Quoth the Institute of Medicine: The current vaccine schedule is safe and effective. Quoth antivaccinationists: Gahhhh!

I sense another disturbance in the antivaccine Force.

Yes, I realize that it was just a couple of days ago that I sensed a previous disturbance rippling through the antivaccine Force. That's when antivaccinationists brought David Kirby out of mothballs from whatever journalistic slime pit he's currently residing in to use every trick at his disposal to convince you that somehow the government has compensated two families of children for vaccine-induced autism when in fact he's playing the same game he's always played: Claiming that if any child who's ever been compensated by the National Vaccine Injury Compensation Program (VICP) who at some point developed any syndrome resembling autism or autism spectrum disorders it means that vaccines caused the autism. It's such a transparent ploy that Kirby's used so often that it only induced ennui.

However, for some reason (probably because I only check out the antivaccine propaganda blog Age of Autism every now and then for yucks), I missed a post there by our old pal J.B. Handley pimping donations about a highly dubious study for which Generation Rescue is raising money. I blogged about this study a couple of months ago. Basically, it's a study that's the holy grail of the antivaccine movement, a study known colloquially as a "vaxed-unvaxed" study. Basically, it's the sort of study that antivaccinationists clamor for as a second choice. While most (but not all) antivaccinationists grudgingly accept that a prospective randomized study comparing vaccinated and unvaccinated children would be completely unethical, they are so convinced that vaccines are pure evil that they want to compare vaccinated versus unvaccinated populations for health outcomes, expecting to find enormous differences, with vaccinated children being all autistic and riddled with chronic diseases like asthma. Or something. For some reason, the investigators doing this study claim they need $500,000. To do what, I can't figure out, given that this "study" appears to be little more than an Internet survey examining home schooled children, who of course represent a highly unrepresentative population to be studying. Its principal investigator is Anthony R. Mawson, M.A., Dr.P.H., who is an admirer of Andrew Wakefield and clearly has antivaccine tendencies.

Then, a few days ago, J.B. Handley repeated his call for money for these science-challenged antivaccine investigators. He framed it as a a "Q & A" session about the study by Suzanne Humphries, which is not a good choice if you want to convince anyone that the study is anything other than an antivaccine study, given that Humphries is known for referring to vaccines as "disease matter." Particularly interesting is this bit:

Q: So if they need Internal Review Board approval, does this mean that there could be other sources of funding? $500,000 is a lot to come up from the grassroots. There needs to be a benefactor or some other creative financing.

A: IRB approval for the study was obtained at Jackson State University, where the study is based, in 2011. Approval was renewed for Year 2 a few months ago. There is no other current funding for the study. The pilot study was funded by Generation Rescue, whose support was financial. They are totally uninvolved in study design and analysis.

It's pretty sad when someone like Humphries or Handley apparently doesn't know that it's Institutional Review Board approval, not Internal Review Board approval, but it's about par for the course for these people. Be that as it may, one wonders what sort of IRB they have at Jackson State University or what they were smoking there to approve such a dubious study like this. Be that as it may, Handley showing up again made me wonder what's going on. Frequently, the antivaccine movement knows about things that are about to happen before I do because, well, they spend incredible amounts of time and effort finding these things out, and I have a job and a life. In any case, it didn't take long for me to find out what probably provoked this (besides, of course, Generation Rescue's only having raised $30,000 out of the needed additional $400,000). Just yesterday, a very telling screed appeared from our old friend Dan Olmsted about the recently released Institute of Medicine report on vaccines, Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies.

Olmsted begins, predictably enough, with a whine:

It isn't worth spending much time and energy to take on the new Institute of Medicine report on vaccine safety concerns-- bought and paid for by the Department of Health and Human Services -- except to note that as the Feds continue trying to bottle up the truth about the autism epidemic, it keeps leaking out everywhere else. The Vaccine Court rulings this week, uncovered by the outstanding reporting of David Kirby and validated over and over by the Unanswered Questions report of EBCALA, are far more important in the long run than the dying yelps of the medical-industrial complex.

In other words, the fact that vaccines are the main driver of the autism epidemic, validated every day by families across the county and now in the world, is far more important than the ginned-up claim by the special interests that they don't cause autism, or autoimmune disorders, or asthma, or ADHD, or juvenile diabetes, and etcetera and etcetera and etcetera.

It's the same ol', same ol'. The IOM is a pharma shill; vaccines are the cause of autism and all sorts of horrible diseases; and, of course, only Dan Olmsted, David Kirby, and their fellow antivaccine travelers know the truth. Of course, that EBCALA report referred to by Olmsted was in itself unauthorized human subjects research—and incompetently done research, to boot.

In fact, the report is nothing unexpected. The IOM, while acknowledging that

The committee acknowledges the evidence that reducing vaccine coverage is associated with increases in vaccine-preventable disease and found only ad hoc, inconsistent, and anecdotal evidence to imply that the recommended immunization schedule is not safe. Furthermore, existing systems for the detection of adverse events provide confidence that the existing childhood immunization schedule is safe, and the committee recognizes that the federal government invests considerable resources to ensure vaccine safety. Nevertheless, some stakeholders have suggested that further work is warranted, such as a comparison of vaccinated children with unvaccinated children or children receiving immunizations on alternative immunization schedules.

Ad hoc, inconsistent, and anecdotal evidence is exactly the sort of evidence that the antivaccine movement relies on is, of course, because it doesn't have any epidemiological evidence or scientific evidence worth bothering with. Its evidence comes from at best low quality, uncontrolled or poorly controlled studies, and studies done by antivaccine investigators like Mark and David Geier, Christopher Shaw, or Andrew Wakefield. In any case, the report goes on to point out that doing a prospective randomized trial of vaccinated versus unvaccinated children would be completely unethical and:

[T]he committee concludes that a randomized controlled trial comparing the recommended schedule with any alternative schedule would be unethical and infeasible and could increase the risk of vaccine-preventable diseases in individuals and in the community.

While I don't necessarily completely agree that testing alternative vaccination schedules would be inherently unethical, depending on the precise parameters of the schedule being tested (after all, we do that in essence when we add new vaccines to the existing vaccination schedule and it probably wouldn't be unethical to test schedules in which certain vaccines are moved up or extra doses are added), I agree completely that a prospective randomized "vaxed versus unvaxed" study would indeed be completely unethical. Moreover, even though a study testing various "alternative" vaccine schedules might be ethically acceptable, depending upon the specific schedules being tested, absent compelling evidence of harm from the existing vaccine schedule, there is no scientific rationale to do such studies. (Hint to antivaccinationists: Just because you want one is not a scientific rationale.) Given that such a study would be very expensive and that the end result of "spreading out" the vaccine schedule would result in more visits and more time for children to be unprotected against vaccine-preventable diseases, such a study would be a waste of time and money.

In fact, for the benefit of antivaccine activists who might read this, I'll explain why a randomized study comparing unvaccinated children versus vaccinated children or alternative vaccine schedules in which children are left undervaccinated too long would be completely unethical no matter what you believe. If vaccines are not dangerous and do not cause autism, as science shows and I accept, and the current vaccine schedule is safe and effective then doing a "vaxed versus unvaxed" study in which one group is randomized to receive no vaccines or a schedule that unnecessarily spreads out vaccines is completely unethical because the unvaccinated (or undervaccinated group) would be knowingly and intentionally left unprotected from vaccine-preventable diseases. Now, even if vaccines did cause autism and were a major cause of sudden infant death syndrome, asthma, and all the other diseases that antivaccinationists try to pin on vaccines, and there was compelling evidence to suggest that this was true, then the study would still be of questionable ethics, because the vaccinated group would then be knowingly placed into a group that would be likely to be harmed by the vaccination schedule. In this latter case, if there were truly evidence of harm, then decisions would likely have to be made on the basis of what that evidence is, what the specific harms suspected are, all balanced against the known harm that would come from cutting back on the vaccine schedule. None of this is to say that a randomized controlled trial of different vaccine schedules would always be unethical. The principle of clinical equipoise holds, after all. However, the classic "vaxed versus untaxed" randomized study some of the more clueless antivaccine activists want would indeed be unethical under pretty much any imaginable circumstance.

None of this stops Olmsted from laying down swaths of flaming antivaccine stupid:

So, it's prospectively unethical. OK, then what about a study of people who are already unvaccinated -- you know, the Amish, homeschoolers, the HomeFirst practice in Chicago? Chiropractors, Christian Scientists, Bushmen, Waldorfers, Spenglerians, Hippie-Dippies (not my term!) in Ashland.

No way. The report says: "Some people have suggested comparing vaccinated children with children in "naturally occurring" populations of unimmunized individuals, such as certain religious communities. With less than 1 percent of the American population refusing all immunizations, however, it would be very difficult to recruit enough willing unvaccinated participants, the committee concluded. It can take tens of thousands of study participants to discover uncommon health problems. Moreover, these populations tend to be much less diverse ethnically, racially, socio-economically, and genetically than the general population, and because such factors can influence health, it would be difficult to determine if differences between the study groups are the result of vaccines or these other factors. The costs of conducting this kind of study or a randomized controlled trial likely would be prohibitive."

The IOM, as it turns out, is completely correct about this. I've explained exactly why multiple times before, remarking that it’s so cute when anti-vaxers try to discuss epidemiology. Actually, it's not cute, but it is ignorant. As I pointed out, even if a researcher could sign up 10% of the entire estimated number of unvaccinated children in the U.S., then the smallest difference in autism prevalence that could be detected would be around a 70% increase in autism prevalence. The reason for this is that there are only estimated to be 50,000 total completely unvaccinated children between 3 and 6 in the entire country. This study would cost millions of dollars to do, as well. If we were to do a more conventional study (say, 5,000 matched controls and 500 unvaccinated children), we might be able to detect a seven-fold increase in the prevalence of autism, but only if we accept a beta error (the chance of erroneously saying there is no difference when there is a difference) of 50%. Check out Prometheus's post and my old post for the full details.

So the IOM is correct about this, and Dan Olmsted doesn't know what he's talking about when he rants and raves and insinuates dogmatism and conspiracy while dismissing scientists' objections to "vaxed versus unvaxed" studies of the type advocated by epidemiology-challenged antivaccine activists as the "Epistemological Obscenity." (So what else is new?) Of course, "Epistemological Obscenity" is a pithy phrase that makes Olmsted sound pithy and profound, but in reality his post and those of antivaccinationists about such "vaxed versus unvaxed" studies are the real Epistemological Obscenities because in them true ignorance about the validity and limits of human knowledge is not just demonstrated, but flaunted proudly, as demonstrated by Olmsted when he compares the simple analyses of ethics, statistical power, cost, and practicality that lead scientists to dismiss him to "some mad extrapolation of Heisenberg's Uncertainty Principle to the macro-atomic level" when it is anything but that. Thinking himself more knowledgeable about vaccines, autism, and biology than scientists who have spent their entire careers studying these issues, Olmsted doesn't even realize or accept that scientists and physicians are correct when they point out that one of studies that he so fervently wants (a prospective randomized trial) is completely unethical, and that his grudgingly suggested fallback (an epidemiological study of vaxed versus unvaxed children) is highly unlikely to give them the answer that they crave. This is not surprising, given that antivaccinationists like Olmsted seem to think that an incompetently performed phone survey or an Internet survey by a German homeopath named Andreas Bachmair that was even more incompetently performed (but that they tout anyway) represents good science.

Of course, ultimately I suspect that's the point. They already "know" vaccines cause autism, SIDS, asthma, and many other problems, and no study, no matter how convincingly negative, will ever change their minds.


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Dammit! Orac scooped me. I'm still reading the report. Extra-long hours at work and home life interfering with my blogging. I shouldn't be surprised, though. Much easier for a box of blinking lights to stay ahead of me.

Nicely written, Orac!

@Dangerous Bacon

I like how they include Dr. Sears' opinion, then immediately show that it's wrong.

@Todd - how soon do you think it will be before Dachel-bot shows up?

I'm sure there will be a deluge of spammy posts before the morning is gone.


She'll almost certainly show up on the story Dangerous Bacon linked to, though. Considering the story was posted last night around 7pm, I'm actually rather surprised she hasn't swooped in already.

I haven't read the details of the study they want to do, but if it does involve homeschooled children, that's sketchy. A lot of kids are homeschooled simply because they have special needs (like ASD) or health concerns (like food allergies), so in any homeschool cohort you will likely find vaccinated kids with ASD or health issues. You will also find plenty of unvaccinated kids (the opt-outers who refuse vaccines, public school, etc., on principle) who don't have ASD, or may simply be undiagnosed due to parental paranoia about "labels" and The Medical Establishment.

On my local homeschool Yahoo Group message board, I see parents looking for doctors who won't "push" vaccines and won't criticize homeschooling. The moms will post things like, "I love our pediatrician!!! She lets me decide which vaccines my kids get and which ones we skip!"

Does an IRB review the quality of the science, or is it just there to make sure patients are protected? I thought the latter, and as it's an internet survey they're talking about all they need to show is good anonymizing and no collection of personal data to clear that hurdle.


The primary objective of the IRB is to ensure the safety of the subjects. Some review of the quality of the science can play a part, especially if there is increased risk to the subjects.

For an internet survey, I could see the IRB raising questions if there was a risk of loss of confidentiality that could lead to social repercussions against the subjects. Exposure of medical information is also a risk, both in terms of social impact and economic (e.g., if an insurance company finds something out, that may impact current or future coverage/fees). Loss of confidentiality could also have some ramifications on employment, depending on the info leaked. For this, that doesn't seem to be a huge issue to worry about. There is no physical risk from the study, so that part's okay.

As long as the researchers have adequate protections in place to guard against loss of confidentiality, even if the science sucks, I could see an IRB approving it. They're more concerned with studies that pose a genuine risk to subjects.

On the proposal to compare the small unvaccinated communities looking for correlation. Wouldn't it also work the other way, and with a much smaller pool of study subjects? Even N>0 in that population would indicate vaccines are not the cause of autism. Kind of a black swan thing.

One Amish kid with Autism basically confirms vaccines are not the cause.



One Amish kid with Autism basically confirms vaccines are not the cause.


Nope. One Amish kid with Autism confirms that that particular Amish kid's autism was not caused by vaccines (if he/she were unvaccinated; remember, the Amish do vaccinated).

There are plenty of Amish with autism. Seen them with my own eyes.

In other anti-vax news:

It appears that John Stone ( AoA) is not at all happy with Dr Larson's ( of LSHTM, JCVI) position on mercury, which is, like that of WHO and the AAP.

She has a conflict of interest because of her connections with the Gates.

A commenter mentions the situation in Gouro, Chad that appeared in the "Journal du Tchad" and "La Voix" ( which several of us here read ).

Perhaps that will be their next big story: paralysis after vaccines.

"What's a Thinking Mom to DO?" ( @ TMR) :
ah yes, what to do when you find yourself in a difficult situation...
well, compare yourself to the late Dr ML King, that's what!
I'm sure that that's absolutely appropriate.

By Denice Walter (not verified) on 17 Jan 2013 #permalink

@ Mike:

I wonder if they would attribute ANY un-vaccinated child's ASD to the child's MOTHER'S vaccination - that's what their editor did when her third child, who is unvaccinated, was diagnosed with autism.

Either that or some type of a time warp or quantum entanglement, I suppose.

By Denice Walter (not verified) on 17 Jan 2013 #permalink

@Denise - isn't that what that nutjob in England has done? He doesn't believe there are any unvaccinated autistics - and he'll also throw in Mom's vaccines, plus dental fillings, right?

Tony Bates!**

Maybe I shouldn't have said his name: it might conjure up an appearance- perish rthe thought.

** I was refering to Kim Stagliano.

By Denice Walter (not verified) on 17 Jan 2013 #permalink


Indeed, yeah.

But given their logic of "the court awarded damages to a kid with (maybe?) Autism, therefore we have proof that vaccines caused it!" it seems the same kind of game.

I was over-simplifying it there, obviously. The anti-vaccine crowd seems agile enough to say "vaccines are only one cause!" rather than the only cause.


Yeah, they do like to move the goalposts. It's the Mercury! Take out the Mercury. It's too many too soon! Etc., Scary to think they blame the mother's vaccines and probably would try the quantum entanglement bit.

@ Mike:

rather than "agile", I'd call it sloppy, using loosely associated material etc.

But I know what your mean.
They'll use anything they find, even if they have to twist and manipulate it so much that it no longer resembles its former self..

By Denice Walter (not verified) on 17 Jan 2013 #permalink

what YOU mean--

sorry, gotta go,

By Denice Walter (not verified) on 17 Jan 2013 #permalink

The groupies at AoA were notified about an ABC TV story on the IOM report and some of them have posted there.


Look for my two posts about the IOM Report and the value I place in the Vaccine Safety Datalink which resulted in the removal of RotaShield vaccine in 1999.


Somehow (I must have posted under a different 'nym years ago), my 'nym there is "abcnurse". Does anyone want to come out and play with me?

As the mother of a child on the spectrum, I blame all the exotic fruit that is now imported into Canada year round. The kind that were unheard of when I was child, especially the mangoes. Oh yes, the presence of mangoes in the grocery store where I shopped when I was pregnant with my ASD daughter is what caused her austism. I just know it. And if it wasnt the presence of the mangoes, it was the number of mangoes especially when combined with the star fruit. It is an unholy alliance, I tells ya.....the Canadian government is covering all this up because they are in the pockets of big fruit (Richard Simmons??) and are only in it for the money...........my other children were never exposed to these fruit because I then only shopped at the local gas station and that is why they are not on the spectrum.....


the Canadian government is covering all this up because they are in the pockets of big fruit (Richard Simmons??)

you win the Internet for this. My Diet Coke can nearly became a neti pot when I read it. :)

By Edith Prickly (not verified) on 17 Jan 2013 #permalink

offtopic: On the St. Lawrence

isn't it cold to be on the St Lawrence at this time?


Over on Facebook, there's an anti-vaccination, anti-circumcision activist named Hollie [redacted]. There is also a pro-science, pro-vaccination activist named Dorit Reiss, who is also a professor of law.

In this video (also at The Poxes Blog), Hollie threatens Dorit. At Dorit's work number. You know, the one at the law school.

Hollie "...was reported to CPS over having a pox party for her 6 year old and looking for a pertussis party. She has an infant. She was also smoking pot while pregnant and while giving birth. Out of everyone who was outraged, she picked the Jew to harass at work, and I'm not just playing the race card as she anti ritualistic circumcision and spends a ton of time critical of Jewish brisses."

Click on my name for the link.

@Liz Ditz

Wow...just went through a couple of fire extinguishers to put out the stupid.

OMH, Holly's a winner. Liz will you keep us updated?

By Science Mom (not verified) on 17 Jan 2013 #permalink

Thanks Liz, saw that and commented. I'd love to know what, if any action the lawyer takes.

By Science Mom (not verified) on 17 Jan 2013 #permalink

Heh, you're such a smart alec Liz. Catherina snuck that one right under my nose.

By Science Mom (not verified) on 17 Jan 2013 #permalink

For more burning stupid, see Dr. Bob Sear’s latest Facebook idiocy:

Why does this wanker keep supplying me with so much blog fodder in such a short amount of time?

He doesn't understand study ethics and cites a study which is not even applicable to the U.S. and EU. And I only just started reading his stupid screed.

By Science Mom (not verified) on 17 Jan 2013 #permalink

Science Mom,

"Why does this wanker keep supplying me with so much blog fodder in such a short amount of time?"

The IAS does the same for me... (Admittedly I rarely convert it into actual blog posts, however.)

To any anti-science lunatics who are planning on unleashing their "If [vaccine] is safe then whyyyy are so many people living with chronic conditions like asthma, allergies, and diabetes?" schtick, let me save you the effort.

They're living with chronic health problems because they're living. That's it, full stop. Without scientific advances such as bronchodilators and corticosteroids, emergency preparations like epi-pens used alongside simple antihistamines, and synthetic insulin. and testing devices, a good chunk of people would not make it to double digits. The same goes for vaccines - not dying from measles,related encephalitis means you get to live with whatever else you have.

So please, don't go there.

@Jake - so you finished your 666 degrees of separation between everyone on the planet (except yourself, of course) and the vaccine industry yet?

OOOOooooohhhhh Jake!

Is it a drive-by posting or you're here to stay for our enjoyment?


Indeed. Maybe Jake will actually try to make an actual argument this time, rather than ad hominems and "six degrees of separation" conspiracy mongering!

Wait. I don't get it. The "signature" at the end states that Jake will attend GW in August. I thought he was already in.

I'm kidding, of course. It was from his GW account that he emailed my bosses, clamoring that I be fired.

What we have in his latest post is the same old thing. This person has a conflict of interest. That person is corrupt. Dr. Offit is a millionaire vaccine industrialist. Unlike other MPH students at GW who volunteer their time in the underserved areas of DC and surrounding counties, Mr. Crosby seems to choose to sit at a computer and dream up stuff.

I wonder how the real world is going to treat him?

I'm still pissed that my alma mater would house a student as f'ed up as Jake, though with the issues GW has had lately, I guess any paying student will do.....


Wow. I'm a little amazed at how readily Dr. Sears displays is ignorance of science and ethics. I shot him a little email (or at least tried, but it bounced 'cause his mailbox was full) with links to my series on the ethics of a prospective vaxed vs. unvaxed study.

@ Ren:

I believe that that's an old post ( I recognise the photoshopped image)- it's not on today's AoA page ( where the continuing -and endless and meaningless- saga of Frua Koma- continues)

I wonder about his future as you do.

By Denice Walter (not verified) on 18 Jan 2013 #permalink

Pardon me that's FRAU...

By Denice Walter (not verified) on 18 Jan 2013 #permalink


Oops. My bad. Sorry, Jake... About some of that stuff.

Elburto -- Every time I take antibiotics, I think of all the times where, without modern medicine, something or other would have killed me. I probably would have died at birth , to be honest (I got cerebral palsy instead), but if that didn't kill me, the rubella I got as a tiny baby might have, or the bronchitis, or one of the two bouts of pneumonia I've had...and that's without taking all those now-rare vaccine-preventable illnesses (like polio, diphtheria, mumps, and so on) into account.

If I had actually lasted until adulthood, probably that bout of pneumonia/sinusitis/throat-ear infection I had in graduate school secondary to influenza would have killed me; it was well on the way to doing so before antibiotics beat it back.

I've had a lot fewer genuinely vicious bouts of sinusitis since Hib vaccination in children became widespread, I'll tell you that. I'm convinced I get fewer really bad ones because the damn little germ vectors aren't giving me Hib anymore...

More people should think seriously about stuff like that, rather than just sitting on their privileged asses and thinking they'd stay totally healthy because [insert spurious rationale here].

By Interrobang (not verified) on 18 Jan 2013 #permalink

I'd probably have gone deaf from repeated ear infections. If I'd actually made it to be born and not been miscarried some time in the second trimester.

By dedicated lurker (not verified) on 18 Jan 2013 #permalink

Not sure where to ask this, but what states keep county-by-county data on immunization levels, and how can one get the (summary) data? (I think Michigan does, & I think I didn't get a response from asking California.)

Yes vaccines are "generally" safe. Like it appears the 1983 schedule under which my children were vaccinated is safe- not many vaccine injuries reported. But now! I believe the science in the movie "The Greater Good" explains it all.
"Too many, too soon"

@ken - the vaccine schedule is 1983 contained a heck of a lot more antigens than the current one, even though there are more vaccines on it.....

Also, the 1983 schedule did not include the disease that gave my kid seizures, and some others that are now either in decline or almost gone.

Back again "ken"...with your nonsensical post about the 1983-vs-2012 vaccine schedule?

Here's where "ken" *sources* his inane post:


It's also the *source* for the anti-vaccine trolls who post at AoA, the Ho-Po and all the other anti-vaccine blogs.

Have you got any other *sources* ken...that prove that newer vaccines that have been added to the "Recommended Childhood Vaccine Schedule" and their rare "serious adverse events" exceed the number of "serious adverse events" associated with contracting the actual diseases that newer vaccines prevent?


Oh, and let us not forget that included in the American 1983 schedule is the MMR vaccine.

@Lawrence prove it

opps checked with the wife- children vaccinated prior to '83

Fancy footwork to avoid the obvious- Why the increase in childhood diseases including autism? Where's the research brilliance displayed in trying to solve this puzzle?
Ped Drs are not neuroscientists- the brain is involved in immune reactions.


[citation needed]


Why the increase in childhood diseases including autism?

Have they really increased? From my perspective as a parent of college age children there has been a decrease in childhood diseases like measles, mumps, chicken pox, etc. Or has there been more autism awareness due to the Internet? Or is it organic food sales?

Whatever your "beliefs" it is unethical to "mandate" vaccinations
when there are known risks as stated in pharma inserts.
A parent has a right to choose. Hep B shot? No way for my grandchildren.

A parent has a right to choose. Hep B shot? No way for my grandchildren.

My condolences on the loss of your actual children.

@chris- silly graph


@chris- silly graph

Exactly. It points out the silly associations people make with things that are not associated with each other, like autism and vaccines.

Ken, newspapers are not actual citations. And from a glance, it looks like the organic food is leading to an increase in obesity: "Doctors and public health officials should be bracing for a wave of chronically ill young adults with weight-related ailments that include diabetes and heart disease, researchers said." Must be too much organically grown soy burgers and gluten free pasta.

And from what I can see, the autism numbers correlate to the rise of the Internets.

@ Chris
Oops it should be encephalopathy not autism-thestir.cafemom.com/toddler/149858/vaccine_court_awards_millions_to


You do know that since children are not getting and dying form VPDs, the chances of getting other diseases increases, right?

You also do know that there are a lot of factors contributing to this, including poor diets and sedentary lifestyles, all of which are causative of chronic disease in children than what you think.

And your last link, encephalitis is NOT autism.

Ken, I think you should know that around here, David Kirby is something of a joke. Put his name into the search box at the top. Orac has repeatedly dismantled him.

By Julian Frost (not verified) on 21 Jan 2013 #permalink

@lilady -in the link you provided Orac states-"There are also a lot of other oddities about this story. For instance, despite multiple visits to doctors in Iran, Ryan was not admitted to the hospital, and he appeared to be fine for seven weeks after his last visit to an Iranian doctor, up until the mother brought him home at the end of February."
The court documents state:
The next day, on January 6, 2004, shortly after the family’s arrival in Tehran, Ryan’s mother took him to the Children’s Hospital Medical Center in Tehran.12At the hospital, Dr. Goudarzi examined Ryan and determined that he had a temperature of 104 degrees Fahrenheit.13Ps’ Ex. 6 at 1. Dr. Goudarzi noted that Ryan was “covered from head to toe in a measles-like rash.” Id. Dr. Goudarzi diagnosed Ryan with a “febrile convulsion, probably related to MMR.” Id.
"The next day, on January 7, 2004, Dr. Allami examined Ryan in his clinic in Tehran.14He diagnosed Ryan with “high fever, skin rash, tremors, [and] lethargy” as “most likely due to an adverse reaction[] to multiple vaccines he received earlier.” Ps’ Ex. 22. Two days later, on January 9, 2004, Ryan returned to the Children’s Hospital Medical Center because he had a persistent high fever of 104 degrees Fahrenheit or greater.

Julian Frost, "ken" knows all about Kirby and the rest of the crank bloggers. Every time ken posts here is the same old arguments against vaccines. Time to put ken in the "Ignore Bin".

I'm still blaming the mangoes. :)

@ Agashem: I think you solved the mystery of mangoes-induced-autism. That causative agent theory is just as valid as the other *theories* out there. :-)

Fancy footwork to avoid the obvious- Why the increase in childhood diseases including autism?

"My children are sick because a witch hexed them" is "the obvious" to a resident of colonial Salem. Next time, ken, if you don't have any evidence to present better than that of the Salem witch trials, don't bother us.

By Antaeus Feldspar (not verified) on 22 Jan 2013 #permalink

Per google cache, the full statement is:

"It's like some mad extrapolation of Heisenberg's Uncertainty Principle to the macro-atomic level. You just can't measure it!"

As someone with multiple degrees in physics, I call gibberish on this statement. Sounds sciency, though, doesn't it?

the uncertainty principle states you can't know the momentum and position precisely at the same time. You can know (measure) both with some uncertaintly, but if you know one precisely, the other is completely unknown.

He might be thinking (again incorrectly) of the observer effect--whereby one can not know precisely the state of a system without measuring it, and in measuring it, one collapses the system into a single state. Schroedinger's cat. The observer effect is related but different from the uncertainty principle. But, again, Mr. Olmsted would be wrong. One can't know without measuring, but one can measure.

And, what is "macro atomic level"? It is either "macro" or it's atomic. The uncertainty principle *is* observable on the atomic level (whether one mistakenly adds "macro" or not).

All in all, it is a string of sciency sounding gibberish.

By Matt Carey (not verified) on 22 Jan 2013 #permalink

what about a study of people who are already unvaccinated — you know, the Amish, homeschoolers, the HomeFirst practice in Chicago? Chiropractors, Christian Scientists, Bushmen, Waldorfers, Spenglerians

Spenglerians? Followers of a pessimistic social historian with a cyclic view of civilisation? Why the feck would they be unvaccinated?

By herr doktor bimler (not verified) on 22 Jan 2013 #permalink

Fancy footwork to avoid the obvious- Why the increase in childhood diseases including autism?

With respect to autism the increase corresponds with broadened diagnostic criteria, diagnostic substitution, increased surveillance, reduction in social stigma associated with a diagnosis of autism spectrum disorder, etc.

One thing it doesn't appear to have anything to do with is routine childhood vaccination: lots of very large scale epidemiologic studies have looked hard for any hint of a causal association and come up completely empty.

bASED ON MY OBSERVATIONS, I believe that herr dokter said the magic word**- on the other thread- which initiated the numbering process.
Merci beaucoup, HDB.

** which was either "feck" or "Splenglerians".

By Denice Walter (not verified) on 22 Jan 2013 #permalink

@ JGC: you'll live to regret replying to that comment. :-)

IMO, the "Obvious correct reply" would be..

The increase in childhood diseases, including autism is correlated with the increase in male pattern baldness.

Oops,wrong thread.
At any rate, I think the numberig started with bimler here.

By Denice Walter (not verified) on 22 Jan 2013 #permalink

@Julian Frost - David Kirby is hardly a joke
@JGC Some children were vaccine injured with resulting encephalopathy- and more children will be injured -those are the facts(Or the package inserts supplied by Pharma are lies) Giving those unknown vulnerable babies the Hep B at birth and a rigid one-size fits all schedule without knowing the genetic history of the baby is irresponsible. Orac is not a pediatrician thank goodness. I'm sure he is an excellent surgeon.


Citation Needed.

And make sure to provide actual verifiable scientific literature to show those vaccine injuries.

And as far as those two resulting encephalopathy, the chance of encephalitis by actually getting measles is one out of a thousand. Over four million doses of the MMR vaccine is given in the USA each year. Do tell when with real evidence that it has caused 4000 cases of encephalopathy in one year.

@ ken:

It's also a straight-up flat-out lie that the vaccine schedule is "one size fits all." It already takes into account REAL contraindications and GENUINE reasons to adjust.

What's irresponsible is leaving children without protection from diseases simply because some moron makes some completely unfounded claims about vaccines.


Looked at the link. Considering all that kirby says that goes against established science without as much as a shred of proof, why should I take him seriously?

Again with the "unvaccinated Amish". For pete's sake. The Amish DO vaccinate, depending on their doctor's recommendations. They DO have autism. I wouldn't trust David Kirby if he told me the sky was blue without checking it; since he couldn't even find the Clinic for Special Children in Ohio, where they vaccinate AND see Amish children with autism. Kirby is a lazy inept reporter.

My bad...I meant the clinic is in Pennsylvania, not Ohio. Ohio has a large Amish/Mennonite population also, and that's the one I know better.

@ken, doesn't that sort of contradict your claim in comment #88 that there's "a rigid one-size fits all schedule" of vaccinations?

lilady, that baby had several other issues at birth.

And again, there are around three million doses of HepB vaccines given at birth (there are almost four million births per year in the USA, the total is more as the full series is given). Again, there needs to be actual proof that a significant number of newborns have issues with the vaccine.

So ken just likes to post links with no explanation?

So I can only assume that Ken is upset that kids aren't receiving the full series of vaccines & he wants it to be improved upon.....again, since he won't comment....

make an (ass) out of (u) and (me)
good nite all......

@ken - actually just you.....since I already know what I'm talking about, as opposed to you.

@Ken, I'm curious what you think would be the correct way to go about this. You don't like “a rigid one-size fits all schedule” of vaccinations even though it's obvious less than rigid because according to your own link, half of all children aren't vaccinated in accordance with the schedule.

So what do you think there should be? A flowchart that the doctor follows, making the required choice at each box and finding at the end ... um ... a rigid one-size fits all schedule for children who fall in that box? No schedule at all, leaving it up to each doctor to decide for himself with no guidance?

Or is it better to have a standard schedule so doctors know what have been found to be good times for different vaccines, leaving it up to the individual doctor to vary the schedule for individual patients? You know, I've never heard of a doctor being punished for failure to vaccinate in accordance with the rigid one-size fits all schedule, not even Jay Gordon, MD, FAAP.

@LW - if that is true & lots more kids aren't getting all the vaccinations, why is the rate of Autism increasing?

Will the very thought of that make the logic-impaired individuals at AOA blow their minds?

@Lawrence: "if that is true & lots more kids aren’t getting all the vaccinations, why is the rate of Autism increasing?"

The evil Big Pharma, with the collusion of the corrupt CDC, is conspiring to add more undisclosed brain-killing contaminants to each shot to make up for children getting fewer shots. Sheesh, don't you know anything?

The AAP noted today that, "Over the years, some anti-vaccine activists have confused ethylmercury with the highly dangerous neurotoxin methylmercury and erroneously linked thimerosal to autism." However, the AAP also indicated today: "A newly signed international treaty banning mercury has granted an exception to the mercury-based preservative thimerosal, widely used in resource-poor countries that depend on delivery of vaccines in multi-dose vials."




@ brian:

And they're already seething about the exception at AoA today.
And ranting about Bill Gates in the comments.

By Denice Walter (not verified) on 22 Jan 2013 #permalink

ethlymercury is harmless?
" The toxicity of ethylmercury is not well studied - exposure standards based on methylmercury (such as those currently recommended by the United States Environmental Protection Agency) have not been demonstrated to be equivalent for ethylmercury.[3]"

@brian- ethlymercury is harmless?

Where has brian said that?

By herr doktor bimler (not verified) on 22 Jan 2013 #permalink

ken -- you are correct that exposure standards for ethyl mercury are based on methyl mercury. This is for two reasons: 1) the toxicity of methyl mercury is well documented so it's a good reference, and 2) one thing we do know about ethyl mercury is that it is *less* toxic than methyl mercury. We just don't know exactly how much less toxic. So, better safe than sorry, wouldn't you say? Or would you prefer to read something into it that's not there?

By Calli Arcale (not verified) on 22 Jan 2013 #permalink


Neither of those studies was in a living system. They were bench studies. While interesting, they do not say anything about what happens in a living organism.

Here's some more info on thimerosal.

Ken (sorry, I am unable to use not capitalize the first letter in a proper name), please tell us which vaccine in the American pediatric schedule is only available with thimerosal. Do not include influenza because at least half do not have thimerosal.

make an (ass) out of (u) and (me)
good nite all……

So you said something stupid and then didn't leave as promised?


If pharma was so concerned they would have a separate vaccine for pertussis w/o a diphtheria component since.....
(From the CDC)
"A confirmed case has not been reported in the U.S. since 2003. Approximately 0.001 cases per 100,000 population in the U.S. since 1980; before the introduction of vaccine in the 1920s incidence was 100-200 cases per 100,000 population."
"Diphtheria is transmitted from person to person through close contact with the discharge from an infected person's eyes, nose, throat or skin."


Wait, you're saying that since the introduction of the vaccine resulted in drastic reductions in diphtheria that we should get rid of the diphtheria part of the DTaP? Really?

I warned you guys about the drive-by poster who drops endless links in endless posts:

I like these comments from Dr. Orenstein, etal, in support in of the WHO's use of multi-dose vials of vaccine that contain Thimerosal:


"...Thimerosal, which contains ethyl mercury, has been used as a preservative in vaccines to prevent contamination of multidose vials from bacteria and fungi since the 1930s.2 Although there are clear neurotoxic effects of methyl mercury absorption, ethyl mercury has not been associated with those consequences. Nevertheless, before data were available on risks of thimerosal in vaccines, in 1999 the American Academy of Pediatrics and the US Public Health Service recommended moving toward removing thimerosal use in preservatives as a precautionary measure.3..."


"...Overwhelmingly, the evidence collected over the past 15 years has failed to yield any evidence of significant harm, including serious neurodevelopmental disorders, from use of thimerosal in vaccines. Dozens of studies from countries around the world have supported the safety of thimerosal-containing vaccines. Specifically, the Institute of Medicine, and others have concluded that the evidence favors rejection of a link between thimerosal and autism.6–12 Careful studies of the risk of other serious neurodevelopmental disorders have failed to support a causal link with thimerosal.13–17 In May 2002, the American Academy of Pediatrics retired its 1999 statement on thimerosal after evaluating new studies.3..,"

And the best for last,

"...Had the evidence that is available now been available in 1999, the policy reducing thimerosal use would likely have not been implemented. Furthermore, in 2008 the World Health Organization (WHO) endorsed the use of thimerosal in vaccines.20..."

@Todd W- I had the smallpox vac as a kid. Should we now give the small pox shot again?

Neither of those studies was in a living system. They were bench studies. While interesting, they do not say anything about what happens in a living organism.

Both studies show that ethyl mercury, in sufficient concentration, will kill neuroblastoma cells by interfering with mitochondrial function. Please show where the authors use their data to estimate safe tolerances for human beings. Otherwise these papers have no relevance.

By herr doktor bimler (not verified) on 22 Jan 2013 #permalink

Ken, answer the question that was asked. List the vaccine on the American pediatric schedule that is only available with thimerosal. That means you actually type out what the vaccine is and not post a link.

So tell us which vaccine on the American pediatric vaccine schedule does not have a thimerosal version. Is it the DTaP? Or the HepB? Perhaps the MMR?

By the way, a couple of years ago a young woman in Australia died from diphtheria. Your concerns would only work if we completely closed the borders. Plus that nothing to do with my question.

So answer my question. If you bring up "mercury", you must know which vaccines contain it that are required without any other viable substitute.


False comparison. Smallpox has been eliminated worldwide. Diphtheria, not so much.

@Chris -No
Good nite

So, by your refusal to answer Chris' question, you admit that your position is null and invalid?

Ken, it is not a difficult question to answer. It has a very simple one syllable answer.

And in other news from the world of antivax lunacy - a former employee of a children's hospital in Cincinnati who was fired for refusing a flu shot (required of all employees), is now suing the hospital for $650,000.

You see, she's a vegan, she refused the shot because of the tiny amount of egg protein in the vaccine, and veganism is, dontcha know, a religion - and the hospital violated her religious rights.


By Dangerous Bacon (not verified) on 23 Jan 2013 #permalink


Veganism is a religion? Huh. Who knew? All this time I thought it was a dietary choice. I wonder what the name of their god(s) is.

On a side note, anyone know if the hospital's policy allowed for mandatory masking for those who did not get vaccinated?

@ Dangerous Bacon: The hospital worker refused the flu vaccine back in 2010. Her lawsuit was original based on violation of her civil rights (which was tossed already) and violation of her religious rights (which the judge in the case has allowed her to proceed).

The hospital stated "veganism" is a life style source...not a religion.


Whether veganism is a religion or not, I do not see how her beliefs trump the safety of patients who trust the hospital to make them well, not infect them with disease.

Her beliefs, religious or not, will not protect her from the influenza virus. Her beliefs, religious or not, will not protect patients from the influenza virus which she breathes around.

She says her work does not bring her in contact with patients, but what about walking to and from her office? What about the bathrooms? What about the cafeteria? Why should she personally be entitled to decide what kind of risk she poses instead of the hospital which is responsible for the wellbeing of patients.

"The hospital stated “veganism” is a life style CHOICE…not a religion."

(I should not post until I've had my morning coffee)

@ Todd W.

"Veganism is a religion? Huh. Who knew? All this time I thought it was a dietary choice. I wonder what the name of their god(s) is."

Rutabaga The Merciful and Starchy


Praise be Thy purple-tan skin and wholesome soup-flavoring goodness.

@ Todd

We eat this soup in remembrance of you...

Is it getting hot in here?

I also saw a post from a parent in Missouri, who claimed that he and his wife are Buddhists, who have been following a vegan diet for years. When their son was born, he too was fed only a vegan diet. At the time of his birth ~ 10 years before, he was given a Vitamin B (?) shot by hospital staff and he states the child received some/all of his early childhood immunizations. (It didn't matter whether or not he missed "a few" because he was home schooled).

When the child was about ten years old, the parents decided it would be a good idea to have the child attend school for socialization with his peers, etc..

The father was SHOCKED, TRULY SHOCKED when it was determined that his immunizations were not up-to-date. Then he started to investigate (using the NVIC as his source), the "ingredients" in vaccines, such as animal proteins and "fetal cells" and the testing of human vaccines using lab animals.

It all turned out well, according to the father, thanks to the very liberal "religious belief exemption" for which he credits his Christian and fundamentalist Christian Missourians who pushed for that liberal religious exemption.

Some children were vaccine injured with resulting encephalopathy- and more children will be injured -those are the facts.

Some of the facts, perhaps. Not all the facts, hoaver, and more critically not enough of the facts to determine relative risk associated with being vaccinated versus remaining vulnerable to infection.

Commuting to work in Boston today saw an article about Aisling McCarthy Brady, a nanny being charged in the death of 1 year old child in her charge due to subdural and retinal hemoraghing caused by blunt force trauma to the head. The child also showed signs of healing from multiple bone fractures.

The paragraph that's makes me consider dishing out a little trauma myself was "The lawyer of a nanny accused of killing a 1-year-old Cambridge girl she was caring for suggested that the baby may have died from symptoms from vaccines rather than by abuse from her client."

Is it at all possible to submit amicus briefs in a criminal proceeding? This is one anti-vaccine lie that needs to be buried.

Is it at all possible to submit amicus briefs in a criminal proceeding? This is one anti-vaccine lie that needs to be buried.

Keep in mind that amicus curiae means friend of the court; it's really supposed be neutral, not advocacy. Anyway, it's a matter of appellate practice.

Speaking of legal matters, has anything happened with Wakefield's appeal?

Her beliefs, religious or not, will not protect her from the influenza virus. Her beliefs, religious or not, will not protect patients from the influenza virus which she breathes around.

There's every reason to believe that the EEOC would be willing to consider veganism subject to protection under Title VII and require reasonable accommodation. See generally Donna Page's "Veganism and Sincerely Held 'Religious' Beliefs in the Workplace" (PDF here),

Thanks, Brian. Gah, another month delay.

I just wish he could be departed for not having an actual job, or for being a scam artist.

Narad: I'm no going to read that long PDF, but was the issue in that case specifically veganism and refusal to get an influenza vaccine or any other vaccine that uses any meat/egg proteins during the manufacturing practice?

I also interested in why one part of the current hospital employee's (she has not been identified as being a HCW who has patient contact), case (violation of her civil rights), was disallowed by the judge...as in...what particular civil right?

@ Brian: Aha, it appears that all the motions and delays are being filed by the appellant's (Wakefield) attorney. Interesting no? Wouldn't you think that the individual who commenced the action would have all his ducks lined up to present the case without the delaying tactics. Unless...Andy *omitted* some *minor details* and told his attorney it was a *sure win*.

@ Chris: I all in for Wakefield to be departed/deported. :-)
I've even offered to donate to a fund to assist the Wakefield clan to be repatriated back to the U.K.

We have a fairly sizable Indian community in this county -- many are devout Jains, who are forbidden by their religion from eating meat, fish or eggs (or even swat ting mosquitoes, as I understand it).

That doesn't prevent them from lining up for flu shots.


(Curse you, lack of preview function).

Narad: I’m no going to read that long PDF, but was the issue in that case specifically veganism and refusal to get an influenza vaccine or any other vaccine that uses any meat/egg proteins during the manufacturing practice?

The article is an overview, but yes, it's happened. A very similar case in California failed, but that was importantly a matter of having been brought under state rather than federal law. In the non-health-care case of Bruce Anderson, which was settled, though, a regional EEOC office stated that it would accept veganism.

Speaking of woo, Mothering.com gets it's turn under the microscope.


Just thought our host might be interested.

By Politicalguineapig (not verified) on 23 Jan 2013 #permalink

“The lawyer of a nanny accused of killing a 1-year-old Cambridge girl she was caring for suggested that the baby may have died from symptoms from vaccines rather than by abuse from her client.”

The lawyer seems to be appealing more to old-fashioned racism -- arguing that the baby's parents had relatives in dodgy places like Pakistan and Saudi Arabia and London, so she probably received her injuries on family trips there.

By herr doktor bimler (not verified) on 23 Jan 2013 #permalink

Ken, you still need to answer my question:

What vaccine on the American pediatric schedule is only available with thimerosal?

As noted before, do not mention influenza vaccine because half do not have thimersal. It is just a one syllable answer, and yet has of last night you have refused to answer this simple question.

So do not expect any kind of response to your posting of an over three year old article until you answer my simple question.

Newsflash: In antiquated American terminology it is "01/13", which means any your cite that includes "2009/10", is over three years old. Plus it is a silly website with no relevance.

If you have real data, then post the title, journal and date of the PubMed indexed paper.

@Chris-I don't know.
The above article includes the testimony of M.Belkin whose daughter died within 16 hours after receiving the Hep B vaccine.
Parents observations don't count?
Pub Med- http://www.ncbi.nlm.nih.gov/pubmed/11164115

"Findings suggest that U.S. male neonates vaccinated with the hepatitis B vaccine prior to 1999 (from vaccination record) had a threefold higher risk for parental report of autism diagnosis compared to boys not vaccinated as neonates during that same time period. Nonwhite boys bore a greater risk." http://www.ncbi.nlm.nih.gov/pubmed/21058170

"The above article includes the testimony of M.Belkin whose daughter died within 16 hours after receiving the Hep B vaccine.
Parents observations don’t count?"

They count only if the evidence backs them up. This is what Mr. Belkin had to say about the whole thing in an interview:

"Yet it soon becomes even more apparent that there are a lot of unanswered questions about his portrayal of [his daughter's] death and its aftermath. Asked, for instance, if he is sure that the medical examiner talked to Merck before switching her assessment of [his daughter's] death, he says: "I think so. I told her to." In other words, [his] allegation is based on nothing more than his own suggestion to the examiner, prompted by his suspicions about the vaccine.
He's also not sure, now that he's asked about it, whether it was the examiner or, as seems more likely, the police who came to his apartment looking for evidence of child abuse. "I don't know . . . somebody . . . don't ask me," he says.
Most crucially of all, [he] says he doesn't know where the pediatrician's notes are that prove that the examiner initially determined that [his daughter] had a swollen brain. "You have to take my word for it," he says.
Later, asked whether he would consent to having the case file from the examiner's office released to Seattle Weekly, he declines. "To me, it's a very invasive and intrusive request," he says, questioning the Weekly's "fixation" with[his daughter's] death. "To me, it's not the story.""

We have to take his word for it? Why testify before Congress if he wasn't going to produce the goods?


Do you have the whole paper or did you just google for an abstract that would back up your claims? Because you owe us a methods and a discussion section in order to evaluate that paper. "Parental reports of autism diagnosis" gives me great pause because it reeks of recall bias.

As to the first link...

Of the CLAIMED associations, two out of three have a 95% CI including 1, so are not associations at all. The third goes down to 1.05, so is arguably a very weak association... if one assumes they did the stats right and corrected for multiple comparisons. Which, if they claim a 95% CI including 1 is an association, I very much doubt they did. Nothing at all here.

So your evidence of a problem is a paper that looked for, but entirely failed to find, one.

Then, Ken, I suggest you find the answer to my question before bringing up the word "mercury" again. Here, I'll repeat it: tell us which vaccine in the American pediatric schedule is only available with thimerosal. Do not include influenza because half are thimerosal free.

Also, in the future restrict your cites to actual scientific papers or official public health pages (the latter is where you can find the answer to my question). Do not include any AgeOfAutism sites, because their veracity is questionable (like Mr. Belkin's personal anecdotes).

Oh, and the actual citation is still just parental anecdotes, it has nothing to do with the actual science. And still, millions of doses of HepB are given each year, and the numbers of "adverse vaccine reports" are still tiny.

My son is too old to have gotten the birth HepB vaccine, yet he had seizures when he was two days old and is developmentally disabled. My daughter got the HepB vaccine after she was born, and did not have seizures, and on Tuesday scored a 52 out of 50 on her bio-psych exam (she hates she missed one of the three extra credit questions).

My anecdote claims that getting the birth HepB is neurologically protective. And it is just as valid as Mr. Belkin's story, and the twelve year old paper you cited.

Do you have the whole paper or did you just google for an abstract that would back up your claims? Because you owe us a methods and a discussion section in order to evaluate that paper. “Parental reports of autism diagnosis” gives me great pause because it reeks of recall bias.

If you Google the title, you can exploit the fairly reliable tendency of antivaccine types to freely redistribute copyrighted material. It's NHIS questionnaire data. Basically they've got 9 of 33 boys aged 3–17 born prior to 1999 (so going back to the 1982 introduction of the birth dose) with autism and early Hep B dose, and 1258 of 7640 without autism. They don't seem to have taken the small step of looking at the same data from a window before the introduction.

Ah, so 9 cases is the triple rate. So the expectation was 3. IOW they're concluding that the Hep B vaccine is dangerous based on a grand total of 6 individuals. I don't have the time to check the numbers right now, though my gut does say that's statistically significant... but not by a lot, and WELL within the range of bias and systematic uncertainties.

Ah, so 9 cases is the triple rate. So the expectation was 3.

It's an adjusted odds ratio. I'm not competent to evaluate the analysis.

The birth dose for HepB did not start until 1991. It was only so-called high risk groups that were vaccinated before then, if they could be found (IV drug users are not terribly compliant).

The birth dose for HepB did not start until 1991. It was only so-called high risk groups that were vaccinated before then, if they could be found (IV drug users are not terribly compliant).

Thanks for the correction. That seems to muddy the waters even further.

As to the first link…
Of the CLAIMED associations, two out of three have a 95% CI including 1, so are not associations at all. The third goes down to 1.05, so is arguably a very weak association… if one assumes they did the stats right and corrected for multiple comparisons.

The 'Adverse Events after HepB" paper was a fishing expedition -- they trawled through the 1994 NHIS dataset looking for *any* adverse effects. No mention of multiple-comparison corrections.
Instead, for the three adverse events with raised odds ratios -- a significantly higher OR in the case of arthritis -- they go back to the 1993 NHIS dataset to see if the associations are replicable. In the cases of arthritis and pharyngitis, the OR was higher in 1993 but not significantly so. In the case of ear infections, the OR was actually *lower* in 1993.

Because the authors have done all this work, they argue that the absence of significant results in the 1993 data is still *confirmation* of the links dredged out of the 1994 data. There is hand-waving of the 'shut-up-that's-why' nature to explain why the *disconfirmation* of any association with ear infections doesn't really matter

The authors note that in a third of the data set, 'HepB' vaccination status was not recorded in medical records but based on parental report. I wondered whether the results were any different between the "recorded" and "parental report" data, but the authors didn't examine that, arguing instead that there was no reason to worry about retrospective memory bias in the absence of bad publicity about vaccines in the 90s.

By herr doktor bimler (not verified) on 24 Jan 2013 #permalink

When I become World Dictator, anyone running one of these retrospective trawls through a database will also have to report those adverse conditions turning up with a reduced odds ratio, i.e. the ones where the vaccination (or other intervention) seems to have had a protective effect.

By herr doktor bimler (not verified) on 24 Jan 2013 #permalink

I wonder if any of those who bring up the Gallagher and Goodman Hep B vaccine-ASD study have actually asked themselves this question: If the Hep B vaccine played no role whatsoever in the development of ASD, what results would have been EXPECTED from that study?

By way of an answer, if you note that the sample included children who were born between 1980 (when ASD prevalence and Hep B vaccination uptake were both low (the vaccine was, after all, introduced in 1981, and the birth dose was not mandated until 1991) up until the year 2000, when the prevalence of ASD was markedly higher and vaccine uptake was much increased, you should understand that even if there is NO connection between vaccination and ASD, the proportion of kids with ASD (most of whom were, of course, born in the later birth cohorts that have higher ASD prevalence) should ALSO have a higher rate of Hep B uptake than did earlier birth cohorts, since the vaccine was mandated for those later cohorts.

It’s useful to compare exposure to Hep B vaccine to the prevalence of other, also unrelated factors. For example, the proportion of US-born girls who were named Sophia increased ten-fold in the decades spanning the introduction of the mandatory birth dose of Hep B vaccine, between 1980 and 2000. In fact, if you compare the Social Security data for the four decades spanning the 1991 introduction of the birth dose mandate for Hep B vaccination, you’ll see that 91 percent of girls who were named Sophia in those decades were born in the years following the introduction of that mandate—and, moreover, according the most recent data, over 37 percent of all the Sophias born in the previous four decades were born just in the few years since influenza vaccination was recommended for all children six months of age and older!

The "Troll" is referring to the infamous Stony Brook University "study"... a "poster presentation" and a "David Kirby/Ho-Po" *special blog*, which Sullivan, Science Mom and Prometheus took apart here:


The PHBPP (Perinatal Hepatitis B Prevention Program) was started in NYS in 1988


Laws and Health Department Regulations were enacted which required every OB to test every pregnant woman, during each of her pregnancies, to test for the presence of acute hepatitis B infection or chronic hepatitis B carriage of the virus, so that infants at risk for vertical transmission of the virus would receive HBIG and the first hepatitis B vaccine within 12 hours of birth. Laws and Regulations were also enacted to require every laboratory to forward every Positive Hepatitis B Surface Antigen test result to the local (County) health departments, as well. NYS added "Pregnant Hepatitis B Carrier patients" to their "Reportable Communicable Diseases" list.

Chronic carriage of the Hepatitis B virus is estimated at 2 % of the United States population (considered by the WHO to be a "low endemic" country). Areas of the world that have higher endemic prevalence are all of Asia, with the exception of Japan, indigenous populations in Australia and New Zealand, the Indian sub-continent, the Middle East countries, Eastern European countries, all of Africa, all of the Caribbean and Latin America. The highest prevalence in the world are certain provinces in China where chronic carriage of the virus exceed 10 %.

Immigrants from those areas of the world who reside in the United States, as well as first and second generation children of those immigrants comprise the majority of women who test positive ( + Hepatitis B Surface Antigen) for hepatitis B chronic carriage.

(I recall the Troll being linking to this Stony Brook University grad student Poster Presentation last year, when "Lurker" and "Grandma Marsha" joined him in the fray).

Link to the letter clarifying the 2005 ACIP Recommendations for implementation of the universal birth dose of hepatitis B policy. Prior to the 2005 ACIP Recommendations, hospitals and birthing centers had the "option" to implement the hepatitis B birth dose.