2010: Another bad year for the anti-vaccine movement, as the Special Masters rule

Perhaps you've heard of the case of Poul Thorsen. Perhaps not. Either way, that anti-vaccine movement was making a huge deal over this Danish psychiatrist and researcher for two reasons. First, he has become embroiled in some sort of scandal involving research funds at his former place of employment, Aarhus University, leading the ever-hyperbolic Robert F. Kennedy, Jr. to post a characteristic bit of conspiracy mongering nonsense to that font of anti-vaccine nonsense, The Huffington Post, in an article entitled Central figure in CDC Vaccine Cover-Up Absconds with $2M. The second reason is implicit in the title, namely that Thorsen was a coauthor on two important studies from Denmark supporting the safety of vaccines and refuting a correlation with autism, one published in the New England Journal of Medicine and dealing with the MMR vaccine and the other published in the journal Pediatrics and failing to show a link between thimerosal-containing vaccines and autism.

Guilty or not, the anti-vaccine movement has pulled out all the stops in its smear machine in order to make it look as though Thorsen was the main researcher behind these two studies, the latter of which is particularly despised by the mercury militia. Being retrospective, the latter study (Madsen et al) is not without flaws, but it is not nearly as bad as anti-vaccine crusaders paint it. In fact, it's pretty darned good. Of course, Thorsen was nothing of the sort; he was listed only as sixth and fourth author on the NEJM and Pediatrics studies, respectively, and the lead author on both studies has stated that his role on both studies was modest at best. However, the truth was never an obstacle to the anti-vaccine movement, and they have labored overtime to paint Thorsen as central to the case against thimerosal in vaccines as being a major cause of autism.

At first, I couldn't figure out why. I thought I had an idea, given that anti-vaccine prophet Andrew Wakefield had fallen so ignominiously over the month preceding the revelations about Thorsen's possible criminal activity. At the time, I thought that the antivaccine movement was desperate and looking for someone on "our side" to attack, hoping that by arguing that someone involved with the Danish studies was involved in unethical and possibly illegal activity they could both distract attention from Wakefield's being discredited and make the fallacious claim that investigators who have failed to find correlations between vaccines and autism or vaccines and thimerosal-containing vaccines are just as bad as any accusation against Wakefield.

I now know that I was wrong.

In retrospect, I realize that it is far more likely that what the anti-vaccine movement was trying to do was to discredit the evidence against a link between thimerosal-containing vaccines and autism by any means necessary, not giving a care about how much they have to lie, smear, and distort, to do it. But why? It is clearly because they knew that the Special Masters of the Vaccine Court were set to rule on the last three test cases of the Autism Omnibus and, in retrospect, my guess is that the smear campaign against Thorsen was in fact designed as a preemptive strike on the expected ruling of the Special Masters. And rule they did on Friday, March 12, rejecting all claims in the three test cases (Dwyer v. Secretary of Health and Human Services Case No. 03-1202V, King v. Secretary of Health and Human Services Case No. 03-584V, Mead v. Secretary of Health and Human Services Case No. 03-215V). In this, 2010 is starting to look a lot like 2009, with a one-two punch against the anti-vaccine movement consisting of revelations of Andrew Wakefield's research misconduct and a ruling against the test cases in the Autism Omnibus.

Because there were over 5,000 claimaints in the Autism Omnibus action, it was decided that the Vaccine Court would hear a handful of test cases representing the two most prevalent hypothesized mechanisms by which vaccines could cause autism. The first batch of test cases would test the hypothesis that MMR causes autism; the second batch would test the idea that the mercury in the thimerosal preservative used in vaccines in the U.S. up until the end of 2001 causes autism. Last year around this time the Special Masters ruled against the first group of Omnibus petitioners, and a year later, they've ruled against the second group just as resoundingly as they did the first, as evidenced by these paragraphs from the three cases.

1. Mead v. Secretary of Health and Human Services Case No. 03-215V:

Petitioners have not shown either that certain children are genetically hypersusceptible to mercury or that certain children are predisposed to have difficulty excreting mercury. The scientific validity of the studies on which petitioners rely has been questioned and the conclusions drawn from the studies have been criticized as unsupported. While differences that reflect the range of naturally-occurring individual variability are known to exist with respect to the responses of individuals to mercury exposure, these differences do not point toward the existence of a hypersusceptible population.

Petitioners' theory of vaccine-related causation is scientifically unsupportable. In the absence of a sound medical theory causally connecting William's received vaccines to his autistic condition, the undersigned cannot find the proposed sequence of cause and effect to be logical or temporally appropriate. Having failed to satisfy their burden of proof under the articulated legal standard, petitioners cannot prevail on their claim of vaccine-related causation. Petitioners' claim is dismissed, and the Clerk of the Court SHALL ENTER JUDGMENT accordingly.

2. King v. Secretary of Health and Human Services Case No. 03-584V:

Nor do I doubt that Jordan's parents are sincere in their belief that vaccines played a role in causing Jordan's autism. Jordan's parents have heard the opinions of physicians who profess to believe in a causal connection between thimerosal-containing vaccines and autism. After studying the extensive evidence in this case for many months, I am convinced that the opinions provided by the petitioners' experts in this case, advising the King family that there is a causal connection between thimerosal-containing vaccines and Jordan's autism, have been quite wrong. Nevertheless, I can understand why Jordan's parents found such opinions to be believable under the circumstances. I conclude that the Kings filed this Program claim in good faith.

Thus, I feel deep sympathy for the King family. Further, I find it unfortunate that my ruling in this case means that the Program will not be able to provide funds to assist this family, in caring for their child who suffers from a serious disorder. It is certainly my hope that our society will find ways to ensure that generous assistance is available to the families of all autistic children, regardless of the cause of their disorders. Such families must cope every day with tremendous challenges in caring for their autistic children, and all are deserving of sympathy and admiration. However, I must decide this case not on sentiment, but by analyzing the evidence. Congress designed the Program to compensate only the families of those individuals whose injuries or deaths can be linked causally, either by a Table Injury presumption or by a preponderance of "causation-in-fact" evidence, to a listed vaccine. In this case, the evidence advanced by the petitioners has fallen far short of demonstrating such a link. Accordingly, I conclude that the petitioners in this case are not entitled to a Program award on Jordan's behalf.

Dwyer v. Secretary of Health and Human Services Case No. 03-1202V

Unfortunately, the Dwyers (and uncounted other parents of children with ASD) have relied upon practitioners and researchers who peddled hope, not opinions grounded in science and medicine. My heart goes out to parents like the Dwyers who struggle daily, emotionally and financially, to care for their children, but I must decide cases based on the law and not sentiment. The law in this case requires preponderant evidence that TCVs caused or substantially contributed to Colin's ASD, and, by that standard, petitioners are not entitled to compensation.

Petitioners have not demonstrated by a preponderance of the evidence that Colin's condition was either caused or significantly aggravated by his vaccinations. Thus, they have failed to establish entitlement to compensation and the petition for compensation is therefore DENIED. In the absence of a motion for review filed pursuant to RCFC, Appendix B, the clerk is directed to enter judgment accordingly.

All three decisions are between 100 and 310 pages long, with the Dwyer decision being the longest of the three. All of them, in particular the Dwyer decision, list in great detail the quackery to which these unfortunate children have been subjected over the years based on the discredited concept that vaccines cause autism, including chelation therapy, IV glutathione, and several others. Moreover, all three test cases relied on what Dad of Cameron has correctly termed bogus urine mercury testing, and the court completely rejected the scientific validity of these dubious tests.

I've said it before, but it bears repeating here. Both groups of test cases for the Autism Omnibus represent the very best cases that the petitioners could come up with. Presumably, the Petitioners' Steering Committee chose these cases because they believe them to represent the very best cases that they could come up with, the ones that they considered to have the best chance of demonstrating general causation that would allow the mass of other cases in the Autism Omnibus to proceed. Both groups of test cases failed. they didn't just fail, though. They failed so resoundingly under relaxed rules of evidence compared to a normal court case that it is difficult to see how an appeal would succeed. Not that that will stop the petitioners from appealing. It also doesn't stop anti-vaccine loons from fanning out across the media to complain about this case or news agencies, in their quest for "tell both sides" faux "balance," from indulging them, as ABC apparently did with Rebecca Estepp of TACA. The message is the same as it was last year, namely that the law is stacked against them, that it's all a conspiracy, as this whine by SafeMinds demonstrates:

The Department of Health and Human Services (HHS) is the defendant in vaccine injury cases and is also responsible for carrying out the very vaccine safety research that should be integral to court decisions. This conflict of interest means the deck is stacked against families when they enter "vaccine court" and is yet one more reason for parents to doubt the integrity of the National Immunization Program.

Parents doubt the integrity of the National Immunization Program because groups like SafeMinds and Generation Rescue do their utmost, through spreading misinformation, fear, and pseudoscience, to persuade parents that the NIP is not to be trusted. They also have a serious martyr complex, as this amazing screed full of talking points from the gloriously Orwellian-named Coalition for Vaccine Safety posted on AoA:

  1. The Special Masters protected the vaccine program - and denied justice to vaccine-injured children.
  2. Vaccines cause autism - this Court and HHS have previously acknowledged that.
  3. These decisions highlight the inadequacy and possible suppression of vaccine safety science.

No, the Special Masters acknowledged existing science; vaccines do not cause autism; and there is nothing being "suppressed." Having lost resoundingly--again--in Vaccine Court, the anti-vaccine movement is now putting its faith in two things. First, somehow it believes that the Thorsen case will somehow "prove" that the science showing no linkage between thimerosal-containing vaccines and autism is hopelessly corrupt. Unfortunately for the anti-vaccine movement, as I have said before, the rejection of the hypothesis that thimerosal-containing vaccines cause autism does not depend upon the Danish studies. Even if they were expunged from the scientific literature, the conclusion would still stand, bolstered by multiple other large, well-designed epidemiological studies in at least three countries. That's the problem with chosing an idea that generates a testable hypothesis, like the mercury hypothesis. It can be falsified. In the case of the mercury hypothesis, it has been falsified. Second, as I predicted, it thinks that Bruesewitz v. Wyeth, which is going before the Supreme Court this fall, will somehow invalidate the National Child Vaccine Injury Act that created the Vaccine Court, allowing a flood of lawsuits in state and federal courts.

No one doubts that the children who are the petitioners in the Autism Omnibus, particularly the test cases, have had a rough time. No one doubts that their parents have had a rough time, in some cases a horrible time, taking care of them. Unfortunately, thanks to the blandishments of quacks and anti-vaccine zealots, these parents' lot has been made even worse. First they were sold false hope and quackery. Then they were sold hope that they could somehow obtain compensation for "vaccine injury." These hopes have all been proven false. None of this means that the anti-vaccine movement will stop. This is not about science; it's about ideology and a religion-like hatred of vaccines, which is why this latest decision in the Autism Omnibus, while a major setback, won't be the last.

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Dunno. I'm actually glad they dismissed them, so now the legal battle can continue in a better venue, because it most certainly will continue.

You can't demonstrate that populations are susceptible to the excretion of certain toxins or drugs if you're not going to specifically study it. Have to stick with what's been studied, and the mechanism. They should probably stick to drug metabolism and liver function. If vaccines induce inflammation in the recipient, how does this affect / inhibit metabolism and removal of thimerosal?

Superb article. As expected. We here in the Northeast were subjected to a nor'easter this weekend. Perfect weather for reading decisions.

First thing...the decisions are extremely well written, with the concepts meticuously laid out, the science cogently discussed, and the conclusions explained and supported.

Second thing...the Special Masters allowed all evidence presented by the PSC to be admitted. NOTHING was refused.

After actually reading all three decisions, I cannot fathom the idea that the anti-vaccinationistas have read them. ANYONE who has an open mind that is not shackled by conspiracy theory and pseudo-science, can only reach the conclusion that these decisions are right on target.

As Orac pointed out, they anti-vaxxers clearly saw this coming, and began their attacks with Thorsen, and will continue to attack as time passes. I suspect that when Thorsen blows over, they will find another target, or revert to some of their usual targets.

The anti-vaxxers have nothing else left for them, except personal attacks, "outing" and their usual and customary vile tactics. They will act as rabid cornered wildlife react.

This will be a fun year.

I feel most sorry for the children themselves. Their parents have been deluded and given false hope by people seeking who knows what (fame, money, whatever, it's irrelevant), but the children have been systematically tortured in the name of a "cure", and their very dignity listed on the bill of sale their desperate parents have signed.

That's the tragedy.

My plea, for what it's worth, to the parents of autistic children: don't fall for this crap. Your kids are still your kids. Do your duty as parents: love them for who they are. Don't castigate them for being born different from other children. Give them everything you have, and stop trying to 'fix' them. They aren't broken, and all you're doing is making them worse.

You can't demonstrate that populations are susceptible to the excretion of certain toxins or drugs if you're not going to specifically study it. Have to stick with what's been studied, and the mechanism. They should probably stick to drug metabolism and liver function. If vaccines induce inflammation in the recipient, how does this affect / inhibit metabolism and removal of thimerosal?

You do realize that this argument applies equally well to, say, vinegar? Quick! We need to study vinegar metabolism in autistic vs. non-autistic individuals to make sure that's not the problem!

Or more seriously, the absolute best that can be done is to study in detail those things that have some evidence suggesting they might be a concern (which does NOT include thimerosal), and rely on safety testing and broad post-approval surveillance to catch anything else. Hopefully unsurprisingly, that's precisely how the system actually works...

@3, Michael

Do your duty as parents: love them for who they are. Don't castigate them for being born different from other children. Give them everything you have, and stop trying to 'fix' them. They aren't broken, and all you're doing is making them worse.

I think I love you! :)

I can only hope that these rulings will at least convince some parents and they stop experimenting on their children. But it will never matter to those who 'know' this is all a conspiracy. I feel sorry for their children.

Second thing...the Special Masters allowed all evidence presented by the PSC to be admitted. NOTHING was refused.

A point I've made in the past, and will make here again, is that both this thinking and Orac's comment on "relaxed rules of evidence" (seeming to mean that Daubert was not used to say "this is inadmissible") simply don't make any sense in the context of the vaccine court. The point of ruling evidence inadmissible in a normal trial is to ensure that the jury does not hear it and be inappropriately influenced by something that, as a matter of law, should not be considered. But that decision is made by the judge after he/she examines the evidence in question to determine its applicability and reliability.

That process simply doesn't apply the same way where there is no jury. The only distinction that could be made is "the Special Master hears the evidence, evaluates it, determines it to be unreliable, and discounts it in his/her decision" vs. "the Special Master hears the evidence, evaluates it, determines it to be unreliable, issues a distinct ruling that the evidence is inadmissible, and discounts it in his/her decision." Functionally, in terms of the evidentiary bar to win the case, there is no difference at all. It's possible that there might be other interesting legal implications, but it really make things easier for the defendant.

Editing fail:

It's possible that there might be other interesting legal implications, but it doesn'treally make things easier for the defendant.

Apologies to all.

Echoing several posts already, it is the children who suffer. Parents throwing gobs of money and time at biomed crap when both could be better spent on and with their kids.

Kids forced to undergo chelation and enduring these unsafe, untested and completely unnecessary procedures at great cost and no small risk and no benefit outside of that which would be expected coincidentally over time with or without the dangers. How does a parent reconcile railing against vaccine 'toxins' and then paying for chelation or other chemical assault on their kids?

The mind boggles.

In re: #1

I know that injecting facts will not change anything here, but how about the simple fact that removing all the thimerisol friom vaccines has not impacted the incidence of autism at all? One would think that if thimerisol was the boogey man it is portayed to be, then removing it should pretty much solve the problem. Given that this has not happened (or even shown a blip) since the removal of thimerisol in 1/13/03, when the last lots containing thimerisol expired, the issue should be dead. It is dead. Let the mourning begin.

Chris

By Chris Ashton (not verified) on 15 Mar 2010 #permalink

@Chris Ashton: "I know that injecting facts will not change anything here, but how about the simple fact that removing all the thimerisol friom vaccines has not impacted the incidence of autism at all?"

Get with the program, man: http://preview.tinyurl.com/yjs6fmo

@Otto: Oh, Jake's blather (over 4000 words as Kim Wombles points out on her blog Countering. The incoherency of his post is astounding).

Please, before you link to anything like that, put up a warning notice. I try NOT to give AOA any more clicks than I absolutely have to, since their conspiracy theories and lies make my head ache.

Thank you! :)

Being unfamiliar with the US legal system - is there a point where the investigative bodies/legal system can tell the anti-vaxxers to bugger off and stop wasting their time? Or can the antivax groupies just fire up their rocket powered goalposts and be back in court again next year, singing the same songs?

"I'm actually glad they dismissed them, so now the legal battle can continue in a better venue, because it most certainly will continue."

anon, really?!? Plaintiffs' couldn't make it past a Daubert/Frye/Havner hearing so they request an indefinite stay of proceedings, move to vaccine court, lose there, and you think moving back to civil court will be better?????

Uh huh....ok.

@Otto: Most people would realize that relying on an undergraduate history major with no understanding of science or medicine to interpret the biomedical literature would be a bad idea.

By bepatient (not verified) on 15 Mar 2010 #permalink

I predicted earlier this year that the events surrounding Wakefield(the GMC ruling,the articles being retracted)would have a withering effect on the general public's belief that there is even a scintilla of a wisp of a shadow of a doubt about *any* connection between vaccines and autism:that they would recognize him(despite the prattling of true believers like Jenny,Loe Fisher,et al)as the scoundrel whose "project" set the entire Rube Goldberg contraption in motion.These rulings will strengthen that impression.That leaves us with those to whom a *governmental* pronouncement is a *shibolleth* that implies its inherent corruption,disrepute, and lack of concern for human life, to carry the torch on their way to the darkest, dustiest,most quack-infested corners of the internet,leading those who *still aren't quite sure* about vaccines' safety.

By Denice Walter (not verified) on 15 Mar 2010 #permalink

is there a point where the investigative bodies/legal system can tell the anti-vaxxers to bugger off and stop wasting their time? Or can the antivax groupies just fire up their rocket powered goalposts and be back in court again next year, singing the same songs?

The legal system cannot - individual cases may exhaust all appeals, but new cases may always be filed (they have no shortage of people to make claims for). Congress could potentially change the applicable laws, however. Anything that simply barred court cases would probably be unconstitutional, but something like barring resubmitting a case dismissed by the vaccine court to the normal civil courts, and/or giving legal force to the "test case" method, might have some potential.

"Most people would realize that relying on an undergraduate history major with no understanding of science or medicine to interpret the biomedical literature would be a bad idea."

That depends on what you're relying upon him to demonstrate.

That depends on what you're relying upon him to demonstrate.

You appear to be relying upon him to demonstrate that the thimerosal/autism idea (which I will not even dignify with the term 'hypothesis') is not deader than a doornail. Something "an undergraduate history major with no understanding of science or medicine" emphatically should not be relied upon for. If your point was otherwise, clarification would be appreciated.

The drug companies themselves should be liable for any damages (which do happen).Just like Toyota. Reagan did a huge disservice by absolving the drug companies of any blame. It just isn't right and you have to admit that.

@otto

I actually clicked that link. My IQ promptly dropped 10pts. I have offered before to provide samples of vaccines to submit for analysis, but of course every analytical chemistry lab is in on the conspiracy. You have gotta figure some low-life lawyer would take that case on contingency, since the potential damages would be huge. Of course there is also the argument I have been given (I think based somewhat on homeopathy) that eliminating thimerisol (or reducing it to "trace used in manufacturing") actually makes it more toxic. "There are only two things in the universe that are infinite. God's mercy and human stupidity." (please give me the proper attribution. I use this all the time!)

Chris

By Chris Ashton (not verified) on 15 Mar 2010 #permalink

"If your point was otherwise, clarification would be appreciated."

My point was otherwise. Clear?

jen, they presented their best evidence to prove damages from the vaccines and failed even with the very generous level "50% plus one feather" to prove causation.

They had their day in court. They lost.

If you have data and evidence that the petitioners should have included, please provide it.

Now try reading what Orac wrote with comprehension, especially this paragraph (with added emphasis by me):

Both groups of test cases for the Autism Omnibus represent the very best cases that the petitioners could come up with. Presumably, the Petitioners' Steering Committee chose these cases because they believe them to represent the very best cases that they could come up with, the ones that they considered to have the best chance of demonstrating general causation that would allow the mass of other cases in the Autism Omnibus to proceed. Both groups of test cases failed. they didn't just fail, though. They failed so resoundingly under relaxed rules of evidence compared to a normal court case that it is difficult to see how an appeal would succeed.

@19:

No, I most certainly do not have to agree with that. If that were the case, then we would have no vaccines at all, because unfounded litigation such as the cases in the autism omnibus would bankrupt the producers, regardless of the merits. Vaccination is such a profoundly important public good that it is 100% appropriate for the government to intervene and shield the manufacturers from such liability.

Who were the "experts"?

By Tsu Dho Nimh (not verified) on 15 Mar 2010 #permalink

My point was otherwise. Clear?

No. What was your point, then?

I'm glad to see the court showing some sense.
No doubt RFK Jr will not be so happy, as he can see millions of dollars in fees evaporating, turning to ash in his mouth like dead sea fruit.

"No. What was your point, then?"

Scott, Daylight Saving Time doesn't mean that I have to come over and change the battery in your sarcasm detector.

It totally made my weekend when I heard this late Friday. However, as nice as it is to have the legal footing and be able to point to these--it's still the science that matters. It's nice that they have aligned, certainly.

But I'm sure the anti-vaxxers are out digging up the goalposts right now for their subsequent relocation.

@29 "But I'm sure the anti-vaxxers are out digging up the goalposts right now for their subsequent relocation."

Yup, on the parenting board I go to, it's all about the aluminum and other "toxins." Although they like to still mention that the trace amount of mercury might still be toxic to certain individuals. There's no reasoning with them.

Nothing will change. They will just find another reason/excuse to continue their rhetoric, pushing alternative treatments and cures, claiming that they are right and being worshiped by those who will listen... or is it those who will not listen?
Anyway, it's one of those things we will be arguing back and forth on until the bovines arrive at the homestead.

Scott, Daylight Saving Time doesn't mean that I have to come over and change the battery in your sarcasm detector.

Nah, that wasn't a dead battery. The cats got at it. Apologies.

@Scott, #6,

True, but you have to consider how far the autism-cranks are willing to shift the goalposts. I'm glad the judge specifically called out that the evidence was all allowed. Still, we already see the cranks saying the court "was stacked against" them, so it may have been a fruitless gesture.

By Bluegrass Geek (not verified) on 15 Mar 2010 #permalink

Since the anti-vax contingent is so resistant to the application of reason and/or logic (multiple studies, court decisions, etc.) do you think that additional--and at this point, marginal--applications of reason and logic will have any measurable effect?

As satisfying/vindicating as the recent court decisions may be, they are liable to have little effect the momentum of the anti-vax movement. They have already proven impervious to science, logic, academic rejection, etc.

Truth is always the first casualty in a marketing war. The anti-vax movement is all about marketing. It has never been about science.

Which idea do you think would gain a greater foothold on popular consciousness?

1. The "vaccinations-cause-autism" movement continually ignores scientific evidence to the contrary and seeks to sell poorly conceived and researched "miracle cures" to desperate parents.

or

2. The anti-vaccination movement is actually a CIA plot to ration health care by convincing people to denounce one of the most effective disease prevention methods ever devised.

I fear #2 will be far easier to sell.

Orac, with all due respect you do not "know" that you were wrong in thinking that vaccine safety questioners were trying to effect vaccine court decisions rather than compare the pathetic case of "Dr." Poul and the MMR studies (actually that sounds like a good band name)with the Salem witchcraft handling of Dr. Wakefield.

Will wonders ever cease? I speculated that the mark of a *real* crank would be the time-honored "Government Plot" device.True to form,on Null's Noontime Radio Woo-fest,the host and his ventriloquist's dummy outline how the government covered up the thimerasol-autism link and that the latest ruling is indeed *evidence* of this dastardly deed.(his nonsense is archived at his websites, Gary Null.com and PRN; about 28 minutes into today's noon show)

By Denice Walter (not verified) on 15 Mar 2010 #permalink

"A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." -- Planck

The die-hard anti-vaxxers won't ever re-assess their position. What will happen is that the number of new recruits will dwindle.

Stephen Salzburg writing today at Forbes "Science Business" (partial quote):

Iâm not optimistic that these clear, decision rulings will have any effect on the conspiracy theorists in the anti-vax movement. Indeed, over at Age of Autism, theyâve already posted an article titled âSpecial Masters Protect Vaccine Program and Deny Justice to Vaccine-Injured Children.â The article, which is a combination of denialism and conspiracy mongering, claims that the trials ignored the science in order to defend the governmentâs vaccine program.

On the contrary, scientists studying autism want nothing more than to understand its cause and eventually to produce effective treatments. A growing body of evidence points to genetic factors behind ASD, but it will take much more work to pin down the complex combinations of genes that cause the various behaviors now called autism spectrum disorder. For example, a recent (2007) study by Sebat et al. found a clear link between ASD and de novo copy number variation (de novo mutations are those that arise for the first time in the children). We need more studies like this one if weâre to figure out this disease.

Excellent overview. Just one tiny slip.

Orac wrote:

The first batch of test cases would test the hypothesis that MMR causes autism;

Instead, the first test cases, including Cedillo, were to test the theory that MMR vaccines and thimerosal-containing vaccines can combine to cause autism. Given that the first batch failed, it was practically a given that the second batch would also fail. The "mercury militia" were probably aware of that; thus the pre-emptive strike.

By Broken Link (not verified) on 15 Mar 2010 #permalink

@ #34

Which idea do you think would gain a greater foothold on popular consciousness?
1. The "vaccinations-cause-autism" movement continually ignores scientific evidence to the contrary and seeks to sell poorly conceived and researched "miracle cures" to desperate parents.
or
2. The anti-vaccination movement is actually a CIA plot to ration health care by convincing people to denounce one of the most effective disease prevention methods ever devised.
I fear #2 will be far easier to sell.

It just might - let's see if I can conspiracy-theorize.

Alright, step one: The evil CIA black-flag operatives start up profitable shills for "alternative" and natural medicine and they decry science-based medicines and vaccination, spreading word to those natural rebels in society, the half-yeti offspring of atlantis.
Step two: Rational big-pharma overlord/illuminati masons/11th dimensional lizardmen brainwashed folks like us all get our vaccines.
Step three: Super-plague wipes out all opposition, aside from those that are vaccinated, leaving the blood-drinking queen of England and her Egyptian demon-god moonchild to rule her enlightened servants.

There's "evidence," of course - the pyramids exist, there's a code in the bible somewhere I'm sure, the comic book The Invisibles is actually about it! And who founded the NCCAM? The government! That's proof, man! PROOF!

@40:

You dare reveal our secret plan in public? Treason! Our Glorious Saurian Overlords will never stand for this. Expect a visit from the Black Helicopters of Doom real soon now.

Originally, there were 3 sets of test cases.
1. MMR and Thimerosal
2. Thimerosal
3. MMR

After the first set of cases were heard, the plaintiffs' steering committee decided that the third set of test cases was not needed as it was covered by the first.

Scott, we mostly all drive and need to drive. Driving is really important in our society. So, I guess the government should shield Toyota from liability, too. I guess even they(pharmaceutical companies) realize that those Fombonne style "safety studies" are crap, too.

jen - if someone crashes their car, Toyota's not responsible unless there was a design flaw in the car.

By dedicated lurker (not verified) on 15 Mar 2010 #permalink

@44: "unless there was a design flaw in the car." You just said a mouthful buddy (thimerosal, aluminum, too many live viruses).But don't worry. People like Fombonne really give us alot of reassurance.
Scott: I know what you mean about all the unfounded litigation that goes on. Did you know that the parent suing the DAN doctors was based on complaints stemming from a custody case?

Yeah jen, we knew. Poor guy was trying to protect his kid from the homicidal woo-happy wife. Apparently she wanted to push more DAN flavored toxins at the kid. He wasn't having it and wanted the courts to agree.

@jen

Your analogy is off. Imagine if people sued automakers because sometimes, in a car crash, the seat belt can cause an aortic dissection or some other fatal injury. Because seat belts can cause this extremely unlikely injury, is this a reason to sue the automakers out of business? Is it a reason to demand seatbelts be removed until a truly foolproof safety system is devised?

Would more people survive car crashes with or without seatbelts? Seatbelts are not perfect, but their simplicity and low expense ensures that everyone who drives has one available and has no excuse not to use it.

Still, you have a small contingent who claim to know someone who survived a wreck only because they were thrown out of the car while those belted in died in a fire. Those people will never wear seatbelts regardless of how much evidence is pushed in their faces.

The big difference here is that 50% of people not wearing their seatbelts won't cause the death of others who were wearing theirs or maybe kids in carseats who can't use the regular seatbelts.

So, jen, do wear your seatbelt despite its imperfections?

By The Gregarious… (not verified) on 15 Mar 2010 #permalink

GM: I do wear seatbelt despite its imperfections. But I won't give my kids every damned vaccine under the sun if I don't feel the risk is worth the benefit. I would never give a baby hep b vaccine. I would never give a kid chicken pox vaccine, or Gardasil. Or any in combination.

"But I won't give my kids every damned vaccine under the sun if I don't feel the risk is worth the benefit."

Which you and every anti-vax organization has failed to establish. Please stop using this rationalization. Simply because you've chosen a point between position A and position B does mean you're still not underwater. It means you are between points A and B. The wisdom of holding that position is entirely unrelated.

By young skeptic (not verified) on 15 Mar 2010 #permalink

Hey, I'll use any damned rationalization I like. It worked for my kids.

Yeah, why would you want to protect your child from cervical cancer anyway? Not to mention I heard a whisper that Gardasil may also provide some protection against penile cancer - although it's tough to establish with any sort of certaintly since penile cancer is so rare - but to hell with that! The same guy is now working on a vaccine against skin cancer and you can be damned sure I won't be using that one either! Never mind my much loved grandpa died from skin cancer, we all know we just have to wash our hands more and skin cancer will die out naturally, just like measles and pertussis and all the rest of them!

jen, the petitioners had five years to find the best cases and compile evidence, and yet they lost. All three of them (six if you count the previous cases).

I asked you before, but you did not seem to answer: What additional evidence do you think they should have used to bolster their lawsuit?

Now remember, all of the files are available for you to read, and are linked to in the above article. You have absolutely no reason to not answer the question.

@jen

Why no Hep B for your babies?

I can understand not giving the chicken pox vaccine to kids if you are extremely risk averse, but what is your opinion for older kids who have never had CP or an adult who has had it but who is at risk of shingles?

Why not Gardasil?

By The Gregarious… (not verified) on 15 Mar 2010 #permalink

Now virtually all possiblities as to how vaccines might cause autism have been firmly ruled out, our local anti-vaxers are frantically quoting this peculiar press release: http://www.medicalnewstoday.com/articles/171457.php
It looks like junk science to me but I'm not a scientist! Any insights?

By NZ Skeptic (not verified) on 15 Mar 2010 #permalink

@jen, #50:
Actually, it so far hasn't failed your kids. So far. Keep them away from India, Pakistan and Africa if you know what's good for them, though. Polio's a pretty horrible disease. Never mind the measles or tetanus, which are endemic to pretty much everywhere now.

Incidentally: Autism? Not a disease, nor is it horrible. At least, it's not horrible until people make it horrible for us.

By Jimbo Jones (not verified) on 16 Mar 2010 #permalink

Have to disagree mildly with Scott @ #16. There is a point at which the facts and law on a subject are considered so well-settled that a lawsuit raising the same old discredited arguments will result in not only quick dismissal but possibly a (rare in the USA) award of attorneys fees and costs against the party bringing the suit.

The Special Master in King broadly hinted at this in the following snippet from Orac's quote: Nevertheless, I can understand why Jordan's parents found such opinions to be believable under the circumstances. I conclude that the Kings filed this Program claim in good faith.

"Bad faith" being the standard for award of attorney's fees and costs against the party bringing a suit, the Special Master's reference to (narrowly) being able to find the Kings acted in good faith serves as a warning to potential future litigants wanting to raise the same issues.

Jimbo Jones: regarding tetanus, it's always been endemic to everywhere on Earth, and always will be; vaccine compliance will not change that, so we will always need that vaccine. The bacterium is not dependent on humans to complete its life cycle, it's not communicable, and it sickens us purely by accident. Consequently, vaccination will never eradicate it. But it's a nasty disease to contract, with a very high rate of morbidity and mortality. The only way to avoid it would be to avoid even slight injury at all costs, and obviously this is not practical, so the tetanus vaccine is mandatory for anyone who doesn't want to get tetanus.

That's one where I really don't get the antivaxxers. It's a really nasty disease, and herd immunity gives you no protection; it's a vaccine that you take purely for your own benefit. Why wouldn't a person want it? (Sucks if you have an allergy or other reason you can't get the vaccine, though, because then you're back to being really careful when working outdoors or cutting vegetables or whatever and getting anti-tetanus shots if you ever get a puncture wound.)

That's not one Jen mentioned, of course. She did mention Hep B. I don't understand the reluctance there. Babies chew on each other, and play rough through childhood; the risk of blood exposure is actually fairly significant even without any "naughty" behavior. I remember some of my second-grade classmates getting caught playing a game of pain endurance; they'd scrape the skin off the backs of their hands to see who cried first. If any of them had had HepB, the others would have been at risk for catching it. School took it seriously; they lined us all up in the hallway and inspected our hands to see who had been playing the game so their parents could be notified because of the risk of blood-borne disease. It's the kind of things kids do, because they don't know better.

So yeah, I let them vaccinate my babies against Hep B. I don't expect my kids to lead charmed lives, after all, though I do expect them to keep their noses clean (metaphorically speaking). I just think it's unreasonable to expect them never to get cut.

By Calli Arcale (not verified) on 16 Mar 2010 #permalink

Calli, when I was in second grade we used to play a game of pain endurance where we would stab each other in the thigh with pencils by surprise.

I also cannot tell you how many times I've been absolutely covered in the blood of another human being. It's a bloody, bloody world out there from my experience, one that has left me carrying severed fingers, applying pressure, and looking like an extra from Pulp Fiction more times than I'd like.

Which reminds me, I need to get my tetanus booster. You would not believe how often I get stabbed working in the garden dirt.

@ NZ skptic #54

That's a press release issued through PR Newswire by some wackaloons who probably have an IPO coming up and need to sucker some punters. Nothing in it at all.

A fragment of the rambling jen-based anti-vax screed caught my eye:

"You just said a mouthful buddy (thimerosal, aluminum, too many live viruses)." [emphasis added]

Jen, how many "live viruses" are in a vaccine and how many would be "just right"?

[Hint: the MMR II (Merck) has 1,000 TCID50 (tissue culture infectious doses - roughly equal to number of viruses needed to infect one cell) of measles vaccine strain virus, 1,000 TCID50 of rubella and 12,500 TCID50 of mumps vaccine strain virus in each 0.5 ml dose. That's not very many viruses when you consider that the average milliliter of seawater contains between 100,000 and 10,000,000 viruses.]

BTW, you did know that live virus vaccines don't have thimerosal (and never did) or aluminium, right?

I keep asking the "green our vaccines" and "too many toxins, too many viruses" folks exactly how they propose to make the vaccines "greener" or less "toxic". I'm still waiting for an answer.

I suspect the reason I don't get an answer is that the people spewing spittle about how "toxic" the current vaccines are haven't a clue what's in them right now. They just know - somehow - that the current vaccines are "bad" and need to be made more wholesome. That's why they insist that vaccines contain "anti-freeze" [Hint: ethylene glycol is anti-freeze, polyethylene glycol is in some vaccines and countless other products] and "fetal tissue" [some vaccines are grown on cultured cells that originated from an aborted fetus twenty to forty years ago].

Given that level of intellectual accuracy, why wouldn't we want to follow their lead?

But first, how about telling us how you plan to get to this magical place where vaccines don't contain "toxins" and "too many viruses", starting with what you would take out of current vaccines.

Be specific. Show your work.

Prometheus

@Prometheus

Do you happen to have the antigen load from older vaccines (e.g., circa mid 1980s) and the antigen load from natural infection?

But, but, but...

If polyethylene glycol is made from ethylene glycol, and ethylene glycol is poisonous, then, then, then...

Don't you see? It's the similarity in the names that does it! Why, adding the "poly" is diluting the "ethylene glycol", and jamming them together shakes up the whole thing. So naturally, it's the same, but a lot worse!

(Bet you didn't know homeopathy worked with words, did you? Well, you learn something new every day.)

But, but, but...

If you take ethylene glycol and add some poly to it, doesn't it still contain ethylene glycol. And how do we know how toxic the poly is. Anybody know?

Jud: the reason for the "good faith" determination in the King case (and AFAIK, all the others) is that the NVICP allows petitioners to be reimbursed for their expenses in bringing a claim, whether or not they prevail, as long as they made the claim in good faith.

Kathleen Seidel has documented how many attorneys and expert witnesses have managed to make quite a good living handling by-and-large losing NVICP cases.

Todd,

The earliest live-attenuated measles vaccines used roughly the same amount of virus as the current MMR. I imagine that, after doing all the work necessary to find an optimum dose, they didn't ever see a reason to change it.

From reading the early (1960's) literature on the live-attenuated vaccine, it is apparent that they were trying to find the smallest dose of virus that would reliably give long-term immunity. For that matter, since the virus replicates on its own, it is pretty much irrelevant how much you administer, just so long as it is enough to get the infection started.

As far as how much (or how little) of the measles virus it takes to cause an infection in humans, that is a bit harder to determine, since nobody has done infection tests on human subjects. Tissue culture and animal studies show that the vaccine strain isn't very good at infecting intact organisms and doesn't produce anything like the immune suppression seen with "wild type" measles infection.

A couple of studies have shown - with animals - that less than 10 TCID50 of "wild type" measles (depending on strain) can produce a clinical infection. However, people who get measles (or influenza or adenovirus or....) do not necessarily get the minimum infectious dose.

The whole point of this exercise is that "too many viruses" is a silly thing to say and demonstrates an absolute absence of knowledge about the subject. The point of a live-attenuated virus vaccine is to provide enough virus to initiate an immunity-generating infection. Less virus will simply result in more people failing to become immune without providing any advantage of safety.

Of course, anyone who knows as much about viruses (or biology) as some of these people claim to know would already know that.

Which, I think, proves my point.

Prometheus

Now virtually all possiblities as to how vaccines might cause autism have been firmly ruled out, our local anti-vaxers are frantically quoting this peculiar press release: http://www.medicalnewstoday.com/articles/171457.php

It looks like junk science to me but I'm not a scientist! Any insights?

Ah yes, this press release. Here's an insight I'd point out right away:

There is no indication anywhere in the press release that this "model" these business-people-dabbling-in-science have created has ever been subjected, in whole or in part, to actual testing.

Well, I have to say (putting my tongue firmly in my cheek) they cannot be accused of misinterpreting the results of their experiments, because they didn't do any experiments. They cannot be accused of ignoring possible confounding factors in their data, because they have collected no data.

When this press release first popped up a few months ago, there were a few things it reminded me of. One was S. I Hayakawa's masterful dissection of Dianetics, where he points out that Dianetics, though promoted as a "science", more resembles science fiction, where "the art consists in concealing from the reader, for novelistic purposes, the distinctions between established scientific facts, almost-established scientific hypotheses, scientific conjectures, and imaginative extrapolations far beyond what has even been conjectured." This press release certainly shows no understanding of the distinction between an "imaginative extrapolation[] far beyond what has even been [scientifically] conjectured" (what their "model" actually is) and established scientific fact (what they think their model is.)

What comes even more to mind now, though, is a blog post of some popularity which distinguishes "The 3 Types Of Knowledge": the shit you know, the shit you know you don't know, and the shit you don't know you don't know. What makes someone dangerous, the blog author suggests, is how much knowledge is in their third category.

If the authors of this press release actually believe what they have written (as opposed to deliberately trying to "sucker some punters" as Visitor suggested) then it seems that almost all of science is in their third category. They don't seem to know that anything happens in science after the devising of a hypothesis. They don't seem to know that real scientists get excited by finding out the places where reality doesn't match what theory says should happen.

By Antaeus Feldspar (not verified) on 16 Mar 2010 #permalink

Prometheus,

Your point has been proved ad nauseam. Not that it make a tiny, miniscule difference to these people. Reason is irrelevant. They know what they know because they know it, and they are absolutely certain that anything that contradicts what they know is wrong, because it does not agree with what they know.

@jen

Wait, wait, wait. I have a real question for jen.

If injecting the virus to induce immunity causes autism, then why does the wild-type virus, the one that causes the disease (i.e., measles) not also cause autism. If we are focusing on the viruses, the wild-type, the infectious virus, is more harmful, and should cause autism routinely.

Please explain.

@Rob

Ooh-ooh-ooooh! (Can I be Horshack for a moment?)

If you are susceptible to autism, the wild measles virus just kills you instead of giving you autism. Which, by the anti-vaxers reasoning, would seem to be preferable.

By The Gregarious… (not verified) on 16 Mar 2010 #permalink

From above press release:
"`If it hadn't been for so many parents insisting that vaccines were responsible for the condition, we might never have found the fact that the stabilizer in MMR and a few other vaccines is hydrolyzed gelatin; a substance that is approximately 21% glycine. It appears that, based on readily verifiable science, the use of that form of glycine triggers an imbalance between the amino acid neurotransmitters responsible for the absorption rate of certain classes of cells throughout the body. '"
So... Jello causes autism?

By David N. Brown (not verified) on 16 Mar 2010 #permalink

Thanks to those who have commented on the press release for me. Our NZ childhood disease promoters are convinced it's the hitherto unrecognised vaccines-cause-autism holy grail, but is being ignored and/or pushed underground by evil medical professionals and big pharma - you know, the usual story! I was wondering myself why my own kids have been fully vaxed - and eaten plenty of jelly - without developing autism!

By NZ Sceptic (not verified) on 16 Mar 2010 #permalink

"So... Jello causes autism?"

Since Jello contains gelatin and gelatin is made of horse's hoofs and glue is also made of horse's hoofs then I say the culprit is horses. Horses cause autism. More evidence: Prior to European exploration in the New World the indigenous people of North America were not exposed to horses, and you will search high and low without finding a single reference to autism in any of their historical records.

whoops- meant to also include as evidence the fact that most kids with autism have used glue.

"Horses cause autism."

Further evidence - whenever I drive past my local hippotherapy centre, there's always loads of kids on horses, and a lot of them have autism.

Coincidence that there just happens to be a lot of children with autism right slap bang in the middle of where there is a high concentration of horses?

I think not..........

Horses with autism? Have they been vaccinated? No doubt it's another instance of the malign influence of Big Farmer....

@David N. Brown

I couldn't read the press release, as it gave me a blinding headache.

This is actually a positive development, because whereas mercury is clearly toxic, hydrolyzed protein, whether animal or vegetable, is not. Duh.

With respect to the horse hypothesis, it is invalid. Dogs love to eat horse's hooves, and I've never seen an autistic dog. Also, dogs get all kinds of vaccines. Sorry to those of you who have invested years of your scientific careers investigating the horse-autism connection, but my personal anecdotes about autism-less dogs blows that hypothesis out of the water.

I think they should label ALL foods containing glycine as such: "Warning: this food contains glycine, a chemical known by the State of California to cause autism."

I can't help noticing that jen has avoided answering any direct questions....

By AussieMarcus (not verified) on 17 Mar 2010 #permalink

Perhaps she is busy celebrating St. Patrick's Day?

Nah, she is over on another thread posting stuff about babies, her education and not answering direct questions.

Rob, you haven't proven anything. Have you, personally, interviewed every dog in the world to determine that they don't have autism? Because unless you've seen, first-hand, a dog regress after eating a horse's hoof, you don't know what you're talking about. I've seen it. Tons of pet owners have seen it, but we're being silenced because nobody wants to believe it. One day our dogs are happily talking to us, using words like "Master" and even full sentences like "I need to go for a walk now, dammit, or you'll regret putting in white carpets" and then, BAM, they eat a horse hoof and it's all gone. I have loads of science on my side, but it's all being represed by Big Meat. They don't want you knowing that their nasty by-products cause disease. By my own calculations, which I can assure you are accurate because I made them up myself, the glue industry in the United States alone is a $3 trillion/year industry, and the Jello lobby is one of the most well-funded in Washington. (You should see their junkets. Immoral. Full of bikini-clad women wrestling in cherry-flavored Jello, accompanied by a Bill Cosby stand-up routine.)

From the press release:

" It appears that, based on readily verifiable science, the use of that form of glycine triggers an imbalance between the amino acid neurotransmitters responsible for the absorption rate of certain classes of cells throughout the body."

Glycine (an amino acid) is a neurotransmitter - an inhibitory neurotransmitter at glycine receptors and an excitatory co-agonist (with glutamate) at NMDA receptors.

However, if the miniscule amount of glycine in vaccines is enough to cause autism, what about the massive amounts in milk? Ditto for glutamate. Chicken soup contains enough glycine and glutamate to kill.....if it could only get to the synaptic cleft.

That, it turns out, is why injected or ingested glycine and glutamate don't lead to excitatory neurotoxicity - the blood-brain barrier keeps circulating glycine and glutamate out of the synaptic cleft, where they could do mischief.

And before someone makes the tired and oft-disproven claim that "autistic children have defective blood-brain barriers", please explain why - if that were so - these children weren't killed by their first sip of mother's milk. If the blood-brain barrier was so porous that the tiny amount of glycine or glutamate in a vaccine could cause autism, the amount of glycine and glutamate in an ounce of milk would cause widespread neuronal death.

The problem is that there isn't any way the miniscule amounts of glycine, formaldehyde, aluminium, etc. in vaccines can cause autism while the much larger amounts of the same compounds in the bloodstream from natural sources (like normal cellular metabolism) don't.

Prometheus

That damn glycine, it will kill you. Damn chemicals.

Not to mention all that damn glycine in those brain proteins. It's a wonder any of us are still alive.

Ya know, you put them foreign chemicals into a baby, and BOOM, the friggin' kid is autistic. (I know all about this, because my dog, who ate those friggin' horses hooves, licked my kid smack dab on the mouth, and the friggin' little bastard (the kid, not the dog) friggin' autismisized right on the friggin' spot. I'm tellin' you, it was like instantaneousically, right then.)

Them autistically type kids don't have no friggin' normal cellular metabolistic stuff. They got their metabolistics all messed up from that friggin' mercury stuff. Don't you know anythin'?

Hey maydijo, I seen some of them glue guys sneakin' around. They was all wearin' bikinis. Pretty damn weird, if you'all ask me.

I keep asking the "green our vaccines" and "too many toxins, too many viruses" folks exactly how they propose to make the vaccines "greener" or less "toxic". I'm still waiting for an answer.

I suspect the reason I don't get an answer is that the people spewing spittle about how "toxic" the current vaccines are haven't a clue what's in them right now. They just know - somehow - that the current vaccines are "bad" and need to be made more wholesome. That's why they insist that vaccines contain "anti-freeze" [Hint: ethylene glycol is anti-freeze, polyethylene glycol is in some vaccines and countless other products] and "fetal tissue" [some vaccines are grown on cultured cells that originated from an aborted fetus twenty to forty years ago].

I suspect another reason is that the leaders have been caught before, pinning their flag to a solid 'hypotheses', which has blown up in their faces (removal of thimerosal didn't reduce cases).
With the 'Green our Vaccines' soundbite they can just whine "Toxins!!!" to their hearts content, cos, youknow - toxins are scary!