are others. You will want to look at the recent Faroe Islands study on autism, as well as the Faroe Islands studies on mercury. I link to them in this comment.

http://scienceblogs.com/insolence/2008/01/david_kirby_when_youre_in_a_h…

Briefly, there was a 996 consecutive birth cohort that was measured at birth for mercury in cord blood and other tissue compartments. There were 747 children with cord blood mercury levels above 65 nM/L and 249 with levels above 201 nM/L. In the 1404 children born during that 2 year period including that tested cohort, there were 5 cases of ASDs, 2 of autism and 3 of Asperger's.

In the infamous DeSoto et al reanalysis of the Ip et al paper, there were 2 children with blood mercury levels above 60 nM/L (one control, one with autism). They were rejected as "outliers".

No doubt there is "recycling" of mercury in the body, as is well known. What is well known about mercury physiology doesn't make the "mercury causes autism" an attractive hypothesis, it makes it a failed hypothesis. Which anyone who looks honestly and competently at the data in the literature will confirm.

Freddy posted: skeptigirl has come up with the T-Shirt for pro-vaccine rationality:
"Keep the thimerosal, eat a few less tuna sandwiches"

Don't know how I missed this one yesterday. Thanks, I love it. I think I may actually order one.

By Skeptigirl (not verified) on 09 Mar 2008 #permalink

Posted by: DocMartyn I think we may be over looking something very obvious; hyperthermia. When you vaccinate, especially babies who have been brought up in a sterile environment, you get fever.
Could we be pushing them over the edge? Hypothermia saves neurones in ischemia/reperfusion injury (blue baby syndrome); couldn't hyperthermia be doing the opposite?

Posted by: anonymous MD and PhD So, now let me translate for the non-docs out there what "secondary inhibition of oxidative phosphorylation" means. This refers to blocking biochemical pathways involved in generating the curency of energy, ATP, ie mitochondrial poisoning. This is a primary mechanism of how heavy metals such as lead and mercury exert there toxic effects upon biological organisms. Food for thought and further discussion. Cheers!

Here's some food for thought for both of you. How was the vaccination supposed to be any more harmful than the hundreds of pathogens and thousands of non-pathogen antigen exposures any child is going to have?

If anything, a parent could easily give an antipyretic after a vaccination and in fact that is included in common advice to parents when their child is vaccinated. Are the Polings claiming this was the first time their child had ever had a fever? Are they trying to claim that "9" antigens in a single vaccine was any more stressful than the hundreds of antigens people are exposed to every day? Are they claiming that the injection allowed more antigens to enter the body than the mucous membrane of the GI and respiratory tracts every day?

It is commonly but incorrectly assumed that combining multiple vaccines "stresses" the immune system just as it is commonly but incorrectly assumed injecting vaccines has a significantly different outcome than natural infections acquired by the usual routes of infection. And it is commonly but incorrectly assumed that vaccine immunity is qualitatively different than any other stimulation of the antigen antibody immune mechanisms. Other than less well matched antibodies and the shorter lasting effect of killed vaccines over live infections, the immune system response is 100% 'natural'.

So what evidence does Dr P and his wife have other than a temporal observed anecdote that the vaccines were the issue here rather than any other antigen or pathogen or cause of fever that would have inevitably triggered this if the etiology is correct?

And if this mitochondrial condition is indeed in some other children with autism, why is there no epidemiological evidence that vaccines were associated with autism? If this case was valid, regardless of how rare (Dr P's article suggests it is not such a rare etiology of autism, merely an unrecognized one) it should still have been detectable if the vaccinations triggered anything.

I propose another hypothesis. The persons responsible for the determination the vaccines were a precipitating event in this case were intimidated by the fact Dr P is a neurologist from Johns Hopkins. And I do not mean intimidated in terms of fear, but intimidated by their perception of his expertise and reluctant to question his medical opinion as so many medical professionals are reluctant to question their peers.

By Skeptigirl (not verified) on 09 Mar 2008 #permalink