Thanks for the measles yet again, Andy

There are many harms attributable to the antivaccine movement and its promotion of antivaccine beliefs. Certainly, the harm those of us who have been combatting antivaccine misinformation fear is the return of vaccine-preventable diseases, which is something we've seen in the form of outbreaks, such as the Disneyland measles outbreak two years ago and, in my own state, pertussis outbreaks. The Disneyland outbreak was a wake-up call to California legislators, who in its wake passed SB 277, a law that eliminated personal belief exemptions (PBEs) to school vaccine requirements. Now, only medical exemptions are permitted, and so far the law has worked well. In Michigan, we're still struggling. The Michigan Department of Health and Human Services issued a new rule that requires parents seeking a PBE to attend an education and counseling session at a local county health office before the PBE is issued. Not surprisingly, local antivaxers are not happy and have managed, by painting this rule as a horrific affront to "freedom" and "parental rights," to persuade legislators to try to pass a law that would not only revoke the rule and explicitly bar MDHHS from issuing similar rules in the future, but it would prevent local health officers from barring unvaccinated children from school during an outbreak. The law failed to pass the first time it was introduced, but Michigan legislators are nothing if not extremely persistent in pursuing harmful policies, and a new version of the same old bill is again under consideration. It matters not one whit to our stupid legislators that the rule change is starting to work to increase vaccine uptake. Unfortunately, we have a fair number of antivaccine and antivaccine-sympathetic legislators.

Although the antivaccine movement in the US has classically been associated with upper middle class and affluent white people, they are not the ones who are likely to suffer the most when herd immunity breaks down. I've written extensively here about how the newest (and perhaps most pernicious) antivaccine conspiracy theory, the so-called "CDC whistleblower" conspiracy theory promoted by Del Bigtree and Andrew Wakefield's propaganda film disguised as a documentary VAXXED, explicitly targets the African-American community, complete with promotional visits featuring the Nation of Islam going to speak in Compton and being involved in protests outside the CDC. Wakefield, as you recall, is the British gastroenterologist who in 1998 published a case series in The Lancet linking MMR to autism. It has since been retracted and shown to have been fraudulent, and Wakefield has had his UK medical license stripped from him. Unfortunately, that only makes him more of a hero to the antivaccine movement, and he's spent the last 19 years playing that role to the hilt.

The "CDC whistleblower" conspiracy theory is based on the story of CDC scientist William Thompson, who in 2013 apparently contacted biochemical engineer turned incompetent antivaccine epidemiologist Brian Thompson to vent about a study he co-authored in 2004 that examined whether there was a correlation between vaccination with MMR and subsequent risk of autism. Not surprisingly, the study failed to find a correlation. However, there was one subgroup, African-American boys, in which the unadjusted data showed a 3.4-fold increased risk of autism. (I'm simplifying for space considerations in providing background, obviously; if you want the gory details, read here and here for a contemporaneous account of the origin of a new conspiracy theory, as well as my review of the book Vaccine Whistleblower and Andrew Wakefield's fraudumentary VAXXED.) Thompson had had disagreements with how the data were presented and how he thought the CDC has "suppressed" the unadjusted data. Unfortunately for him, Thompson didn't realize that Hooker was recording their conversations, and Andrew Wakefield found out about it. Thus, he became the "CDC whistleblower" who seemingly validated what I like to call the central conspiracy theory of the antivaccine movement, specifically that the CDC "knows" that vaccines cause autism but covered it up. It didn't matter one whit that the correlation was found only in a small subgroup (African-American boys), but it did matter because African-Americans already have reason to distrust the medical community based on history. The "CDC whistleblower" myth feeds into that sad history, which is why Wakefield loves to invoke the Tuskegee syphilis experiment.

This is also not the first time Andrew Wakefield has targeted people of color with his pseudoscience. By any objective measure, for the most part the CDC whistleblower conspiracy theory and VAXXED have not had much resonance in the African-American community other than in the Nation of Islam and among a handful of parents like Sheila Ealey who really believe vaccines caused their children's autism. The first time around, unfortunately, Wakefield was much more successful. Now, nearly a decade after he first started targeting the community, they are continuing to suffer measles outbreaks. I will begin with the story as it stands now and then go back and look at how it got to this point. The story takes place among a seemingly unlikely group of people in an unexpected location. It's also a story that I can't believe I've never blogged about before, given how long it's been going on.

Measles outbreaks among Somali immigrants in Minnesota

Before I first encountered this story several years ago, I had no idea that there was a large community of Somali immigrants in Hennepin County in Minnesota, but there is. In fact, it's the largest community of Somali immigrants in the US that began forming over a quarter of a century ago and now numbers in the several tens of thousands. Right now, the community is the center of a new measles outbreak, which is just the latest. From the StarTribune a week ago:

As a registered nurse and a consultant to the Minnesota Department of Health, Asli Ashkir has spent nearly a decade talking with Somali parents about autism, vaccines and the importance of getting their children immunized.

Last week she redoubled her efforts. A measles outbreak in Hennepin County has sickened 12 children — all of them unvaccinated and all of them from Somali families, according to the department — throwing a spotlight on low immunization rates among Somali children.

Now state and county public health workers are doing their best to contact Somali parents and underscore the value of immunization. “I know when parents have facts, they do the best they can to make the right decision,” Ashkir said.

I note that the total number of children sickened had reached 32 by the weekend, and the toll is still growing.

The story shows why the Somali community in the Twin Cities area is so susceptible to measles outbreak. All you have to do is to look at this graph of MMR vaccine uptake by year:

MMR uptake among Somali immigrants in Minnesota: This is the effect of nearly a decade of antivaccine propaganda. MMR uptake among Somali immigrants in Minnesota: This is the effect of nearly a decade of antivaccine propaganda.

The graph above shows what can only be described as a catastrophic plunge over the course of just one decade in MMR uptake among American-born children of Somali descent, from 92% to 42%. There is, for all intents and purposes, no herd immunity in this community. The interesting thing here, though, is that this plunge is very specific. It's noted in the story that there is not a fear of vaccination in general among the Somali immigrant population. Rather, it's fear of just one shot: the MMR. It is a fear that antivaxers stoked, beginning sometime around 2008, and they have unfortunately been wildly successful in inculcating fear of the MMR in Somalis in Minnesota. Indeed, a 2014 study examined attitudes towards the MMR vaccine in Somali and non-Somali children in Minnesota and found:

Somali parents were more likely than non-Somali parents to have refused the MMR vaccine for their child (odds ratio, 4.6; 95% confidence interval, 1.2–18.0). Most of them refused vaccines because they had heard of adverse effects associated with the vaccine or personally knew someone who suffered an adverse effect. Somali parents were significantly more likely to believe that autism is caused by vaccines (35% vs. 8% of non-Somali parents). Somalis were also more likely to be uncomfortable with administering multiple vaccines at one visit (odds ratio, 4.0; 95% confidence interval, 1.4–11.9) and more likely to believe that children receive too many vaccines.

It was a small survey, but it was the only one I found in the peer-reviewed medical literature thus far. Its results are not surprising, however, to anyone directly involved with the Somali community, particularly public health officials. There haven't (yet) been studies published about this latest measles outbreak, but there was a study about the 2011 measles outbreak in Minnesota, which, to that point, was the largest such outbreak in 20 years, with 21 cases identified. Its conclusions were also unsurprising. The source was found to be a 30-month-old US-born child of Somali descent infected while visiting Kenya and then spread to the Somali and non-Somali population primarily through the unvaccinated:

Three case-patients had unknown vaccination status, 1 was vaccinated before the recommended age (11 months), and 1 was a health care worker who was thought to be immune (IgG-positive documented >10 years previously). Sixteen of 21 (76%) were unvaccinated; 7 of 16 (44%) were too young for routine vaccination. Nine (56%) children were age-eligible for routine vaccination but unvaccinated, 7 because of safety concerns owing to the misinformation that MMR vaccine causes autism; 6 of these children were of Somali descent. Two other children did not refuse but were behind on immunizations.

This is how the outbreak spread:

This outbreak began with an unvaccinated US-born child who was exposed to measles in an endemic region of Africa and developed disease on return to the United States. Low vaccination rates in the local Somali community, and subsequent exposures among susceptible homeless shelter residents, fueled ongoing transmission of measles. Delay of the source case-patient’s measles diagnosis also may have contributed to transmission before public health interventions. Although post-exposure prophylaxis, vaccination, and voluntary isolation and quarantine were implemented after the first known case, there was ongoing transmission in 1 of the 2 affected shelters. This transmission was attributable to several factors, including exposures that occurred before the first identified case, an exposure of an infant too young for MMR vaccine according to the routine schedule, as well as exposure of an infant who was too young for the early MMR vaccine outbreak recommendation. Other contributing factors were caused by the challenges of quickly assessing and documenting immune status in a large group of individuals living in a temporary, communal setting. These challenges allowed transmission to individuals who initially were assumed to be immune, but who lacked documentation. After ongoing transmission was seen, immune status testing was implemented for those who lacked documentation.

Notably, two-thirds of the cases in this outbreak were hospitalized, and many of these were hospitalized for respiratory complications in addition to dehydration, highlighting that measles is a severe infection even in well-resourced countries.

If measles is as harmless as antivaxers claim that it is, then why were two-thirds of the people stricken with measles in this outbreak hospitalized for complications? That's a rhetorical question for antivaxers, obviously.

The first question that faces Minnesota public health officials is, of course: How did we get here? The second is: What can be done to combat MMR fear-mongering? I can't help but note that the fear of the MMR that is so prevalent among Somali immigrants in Minnesota, while primarily about the MMR, is bleeding over to other vaccines. Some Somali immigrants are starting to show susceptibility to the "too many too soon" myth and, as a result, spacing out the remaining vaccines other than the MMR that they are willing to administer to their children, believing that early vaccination can "damage an infant's language skills." Basically, if you live in Minnesota, combatting antivaccine and anti-MMR views in the Somali immigrant community is imperative. Even if you don't live there, given that the Twin Cities area is a hub of national and international transportation, measles could be as short as a quick plane flight to where you live.

So let's look at how we got here. Andrew Wakefield has his fingerprints all over this, but it didn't start with him. As is his usual MO, he opportunistically took advantage of a situation, as he did when he discovered that Brian Hooker had been recording telephone conversations with a disgruntled CDC scientist.

2008: Autism in the Somali immigrant community

The story of how the myth that MMR causes autism became so firmly entrenched among Somalis living in Minnesota began sometime around 2008, with a cluster of autism cases among the community and a news story, as described by Bahta et al. in Minnesota Medicine:

Parents in Minnesota’s Somali community have voiced concern that their children are disproportionately affected by autism spectrum disorder (ASD) compared with children of other ethnicities. Many in the community blame the MMR vaccine. In an August 2008 news story on WCCO-TV, one parent was quoted as saying, “It’s the vaccines.”

Shortly after the story aired, the Minnesota Department of Health reached out to members of the Somali community to gather more information. Health department staff attended meetings with Somali parents, many of whom were unfamiliar with ASD. Repeatedly, they stated that they don’t even have a word for autism in their language. In telling her story, one mother reported that in their attempt to understand ASD, she and others discovered groups that supported the claim that vaccines, particularly MMR, cause autism. Misinformation can spread rapidly in the Somali community, which has a rich oral tradition of passing information to one another. It is now widely accepted among Somali Minnesotans that MMR is to blame for autism.

The antivaccine movement was all over this story in 2008. For example, David Kirby, author of the book Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy, which was one of the early works using pseudoscience to link thimerosal in vaccines to autism was writing articles like 'Autism May Be Caused By “Chemical Exposures”' specifically about the Somali community in Minnesota, with a "wink, wink, nudge, nudge" that the "idea that 'chemical exposures' (vaccine related or otherwise) might cause autism still brings virtual apoplexia to certain scientific circles." He had previously hammered the same theme on the antivaccine blog Age of Autism, noting from the data presented that "rate of autism among Somali children in the public schools had been reported at 1 in 28 kids" and that the "80 or so Somali parents who attended were disappointed, by all accounts, that Dr. Punyko had no way to tell them if autism among their children was, as they strongly suspect, more common than among non-Somalis the same age."

But was autism more than twice as common among the American-born children of Somali immigrants, as the data linked to above suggest? In early 2009, the Minnesota Department of Health released a study of autism among Somali immigrants. It is a substantial read. Here are a couple of key findings, which, as is often the case in studies of autism compared to parental perception of autism prevalence, are not as clear as the prevalent belief among the Somali community in Minnesota or as the antivaccine movement latched onto:

  • The administrative prevalence for three and four year old Somali children was significantly higher than for non-Somali children. This is consistent with the perceptions of the community that a larger number of Somali children were participating in ASD programs. Because of the study’s limitations, it is not proof that more Somali children have autism than other children; however, it does raise an important question about why Somali children are participating in this program more than other children.
  • The relative difference between Somali and non-Somali administrative prevalence decreased markedly over the three years covered by the study. It is unclear if this is an identification issue, a change in parental awareness for the need for developmental screening or some other issue.
  • Administrative prevalence rates for the Asian and Native American groups were found to be “strikingly low.” The reasons for these low rates are unknown, but they could be important to understanding whether the rate of ASD is higher among Somali children or underestimated among other children. In other words, the seemingly low prevalence rate among Asian and Native American children may artificially boost the comparative rate among Somali children, distorting a true understanding of all groups involved.

So, yes, administrative prevalence of autism was higher among Somali-Americans in Minnesota, but there were a lot of issues that made it difficult to use these data to determine for sure whether actual autism prevalence was higher, not the least of which was that as was noted in Left Brain, Right Brain, Department of Education data are not reliable for tracking autism. Jim Laidler made the same point in a publication in Pediatrics in 2005. Indeed, the most recent study of autism in the Somali-American community in Minneapolis was published in 2016 and found that Somali children were as likely to be identified with an autism spectrum disorder (ASD) as white children but that Somali children with ASD were significantly more likely to have an intellectual disability than children with ASD in all other racial and ethnic groups. Meanwhile, Steve Novella examined the cluster and proposed other potential causes for it, if even there was a cluster, such as vitamin D deficiency or a founder effect. Of course, as I pointed out above, it appears that children born to Somali immigrants are no more likely to be diagnosed with autism than white children; so there wasn't even a cluster there. Unfortunately, it took eight years to figure that out.

By long before then, the damage had been done and the seed of distrust in the MMR and other vaccines had been planted by antivaxers. Over the next several years, as you will see, antivaxers nurtured that seed until it blossomed in the form of measles outbreaks.

Enter Andrew Wakefield

It's not clear exactly when Andrew Wakefield first made contact with the Minnesota Somali community, but I do know that Age of Autism was on the case as early as August 2008 and that the founder of the antivaccine group Generation Rescue J.B. Handley published "An Open Letter to the Somali Parents of Minnesota" in which he told them it was the vaccines and that they can't trust the local health authorities. He even went so far as to urge them to declare a "state of emergency within your community and create a new vaccine schedule for your kids." Meanwhile, also as early as August 2008, David Kirby had been writing stories like 'Is Autism an “American Disease?” Somali Immigrants Reportedly Have High Rates.'

I do know for sure from media accounts and triumphant blog posts in Age of Autism that he met multiple times with the community and its leaders between 2010 and 2011 and that he appears to be still intermittently in contact. For instance, here is one contemporaneous account in local media from 2010. It was a time when he proposed as "study" of autism in Somali immigrants and promised to raise funds for it, something he appears never to have done. At the same time he sold the study this way:

Minnesota Somalis worried about autism rates among their children recently invited controversial British researcher Andrew Wakefield to Minneapolis to talk to their community.

At a Somali community meeting in Minneapolis, Wakefield asked his audience to participate in a study. He told about a hundred people gathered at a Somali-owned restaurant that they could help find the cause of autism.

"It is solvable, it has a cause, it had a beginning and it must have an end," Wakefield said. "We cannot accept the damage that is being done to all of these children. It is completely unacceptable and the suffering you're going through."

At the same talk, Wakefield claimed that there were no known cases of autism in Somalia, characterized in the story as an "anecdotal observation many Somalis confirm." It staggers the mind that Wakefield would make such a claim (OK, actually, it doesn't, given how big a liar Wakefield is), but it does not stagger the mind that Minnesota Somalis would find such a claim credible. Somalia is a poor country, and it does not stretch the imagination to speculate that most people living there are unfamiliar with autism. Nor does it bend credibility too much to observe that a Third World country is unlikely to have the same sort of screening and support programs for autism that we have in the US and other developed countries and that in such countries most cases of autism other than the most severe would go undiagnosed. Indeed, even the severe cases might well be diagnosed as mental retardation rather than autism.

Be that as it may, the cluster of autism in 2008 led to perceptions like this one:

She recalled a Somali mother who spoke at a public health meeting at the Brian Coyle Community Center some years ago. She had given birth to several healthy children in Africa, but her first child in the United States showed autism symptoms at an early age.

Wakefield visited Minneapolis again right in the middle of the 2011 measles outbreak to give a talk at a Somali restaurant. It was noted at the time that there were "a number of vocal pediatricians and doctors of Somali descent trying to speak out about this" but that distrust of health authorities was very high and local antivaccine groups like the Vaccine Safety Council of Minnesota were actively influencing Somalis. They still are. In 2016, for instance, the VSCM board member Patti Carroll published a warning to Somali parents that the Minnesota Department of Health "schools professionals to persuade Somali parents to give their children the MMR vaccine, despite clear opposition."

Gee, you say that as though it were a bad thing.

That's the problem, of course. Antivaxers are opportunistic in the extreme. If they see a population who are vulnerable to their disease-promoting message, they will pounce, and it's always about the vaccines. They saw a story of a possible autism cluster among the children of Somali immigrants in Minnesota. Where scientists see such a story and ask "Is the cluster real and not spurious?" and "If it's real, what might be causing it?" antivaxers see such a story and assume it absolutely, positively must be the vaccines. In this particular case, they took advantage of a newly arrived immigrant community's lack of knowledge about autism and vaccines, its tradition in which information is primarily transmitted orally, and the distrust some of its members had for the local health authorities. The results are still playing out in catastrophically low MMR uptake and measles outbreaks.

Over the weekend, it got even worse, as a coalition of antivaccine groups gathered together to tell the Somali immigrant population that the "the epidemic is autism, not measles":

As Minnesota confronts its second measles outbreak in seven years, public health officials are battling to contain the disease while also trying to educate parents in the face of an organized opposition.

As happened in 2011, anti-vaccine activists are reaching out to Minnesota’s Somali community, where both outbreaks have been centered, with messages that reinforce the discredited belief that vaccines cause autism.

On Sunday afternoon, a coalition of anti-vaccine organizations plans a meeting at the Brian Coyle Community Center on Minneapolis’ West Bank in an effort to bring their message to Somali families, saying “The epidemic is autism, not measles.”

Just what the Minnesota Somali immigrant community needs.

What can be done?

As every source I've read over the years about the Minnesota Somali community and vaccines has stated, suspicion and fear of the MMR vaccine are now very much entrenched and will be very difficult to reverse. Indeed, it's been pointed out:

Minnesota Department of Health staff found that fear of autism was often the reason for parents’ refusal to have their children vaccinated. Highly educated Somali Minnesotans are not exempt from this fear. As one Somali educator admitted, “My children did not get the MMR; my evidence is the Somali children I see who have autism.”

Parents who cited fear of autism as the reason for their vaccine hesitancy told health department staff that they received their information mostly from other Somali Minnesotans. Being told that MMR does not cause autism was not satisfactory for many parents because no one could tell them what does cause autism. Yet, when asked whom they would trust for health information, nearly all said they trusted their health care provider. And a significant number who refused vaccinations said they would reconsider their decision if they were given more information.

Parents of children diagnosed with ASD were articulate about their belief in an association between MMR and autism and sometimes also implicated receipt of multiple vaccines as the cause of their child’s autism. Some Somali parents have come to realize that autism and vaccines are unrelated, but they are in the minority.

Vaccine hesitant Somali parents thus resemble our own native-grown antivaxers and vaccine hesitant parents in many ways. Many are highly intelligent and educated. They get their misinformation about vaccines and autism from their peers more than from medical authorities. Also, it is the parents who have children diagnosed with ASD who are the most passionate and persuasive in arguing that vaccines are linked with autism, and, because of the low rate of measles (thanks to the MMR) many Somali parents view autism as a greater threat to their children than the measles and base their decisions about vaccines on that misperception. One difference is that, unlike many of our native antivaxers, Somali immigrants generally hold the medical profession in high esteem and are thus more open to being influenced by physicians and other clinicians. Actually, I should be a bit more clear. American antivaxers generally distrust the medical profession, while American parents who are vaccine-hesitant tend to hold the medical profession in higher esteem.

Be that as it may the Minnesota Department of Health has been trying to meet the challenge of reaching Somali parents through outreach programs in the schools and day care centers aimed at increasing awareness of Somali children's growing vulnerability to vaccine-preventable diseases. Bahta et al note:

Finding ways to leverage the respect Somalis have for doctors and other health care professionals is challenging. In studies examining how clinicians can provide effective care to Somali patients, building trust has been identified as important. Two things that contribute to trust that are repeatedly cited in the literature are the availability of a competent interpreter and not feeling rushed by the clinician. Clinic policies such as ensuring that a professional interpreter is available, adding time to appointments when interpreters are needed, and consistently scheduling families with the same clinician can support efforts to build trusting relationships with Somali patients.

At their heart, strategies like these are no different than techniques used with the vaccine-hesitant of any race or nationality, adapted to Somali parents by including an interpreter. There's one area where the Minnesota Somali community might be a bit different, though:

They also want clear direction from their physicians. Providing parents with options may confuse them. A statement such as, “We can give your child the vaccine today, or if you want, we can wait,” may be perceived by the parent as meaning that the clinician also has reservations about vaccines or thinks that either choice is acceptable. One Somali interpreter described an interaction this way: “When the mother told the doctor that she did not want her child to get the triple-letter vaccine, the doctor said, ‘OK.’” The interpreter was worried that the parent thought the doctor agreed that the MMR vaccine wasn’t needed or that he, too, was worried about its effects.

This is different from American parents, who tend to resent being told too firmly what to do and want to make their own decisions. Again, what this shows is the importance of flexibility in dealing with vaccine hesitant parents and how strategies and messaging, although generally sharing the same broad themes, have to be adapted to the specific population being targeted. It's also important to remember that Minnesota Somalis are not monolithic. Although anti-MMR views predominate and antivaccine views have become common, there have been (and still are) members of the community who are joining forces with Minnesota health officials to push back.

Unfortunately, progress is likely to be slow, as changing entrenched beliefs is difficult and requires a sustained, targeted effort. In the meantime, the children of the Minnesota Somali community will remain vulnerable to measles and potentially other vaccine-preventable diseases and are likely to serve as the nidus for further outbreaks until the MMR uptake rate can be raised back to what it was in 2004. Remember, it took the UK many years to lift its MMR uptake level back to somewhere near where it was before Wakefield, aided and abetted by the tabloid press, caused the MMR panic. There's no reason to expect that a similar recovery will take any less time in Minnesota.

Sadly, measles is the gift that keeps on giving, and nobody is better than giving it than Andrew Wakefield and his acolytes. The Somali immigrant community in Minnesota is now finding that out.

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Wakefield claimed that there were no known cases of autism in Somalia

The reasons you cite for this claim being not the whole truth, that Somalia is a poor third world country, are valid, but Somalia isn't just any third world country. It's a failed state. That's a major reason why there are Somali communities in places like Minneapolis and Lewiston, ME: cold winters are less of a challenge than what they had to deal with in the old country. There are lots of third-world countries that may be less than rigorous about identifying autism cases, but at least some of the infrastructure is there, at least for the country's elites. Somalia doesn't even have that.

I invite Andrew Wakefield to book the next available flight to Mogadishu to investigate for himself why there are no known cases of autism in Somalia.

By Eric Lund (not verified) on 01 May 2017 #permalink

"Notably, two-thirds of the cases in this outbreak were hospitalized, and many of these were hospitalized for respiratory complications in addition to dehydration, highlighting that measles is a severe infection even in well-resourced countries."

In light of this, the relatively high hospitalization rate during the Disneyland measles outbreak and my perception that in the "old days" hospitalization for measles was less common, are we seeing 1) more medical caution now related to clinicians' unfamiliarity with measles, 2) greater virulence of modern measles strains, or 3) hospitalization for measles really was this common in the 1950s-60s and I just didn't realize it?

By Dangerous Bacon (not verified) on 01 May 2017 #permalink

The community center ended up cancelling the event and it was held in a restaurant, and appears sparsely attended. Mark Blaxill claimed that the government admitted vaccines cause autism by compensating such cases (using the old Holland et al article that claimed that cases compensated on other theories are compensated for autism).

He referred to cdcwhistleblower and worked hard to create fear and doubt.

Because 29 cases and 11 children hospitalized in that community isn't enough for the anti vaccine activists.

By Dorit Reiss (not verified) on 01 May 2017 #permalink

What will it take for medical groups and health departments to call out by name the anti-vaccine/pro-disease groups for their lies they tell and the threat they present? Not one large medical group such as the AMA, AAP, AAFP has been willing to call Wakefield the fraud that he is. Even simply the local HD holding a press conference to state that Blaxhill has no medical experience/authority and is not to be believed could help. I don't get this.

By Chris Hickie (not verified) on 01 May 2017 #permalink

Sorry you're still butthurt Andy got exonerated and met our pres.

Good to know you blame him for measles, though, of course you'd be dumb enough to conflate speech with actions. I will blame you for every case of vaccine injury since you started blogging then. What's fair is fair.

By Jake Crosby (not verified) on 01 May 2017 #permalink

In the real world, Andrew Wakefield has not been exonerated. His claims are disproven, his dishonesty well documented.

And it's not hard to trace a causal link between scaring people from using MMR and a measles outbreak.

By the way, here is some news coverage of the anti vaccine meeting, for those seeking it.

http://www.mprnews.org/story/2017/05/01/public-health-workers-push-back…

By Dorit Reiss (not verified) on 01 May 2017 #permalink

How's that dating scene going for you, Jake? You're as knowledgeable about women as you are about measles, vaccines, and causes of autism. As an epidemiologist, you're a disgrace.

I think I'll go with Orac's description - yes, the Gnat is butthurt that he's obliterated any chance of a real job & obviously set himself up for life-long celibacy.

And for what is happening in Minnesota, there is a direct link between Wakefield's visit & the drop in vaccination rates - which means that he is, indeed, now directly responsible for this outbreak (of course, the initial case isn't his fault, but that he prepared the ground for mass infection to occur among a vulnerable population - he is 100% culpable for that).

If any of those kids die, I hope they sue the crap out of him.

Eric, I think Jake should join Wakefield on that investigational trip to Somalia . . . .

"Andy got exonerated"

So, where is he licensed to practice medicine now? I must have missed that stunning development.

By Dangerous Bacon (not verified) on 01 May 2017 #permalink

"...butthurt that he’s obliterated any chance of a real job & obviously set himself up for life-long celibacy." - So that's what you were afraid would happen to you when I posted a link to your linkedin profile. No wonder it disappeared so fast!

By Jake Crosby (not verified) on 01 May 2017 #permalink

The infant at the beginning of the post is adorable.

In the future, it is my wish that vaccines will be free of packaging warning-labels and every Somalian child is fully vaccinated and healthy.

By Michael J. Dochniak (not verified) on 01 May 2017 #permalink

@11
So this is the best that the anti-vaccine attack gerbil can come up with? I think Orac gives you far too much credit as a serious threat to vaccination. Your attacks on people are as feeble as your arguments that vaccines cause autism. As others have stated, please feel free to travel to Somalia and look into the lack of autism. Maybe even wok in a trip to North Korea, Oman and Afghanistan where there is very low reported cases of autism as well. It's almost like poor and failed nations don't do much research on things they view as unimportant. Try to read this link (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763210/) and educate yourself on reality and not your safe little fantasy world.

By Anonymous Pseudonym (not verified) on 01 May 2017 #permalink

Jake, you seem to agree with BS Hooker that the Bonferroni correction is not a good way to adjust for multiple tests within one dataset. Why don't you ask your advisor about it? She's in genetic epidemiology, isn't she? Genetic epidemiologists use it a lot. Are they all wrong?

While we're at it, what kind of biostats are you using on your doctoral thesis? Me? I'm using GLM with Poisson distribution. Should probably use multi-level modeling, but GLM is more "elegant," in the words of BS Hooker.

Jake, in between complaining that he can't get any woman to pay attention to him (which is surprising given how well he speaks of women on his blog), criticizes the very biostatistical methods he's going to need to use for his work in public health. Because you ARE going to work in public health after the PhD, right?

DB@10: In addition, when was the retraction issued for the retraction of Wakefield et al. (1998)? The Lancet's investigation found that the data were fraudulent and that Wakefield had an undisclosed conflict of interest (remember that at the time he was an expert witness for a company offering a competing vaccine to MMR). To paraphrase Arthur Dent, this is some usage of "exonerated" of which I was previously unaware.

I'll agree that the Gnat should join Wakefield on that field trip to Mogadishu.

By Eric Lund (not verified) on 01 May 2017 #permalink

"...when I posted a link to your linkedin profile."

That's journalism in Crosby's Labyrinth. Reveal your sources, doxx your commenters, and use foul language.

It's so nice that Jake can doxx people. Shows what high quality morals he has. /sarcasm.

Different statistical tests are appropriate for different measures.

"complaining that he can’t get any woman to pay attention to him"

Other topics include: the autistic knight, the short bus that now regularly stops at Sesame Street and my Kekistani citizenship (Praise Kek).

By Jake Crosby (not verified) on 01 May 2017 #permalink

I didn't dox him. His information was already online and public.

By Jake Crosby (not verified) on 01 May 2017 #permalink

"Different statistical tests are appropriate for different measures."
Next, you'll tell me that water is wet and the sky is blue. Way to put a truism into words, Jake.

Other topics also include your nascent racism. Tell me, Jake, am I a cancer also? After all, I'm an immigrant AND I support Black Lives Matter, AND I don't think women are property there to be raped at will. Those are your qualifications to call someone or a group a cancer.

It's nice to have a conversation with Jake here, in the open. As opposed to having my comments edited or outright deleted from his site.

Crosby's Labyrinth:

"His information was already online and public."

Yeah, but he was commenting anonymously (at least by first name only) on your blog. A reasonable person could not have put two and two together. That is, until you outed him.

"...AND I don’t think women are property there to be raped at will." - What are you talking about? I haven't converted to Islam.

Also, I've approved five consecutive comments of yours on a fairly recent AI post. Don't pretend that you're not allowed to comment at AI. You're more than welcome to now.

By Jake Crosby (not verified) on 01 May 2017 #permalink

It’s nice to have a conversation with Jake here, in the open. As opposed to having my comments edited or outright deleted from his site.

And, of course, I let The Gnat's comments through because they reveal much about his character.

I really just wanted to see if he was man enough to put his name to his own shit-posting. He failed miserably.

By Jake Crosby (not verified) on 01 May 2017 #permalink

I really just wanted to see if he was man enough to put his name to his own sh*t-posting. He failed miserably.

By Jake Crosby (not verified) on 01 May 2017 #permalink

Why don’t you ask your advisor about it?

Jake has an advisor? At the Florida satellite campus?

What are you talking about? I haven’t converted to Islam.

That's a Suspiciously Specific Denial if I ever heard one. While undoubtedly there are some Muslims who consider women to be chattel, there are many others who don't, and many non-Muslims who do. In particular, Men's Rights Activists (a group that AFAICT has little if any overlap with Muslims) seem to behave in ways that are indistinguishable from considering women as property.

By Eric Lund (not verified) on 01 May 2017 #permalink

Statistically, there have to be children who are Autistic who've never been vaccinated. What are the anti-vaxerss excuses for them? Or are those kids just not being diagnosed?

"I haven’t converted to Islam."

Ah, there it is. There's the nascent racism. More than nascent, really.

And you must think I'm stupid if you think I'm going to comment on your teenage fan fiction blog given how you're editing comments and people's names, and doxxing. And, no, my comments on "recent" posts are not mine. I haven't commented on your blog since September of last year. If that is "recent" in Crosby's Labyrinth, then I'd hate to read your lit review section.

You know, Gnat, not that you ever had any journalistic integrity to start, but the fact that I could get that far under your skin by merely pointing out that your choice of topics and tone would have serious repercussions on future employment opportunities, just shows how ill-prepared you are for the real world.

Security settings are a wonderful thing, as are privacy settings.

"What are the anti-vaxerss excuses for them?"

In the case of Kim Stagliano, who has an autistic child who, as far as I know, is unvaccinated, the autism was the result of Kim's vaccines. That is, if I remember correctly.

Ah yes, the "sins of the father" excuse.

Islam isn't a race.

I maintain the integrity of comments, except when it's Brian Deer trying to sign off as "Becky". Everybody already knows who you are anyway, Ren. You have nothing to be afraid of, unless it's of being wrong.

By Jake Crosby (not verified) on 01 May 2017 #permalink

Islam isn't a race, but many believers - the majority - belong to races that can be painted as others.

We can point out that you are biased and prejudiced unfairly against a religious group, if it makes you feel better, and reduced to making generalized hate-filled statements against them.

Your posts about women are troubling, disrespectful, and should give any woman considering being alone with you - let alone creating a relationship with you - pause. Maybe you should consider what you said and why it's an issue, rather than lashing out at Muslims.

By Dorit Reiss (not verified) on 01 May 2017 #permalink

In reply to by Jake Crosby (not verified)

Nothing wrong with being afraid of being wrong, Jake. It's called maturity and integrity. One must check himself before he wrecks himself, so to speak.

People who are not afraid of being wrong have a personality disorder of one type of another. They can also be described as "a-holes, not otherwise specified."

If I'm wrong in a statement of fact, not opinion, then I'll correct myself. I won't do an Andy and claim persecution. Heck, Andy would have become more credible had he accepted the retraction and then worked to correct his mistakes.

"Islam isn't a race" <-- Another truism aimed at deflecting from the xenophobia.

In the case of Kim Stagliano, who has an autistic child who, as far as I know, is unvaccinated, the autism was the result of Kim’s vaccines. That is, if I remember correctly.

Thank you! I should have guessed; after all, everyone knows that vacinations are inherited. /s

“Islam isn’t a race” <– Another truism aimed at deflecting from the xenophobia.

Indeed. While I agree with certain New Atheists that "Islamophobia" is the wrong word for anti-Muslim bigotry - Islam is a religion, an idea, and should be criticized - criticism of the term is often used as a smokescreen to hide clear anti-Muslim bigotry.

@Dorit: I've stood up for women against a vaccine that's made them infertile, paralyzed and dead. I'm a way bigger advocate for women than you'll ever be.

By Jake Crosby (not verified) on 01 May 2017 #permalink

especially since I'm not blind to oppression of women in Islamic countries

By Jake Crosby (not verified) on 01 May 2017 #permalink

@39 (Gnat)

I’ve stood up for women against a vaccine that’s made them infertile, paralyzed and dead.

No, you haven't. You've stupidly attacked a safe and effective vaccine that protects women from potentially fatal cervical cancer because, for you, it's always the vaccines, toxic boy.

Oh, look at the big Gnat, trying to claim that espousing anti-vax views against a vaccine that prevents cervical cancer (among others) is "fighting for women's rights.

Sorry, but I'm sure the 6000 or so women that die every year from HPV-derived cervical cancer would tell you go to hell, if they were able.

"especially since I’m not blind to oppression of women in Islamic countries"

And ONLY Islamic countries, amirite? Because, according to you, "rape culture" is not a thing in America... Well, privileged frat boy America.

Yeah well those women wouldn't have been saved by the HPV vaccine even if it is effective. The data just isn't there yet. The only deaths related to the vaccine are the deaths caused by the vaccine, but I'm not here to open that front in this flame war.

I'm only saying that if I really didn't like women, I wouldn't give a f*ck. I actually do.

By Jake Crosby (not verified) on 01 May 2017 #permalink

He's beyond hopeless. Since AoA kicked him to the curb, he's been looking for another group to attach himself to - and obviously he's found it.

And it represents the literal worst of the alt-right.

I’m a way bigger advocate for women than you’ll ever be.

See if the Geiers can score you some Lupron, and then we'll talk.

And obviously hopeless when it comes to epidemiology, since he doesn't appear to understand that if someone isn't infected with a strain of HPV that causes cancer, they can't get that cancer....and since we've already seen an over 60% reduction in cancer-causing HPV strains since the vaccine came out, the evidence is already apparent that lives will be saved.

@Lawrence:

It's clear the results of this past election still have not fully registered with you. Trump supporters are not "alt-right", we're THE Right.

By Jake Crosby (not verified) on 01 May 2017 #permalink

"The data just isn’t there yet."

Here's where that lack of fear to being wrong comes into play. Obviously, there are plenty of data to support the use of the HPV vaccines (all the formulations), from safety and effectiveness studies to observable declines in rates of abnormal Pap smears and ensuing malignancies. It's all there in the literature, but, since "recent" to Jake means last September, and he's still suckling from the anti-vax teet of a case series from the late 1990s, I guess he's not quite through catching up to the current decade.

I guess the 32 references on this page from the National Cancer Institute are not really data. In Crosby's Labyrinth, we're seeing things.

I'm talking mortality Mr. Johns Hopkins.

By Jake Crosby (not verified) on 01 May 2017 #permalink

While there are, naturally, internet stories of deaths happening after the HPV vaccine, I have yet to see real evidence of deaths caused by it. I have seen several cases of clear other causes, like heart conditions or, in one case, a Benadryl overdose.

HPV infections kill thousands. Each year. And the vaccine is increasingly shown very, very effective in preventing them.

By Dorit Reiss (not verified) on 01 May 2017 #permalink

In reply to by Jake Crosby (not verified)

@Jake Crosby #5:

and met our pres.

Given that your president has a truly amazing capacity for surrounding himself with incompetent arseholes, that's not exactly a badge of honour.

By Rich Woods (not verified) on 01 May 2017 #permalink

And any president - even a more conventional one - could slip and meet with someone with a bad past if a donor suggested it. That by itself isn't suggestive.

The meeting with RFK jr. was more a cause of concern, though the administration does not seem to be continuing down that weird path.

By Dorit Reiss (not verified) on 01 May 2017 #permalink

In reply to by Rich Woods (not verified)

There are "Trump supporters" and then there are the ilk that you've decided to align yourself with. I won't tar the majority of people who support the current President, but the "alt-right" - merely another name of ultra-right wing racist xenophobes, deserve all of the derision they get.

Islam is a religion, an idea, and should be criticized – criticism of the term is often used as a smokescreen to hide clear anti-Muslim bigotry.

My only quibble with this is that Islam is not a monolithic religion. Some versions, like Wahhabism, are indeed toxic, but many others allow their adherents to take a live-and-let-live attitude toward their neighbors. I know a few Muslims (at least nominal Muslims--some of them drink beer on occasion, and not all of the women wear the hijab) through work, and they aren't out to convert me, let alone kill me if they fail to convert me.

That same wide range of interpretations holds among those who call themselves Christian. Southern Baptists and Wahhabists have much more in common than either group would like to admit, and more in common with each other than with either the Muslims of my acquaintance or most non-evangelical Christians.

By Eric Lund (not verified) on 01 May 2017 #permalink

My only quibble with this is that Islam is not a monolithic religion.

Oh, absolutely. I hadn't meant to imply otherwise.

I know a few Muslims (at least nominal Muslims–some of them drink beer on occasion, and not all of the women wear the hijab) through work, and they aren’t out to convert me, let alone kill me if they fail to convert me.

Indeed, I had many friends of Lebanese descent back in Ann Arbor. Not all of them were religious, but some were, and were perfectly lovely people who never really brought up their religion, let alone tried to convert me. And yeah, even some of my more religious Muslim friends drank.

Hell, even most of the guys who ran the liquor stores in Ann Arbor spoke Arabic, although I guess that doesn't necessarily mean they were Muslim; I never asked, but I did often greet them in Arabic.

I replied to Eric Lund and it seems to have disappeared into the ether. I shall try again.

My only quibble with this is that Islam is not a monolithic religion.

Oh, absolutely. I hadn't meant to imply otherwise. I still think even moderate religion can be criticized, but there is no need to be obnoxious about it.

I know a few Muslims (at least nominal Muslims–some of them drink beer on occasion, and not all of the women wear the hijab) through work, and they aren’t out to convert me, let alone kill me if they fail to convert me.

Indeed, many of my friends in Ann Arbor were of Lebanese descent. Not all were religious, but the ones who were were apparently very moderate, since some of them drank, and they never brought up their religion, let alone tried to convert me.

Heck, even most of the guys who ran the liquor stores in Ann Arbor spoke Arabic, although I suppose that doesn't necessarily mean they were Muslim; I never asked. I did learn Arabic greetings from them, though.

^ Ah, I see that the original comment appeared. I guess there was a swear in it or something.

"there are the ilk that you’ve decided to align yourself with...ultra-right wing racist xenophobes"

Some accusation to make against a Jewish scientist's autist grandson.

By Jake Crosby (not verified) on 01 May 2017 #permalink

"I’m talking mortality Mr. Johns Hopkins."

I guess you really haven't been reading the literature at all, then. You've missed the analyses where younger women are not dying from cervical cancer as much. I guess in Crosby's Labyrinth the "yeah, the cohort is still alive after age 60, but give it some time. They might still get cervical cancer and die" paradigm is in full effect.

How do you plan to write-up shifting of goalposts on your thesis, Jake?

I continue to maintain that putting on a tux and going to one of a dozen inauguration parties is not the same as getting a meeting with the President. Wakefield didn't meet with Trump, at least not since he was elected. If he did, we'd have pictures. I've seen pictures of Wakefield in his tux outside a party, not inside it and not meeting with the President.

And shaking hands in a reception line is not meeting with the President, either.

And Jake, spare me your "help." Blocking the prevention of cervical cancer is not the kind of help I need as a woman.

"...younger women are not dying from cervical cancer as much."

For a guy whose ilk loves to lecture the autism community on the ecologic fallacy, you sure do fall for it.

By Jake Crosby (not verified) on 01 May 2017 #permalink

There is obviously no accounting for taste - because it isn't an "accusation" it's just a fact.

^ Ah, I see that the original comment appeared. I guess there was a swear in it or something.

Most cuss words send a comment to automatic moderation. I usually let them publish after review, but I like to try to keep this blog PG13 rated rather than R or X.

I’m a way bigger advocate for women than you’ll ever be.

Good grief he's even stealing Trump's lines. The little gnat isn't at UT-Austin anymore?

On topic, Mark Blaxill and Jennifer whatshername, the anti-vaxxer who is always by Blaxill's side are beneath contempt for showing up continuing to scare the Somali Community amidst a measles outbreak which they directly contributed to.

By Science Mom (not verified) on 01 May 2017 #permalink

Most cuss words send a comment to automatic moderation.

I think the strongest word in the comment was "hell," so I was a bit bemused. :-)

Maybe I did something else to trigger automatic moderation, I dunno

Here in Minnesota, there is indeed considerable concern. The recommended age for completing MMR vaccination was lowered, and they are advising vaccination at 6 months for high risk groups and those intending international travel. But it's a little like closing the barn door after the cows have gone; hopefully the current outbreak will burn out soon, but with the low uptake in the Somali community, that's very uncertain.

BTW, as to mental health records in Somalia, one only has to see the state of mental health care to know that autism would not be something anyone would pay attention to. Not merely because they had bigger problems, like finding food and not getting killed in the fighting, but also because as in much of the world, mental illness of all kinds has a gigantic stigma. The mental hospital (and I use that word lightly) in Mogadishu did what it could, but they basically only took the ones who were completely incapable of caring for themselves, or who were a danger to those around them, and whose families had abandoned them. They were kept in chains, because the staff had nothing else they could use to control them. Warehousing them, in essence. A lot of that was doubtless due to the general breakdown of order; we're talking a population that has not had a stable government in two generations. Anyone attempting to care for the mentally ill there has few resources beyond their own wits.

When that's all you look at as mental illness, you are not going to even notice autism as a condition. When your treatment options consist of a choice between "suck it up" and "chained to a wall", fine distinctions like actual diagnoses are simply not going to happen.

This, of course, made the Somali community perfect targets for Wakefield, and he cynically exploited that. Not even for financial gain -- for his own personal aggrandizement. He disgusts me.

By Calli Arcale (not verified) on 01 May 2017 #permalink

Given that even when Somalia had a government, it didn't act in the best interest of its people (and of course, much worse since then), I can understand why this minority group would be very susceptible to the idea that the government was intentionally trying to harm them.

Sad, really.

Ah, I see that Jake has moved the HPV goalposts. It's not enough that fewer women (and now men) are being diagnosed with HPV and needing treatment. It's that "we don't know if fewer will die of cervical cancer". I almost regret that Jake isn't a woman - I'd have great trouble NOT wishing him the experience of a colposcopy and loop procedure. Then he'd understand the issue, perhaps.

And Jake: can you give us the numbers of women who have ACTUALLY died from a HPV vaccine? IIRC, it's a very low number (single digits in VAERS), and all related to allergic reactions. Also, as an epidemiologist (you ARE an epidemiologist, right? Right???), you can obviously show the numbers that prove the HPV vaccine is causing more problems with infertility, premature ovarian failure, etc, above baseline from reliable sources that have been peer-reviewed.

Some accusation to make against a Jewish scientist’s autist grandson.

You can invoke all the minorities you want, that doesn't give you a pass for being a bigoted and repugnant areshole.

By Science Mom (not verified) on 01 May 2017 #permalink

Some accusation to make against a Jewish scientist’s autist grandson.

When something looks like a duck, quacks like a duck, and waddles like a duck, it is rational to conclude that the thing in question is in fact a duck.

By Eric Lund (not verified) on 01 May 2017 #permalink

"For a guy whose ilk loves to lecture the autism community on the ecologic fallacy, you sure do fall for it."

For the uninitiated -- and we are initiated, aren't we, Jake? -- the ecological fallacy is when one attributes to an individual the characteristics of the larger group. For example, when Jake is told by his friends on xenophobe chat rooms that Islam devalues and denigrates women, Jake thinks that the Muslim person sitting next to him at lecture devalues and denigrates women.

What Jake tried to hit me with is the opposite of this fallacy, the atomistic fallacy, where one attributes to the larger group the characteristics one sees in an individual. For example, if Jake is rejected by a woman, then he sees all women as being rejecting of him.

When I told you, dear Jake, that fewer women are getting cervical cancer and that deaths from cervical cancer are on the decline as a natural effect of lower incidence of cervical cancer in the population, I did neither the atomistic nor ecological fallacy.

So what does Jake engage in when he sees a handful of deaths in individuals who get the HPV vaccine but then extrapolates those outcomes to all who get the HPV vaccine? Atomistic or Ecological fallacy?

Anyone?

Ren, I'll freely admit I'm not an expert in epidemiology but it sure sounds like the atomistic fallacy to me.

And I can certainly see that if how he writes about women is how he interacts with them, atomistic doesn't become such a fallacy in his case.

I'm autistic too, Jake . . . Asperger's. I take ownership of my words and deeds. If I'm out of line, I encourage people around me to hold me accountable. So do NOT sit there and make excuses for your racism, xenophobia, and misogyny and cry autism as a defense.

Only a matter of time now before the Gnat chimes in that you're obviously a lesbian....per his own writings.

That's the standard defense of many a loser who can't get a girl to go out with them, much less sleep with them.

The only thing I look for in a guy is that he's a nice person. The Gnat doesn't qualify.

The gnat seems to have directed the comments away from what this blog entry is about; a possible higher rate of autism in Somali children living in MN.

If my member of my anthropology days serves me correctly; the nation of Somali is made of many of what we would call clans. These clans tend to inter-marry so they are genetically very similar.

It is possible that the MN Somali population came from only a few of these clans and therefore maybe genetically very similar.

If this is the case; it would make a great epi study. If autism is genetically linked then the link maybe found more easily (scientifically) in population that is genetically than looking in a diverse genetic population.

Gnat your supposed to be an epi grad student and I probably know more than you do as an EHS,

The little gnat isn’t at UT-Austin anymore?

Tish tosh. He's "pursuing" a degree. Like snatch, I suspect.

That should read, in population that is genetically similar than

I can't remember where but someone is shaving cats, So maybe the gnat likes a little shaved pussy.

"It is possible that the MN Somali population came from only a few of these clans and therefore maybe genetically very similar."

No. I'm sorry, but this is a gross misunderstanding of how genetics work. You only need a small group of people to get a diverse enough gene pool. To get any real genetic abnormalities, you need the same family to inter-marry over and over again through generations and not weed-out genes that are disadvantageous.

Furthermore, autism has all the indications of not being a genetic "error," per se. It's more of a natural variation in what is a very complex system.

The more likely reason for more autism in Somalis in America than Somalis in Somalia is better diagnostic criteria, better access to care, and better screening as they are relocated here. As was stated above, Somalia is a failed state. It just doesn't have the infrastructure necessary for screening and identifying autistic children and generating the necessary surveillance reports.

Finally, Mogadishu is a city of 3 million people. That's hardly a "clan" society where interbreeding would be present. Then again, maybe I'm committing the ecological fallacy? LOL.

Ren,

I don't disagree with your statements at all. I probably worded what I was trying to say poorly. We a have a group that is more genetically similar to each other than the general US population. If autism is more prevalent (by no means proven) it may be easier to isolate a genetic trigger for autism from this population than looking at a more diverse population. I work for a native American Tribal Nation and diabetes, alcoholism, obesity are much higher than in the general US population. There appears to be a genetic basis for these differences.

Rich, I think Ren's point is that the Somali refugee population is no more similar to each other than the America population is to other Americans.

There IS a predisposition among Native Americans that is true, but it doesn't come from inbreeding, and cultural factors and isolation from other populations for centuries before Columbus "discovered" America are undoubtedly at play here. The Somalis had frequent contact with other populations through the centuries.

If autism is rising among the Somali population, better diagnostics are a much better explanation than genetics given the research that has already been done shows rates of autism similar to those of the general American population.

Correct, Panacea.

Rich, I'm worried you're falling into the "they all look alike, so they must be alike" fallacy.

Ren, I don't believe I am. People are people no matter what they look like or believe.

I just received an email from HHS (general broadcast type), that shows that the neutering of FDA has begun. This such a simple idea but the Rump administration is doing it:

Health and Human Services Secretary Tom Price, M.D., issued the following statement on the Food and Drug Administration’s actions to delay the implementation of its proposed Menu Labeling Rule until May 7, 2018:
"The FDA has made the right decision to delay a rule that would have essentially dictated how every food service establishment in America with more than 20 locations — restaurants, grocery stores, movie theaters, and more — writes and displays their menus.
……..
"Under President Trump, our department will focus on promoting public health in ways that work for American consumers. Toward that end, the FDA is asking for feedback about how to make the Menu Labeling Rule more flexible and less burdensome while still providing useful information to consumers. We look forward to working with all involved to find the right balance."

I though there was data to suggest that people who live in Africa have greater genetic diversity than people who live outside of Africa.

Rich, I think that even with a clan system there is a lot more out-of-group marriage than in say, the Amish, so while that's a tempting theory, I don't think it holds up well.

I'm going to agree with Ren on screening. And maybe rising parental age of children born in the US compared to children born in Somalia (to the same parents).

By JustaTech (not verified) on 01 May 2017 #permalink

Hey, at least I got the comments back on track vs the gnat.

Also, I am headed to Chiang Mai, Thailand in 18 days. I hope I don't think everyone that looks the same are the same.

I would love someday to get all the minions together and just have a free for all conversation. Wouldn't that be great fun.

Rich

Tish tosh. He’s “pursuing” a degree. Like snatch, I suspect.

Heh, that rings as hollow as saying one is pursuing an acting career while coffee-jockeying at the local Starbux. Nothing says, "I'm a great candidate", quite like prominently displaying Pepe the Frog on your blog.

By Science Mom (not verified) on 01 May 2017 #permalink

I wonder how they think their presentation will be perceived if, and I hope not, any of the children dies or gets SSPE.

I'm going to assume they sincerely think they're protecting people and giving warnings they believe in. But it goes back to what many of us previously discussed, the trouble with seeing autism as worse than SSPE.

By Dorit Reiss (not verified) on 02 May 2017 #permalink

In reply to by Johnny (not verified)

Love this, very thorough, am already spamming all over facebook. Thanks.

Just posted a comment there, Johnny. And I'm cross-posting it here, since either Jake won't have the cojones to approve it, or will try to change my words.

Sad, Jake. Really sad. First of all, there are no single-dose vaccines - not even the flu vaccine - that contains thimerosal. And you really should be adult enough to use the correct term, instead of "mercury", which in its elemental state was never in vaccines anyway.

As for your other points...well, they are as well documented as anything else you have written about. To say, not at all. Your writings would be a disgrace to an eighth grader told to write a research paper, much less a doctoral student in any discipline.

And, btw...don't try to change my words. I'm cross-posting this comment on RI, just in case you don't have the nerve to approve it or try to alter it.

At least Jake hasn't changed the text of my latest comment. Just my name. (Actually, that's not my latest post. He moderated that one out of existance.)

By Rebecca Fisher (not verified) on 03 May 2017 #permalink

Is there really a person on this planet who would prioritize the judgment of some little squirt and his poison pen blog to the considered opinions of the UK General Medical Council, the editor in chiefs of the Lancet and British Medical Journal, and at least three High Court judges who've put the put into Wakefield (including Mitting)?

Even he would have to be afflicted by some profound personality disorder to live in that particular world of cuckoos.

By Brian Deer (not verified) on 03 May 2017 #permalink

Sorry: editorS in chief

By Brian Deer (not verified) on 03 May 2017 #permalink

# 92 Dorit:

I guess the thing about SSPE deaths is that they take so long to be reported. A child can take up to three years, going through gait disturbance, collapses, fits, coma, vegetative state and eventual death, that no parent would want to go public while they were watching it unfold.

There was a US SSPE case reported recently in the US, as I recall. But people like Blaxill are so twisted that they will happily enter an infectious disease outbreak and encourage parents not to protect their children. He wouldn't even blink at the horror.

By Brian Deer (not verified) on 03 May 2017 #permalink

Brian-I wonder how many of the anti-vax parents even know what SSPE is? The anti-vaxxers try to downplay the severity of measles as much as they can, so if those parents are getting their information from only anti-vaccine "sources", it is very possible that they don't even know about SSPE.

@Jake-Wakefield was not "exonerated"-FYI, Walker-Smith winning his appeal does not "exonerate" Wakefield .

And Mitting specifically stated "There is now no respectable body of opinion which supports his hypothesis, that MMR vaccine and autism/enterocolitis are causally linked."

Also, Jake, Wakefield tried to sue Brian Deer in the UK, where the libel laws are more favorable to the plaintiff than they are here in the U.S., and he still lost.

I wonder how much shorter the video would be without the "uh" and "umm"? They do teach media advocacy at UT Austin as part of your PhD, right Jake? Or, at the very least, do they teach how to present the findings of your research in a professional way?

There has to be a flow to it, Jake. Put together a production outline of what you'll do. Get the camera up at your eye level. It doesn't matter if you don't look into it, but also don't look like you're just checking your image to see how you look all the time.

Also, go get some of that sweet Crosby-Cranberg cash and buy yourself a decent camera and a microphone. A 4K camera is cheap today, especially if maybe, for example, you've done business promoting RounUp! or are in the Texas Big Oil syndicate. That will up your game. Then use iMovie or some other video editing to do quick cuts to eliminate your pauses. Maybe add a soundtrack in the background.

Good luck with that vlogging thing.

While we're here, y'all should go check out Jake's attempt at filibustering about vaccines and vaccine injuries then get gloriously shot down by the panel members, with one member even going as far as to say that anti-vaccine people are "off their rockers."

https://www.youtube.com/watch?v=90wD-aya-qg

I got no more than one minute into a video Crosby links to, of himself, and he's already lied twice. Either that, or he is so monstrously stupid, it's incredible he can find the button to turn on a camera.

I have never said three children in Wakefield's series "weren't autistic". And I never published anything to the effect that Wakefield's pathology was fraudulent.

This is what they do: classic Wakefield. They change the charge and refute something that was never said.

What the BMJ stories found - and proved, and stand by all these years later, with not the slightest doubt or hesitation - on these points was that Wakefield claimed that three children had a "behavioral diagnosis" of "autism". They didn't. He was lying.

Nor did we say that Wakefield's pathology was fraudulent. We said it was wrong. We didn't have the raw data on that point and so could make no judgment. Nevertheless, we did later get the raw data - from another malignant crank, David Lewis - and now are clear that the reporting of the pathology, too, was fraudulent.

Most of the relevant information is set out here:

http://briandeer.com/solved/slapp-amended-declaration.pdf

Just tragic that anybody would listen to such a sly or stupid twerp.

By Brian Deer (not verified) on 03 May 2017 #permalink

Brian Deer- I've seen anti-vaxxers try to claim that "measles is only dangerous in third-world countries" , even though hundreds died each year from it in the U.S. before the vaccine was developed (and many more suffered severe, sometimes life-altering, complications), so I'm not at all surprised when I see them lie.

After all, if someone is willing to make such a blatantly false claim, that can be so easily debunked (anyone who looks at what happened in during the 1989-1991 measles epidemic knows that measles is a serious disease), then I think one should expect that they (I'm talking about the anti-vax "movement" in general, not just Jake Crosby) will not be truthful. Unfortunately, the uneducated and/or gullible sometimes believe their misinformation.

At least Jake hasn’t changed the text of my latest comment. Just my name. (Actually, that’s not my latest post. He moderated that one out of existance.)

Wait, what?

Sure, Jake doesn't allow comments he doesn't like, and he has some silly ideas who some people are, but he edits people's comments? As in, changes the words? Beyond fixing grammar?

I think Jake has it right. He is deplorable, and not just for being a Trump fanboi.

# 107. That's about par for his new eruption. After Dan Olmsted tragically killed himself, Crosby scraped Olmsted's journalism and pasted it into his own website.

Really seedy opportunist stuff from somebody who wanted the clicks, but without the drudgery of content generation.

By Brian Deer (not verified) on 03 May 2017 #permalink

After Dan Olmsted tragically killed himself

Oh, man, that I wasn't aware of.

After Dan Olmsted tragically killed himself...

According to his spouse, Mr. Olmsted died of a prescription drug overdose. This was noted by the Washington Post on their obituary page.

According to conspiracy theorists on Olmsted's Facebook page, he died because he was killed by the CIA the day before he was to have a top-level meeting with Trump. Another site mentions the same theory, and then it adds that Robert DeNiro went "fuming" to the FBI to have them investigate.

Who to believe?

In fairness, it's also not clear from the account whether Olmsted killed himself or whether it was an accidental overdose. Most overdoses of prescription opioids (the most likely candidate) leading to death are accidental. But, yes, the Washington Post did note in its obituary that that's what Olmsted's spouse said he died from: A prescription drug overdose.

"I have never said three children in Wakefield’s series “weren’t autistic”...Wakefield claimed that three children had a “behavioral diagnosis” of “autism”." -contradiction, a person is defined as autistic based on whether or not they're diagnosed as autistic.

"Nor did we say that Wakefield’s pathology was fraudulent."

You said it was one of the ways "how the case against the MMR was fixed." Yeah you did.

By Jake Crosby (not verified) on 03 May 2017 #permalink

One notes that The Gnat, as usual, fails to provide hard evidence to back up his claims.

"According to his spouse, Mr. Olmsted died of a prescription drug overdose. This was noted by the Washington Post on their obituary page."

But according to Brian Deer, this must amount to suicide. He never considered mislabeling/physician malpractice, and this is the guy who "discredited" the vaccine-autism link according to his fellow dishonest reporters. You all deserve each other.

By Jake Crosby (not verified) on 03 May 2017 #permalink

@Orac: Well Deer contradicting himself is there in his comment, so you don't have to take my word for it. As for his falsely accusing Wakefield of fraudulent pathology reports, go read the BMJ for yourself. Of course, Orac doesn't give a shit about evidence he just acts as cheerleader to anything that portrays child-poisoning vaccines as safe. He has lots of suffering on his hands in his decade of iatrogenic blogging.

By Jake Crosby (not verified) on 03 May 2017 #permalink

@Orac: Well Deer contradicting himself is there in his comment, so you don’t have to take my word for it. As for his falsely accusing Wakefield of fraudulent pathology reports, go read the BMJ for yourself. Of course, Orac doesn’t give a sh*t about evidence he just acts as cheerleader to anything that portrays child-poisoning vaccines as safe. He has lots of suffering on his hands in his decade of iatrogenic blogging.

By Jake Crosby (not verified) on 03 May 2017 #permalink

"Mislabeling"?

"But according to Brian Deer, this must amount to suicide."

If that's his opinion, that's his opinion. A reasonable person would read that as an opinion, and a reasonable person also knows that suicides do happen through an overdose of prescription drugs. It may also have been an accidental suicide.

Those are all reasonable things that reasonable people say/write, Jake.

You, Jacob L. Crosby, a doctoral student at the University of Texas, continue to state time and again that Dr. Offit said a child should be vaccinated 10,000 times. You continue to call him an industrialist. You've claimed that men have higher IQs than women, that autistic women are more likely to be "dykes," and that surgical gender reassignments are tantamount to genital mutilation. These may all be your opinions, but I'm having a hard time thinking that they are reasonable opinions or that reasonable people would see them as such.

You, Jacob L. Crosby, purportedly a doctoral student at the University of Texas

FTFY.

I'm getting ready to head out the door, but I did some homework, something Jake doesn't seem to do, in my opinion, for his readers.

Here is the article How the case against the MMR was fixed: ht_tp://www.bmj.com/content/342/bmj.c5347

In it, there are four mentions of pathology:

1. "Curiously, however, Wakefield had already identified such a syndrome before the project which would reputedly discover it. “Children with enteritis/disintegrative disorder [an expression he used for bowel inflammation and regressive autism10] form part of a new syndrome,” he and Barr explained in a confidential grant application to the UK government’s Legal Aid Board11 before any of the children were investigated.12 “Nonetheless the evidence is undeniably in favour of a specific vaccine induced pathology.”"

2 and 3. "For the Royal Free team, however, when reporting on these patients, such motility issues 112 were sidelined in the hunt for Wakefield’s syndrome. In almost all the children, they noted commonly swollen glands in the terminal ileum, and what was reported as “non-specific colitis.”113 114 In fact, as I revealed in the BMJ last April,115 the hospital’s pathology service found the children’s colons to be largely normal, but a medical school “review” changed the results.

In this evolution of the gut pathology noted in the records to what was published in the paper, child 3’s case is a prime example. After ileocolonoscopy (which, GMC prosecution and defence experts agreed, was not clinically indicated116), the hospital’s pathologists found all colonic samples to be “within normal histological limits”.117 But three months after the boy was discharged, Walker-Smith recalled the records and changed the diagnosis to “indeterminate ileocolitis”.118"

4. "In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”"

You all can go read and see how Jake has filed this into Croby's Labyrinth.

"If that’s his opinion, that’s his opinion. A reasonable person would read that as an opinion" - Not a reasonable person who knows he's a "journalist" of sorts.

Also, those are all facts (although you dishonestly misrepresented my writing of IQ and gender, which I discussed in terms of population distribution). You shouldn't be in grad school if you're emotions get in the way of your acceptance of facts.

By Jake Crosby (not verified) on 03 May 2017 #permalink

"You shouldn’t be in grad school if you’re emotions get in the way of your acceptance of facts."

So you have left grad school, then?

@105 (Brian Deer)

Dr. Deer,

Thanks for the link to your document, which states that the authenticity of Wakefield's August 1997 draft of his retracted February 1998 Lancet article is uncontested and that, indeed, its authenticity was confirmed by Professor Brent Taylor. Comparison of that draft with the published paper provides clear evidence that Wakefield fraudulently manipulated his data.

Even graduate students who have never published a paper should realize that you don't change your data between drafts.

Thank you for your efforts.

I wrote that Jake seems to take gender reassignment surgery as tantamount to genital mutilation. Jake says I'm misrepresented him. Well, here's Jake on gender reassignment surgery, from ht_tp://www.autisminvestigated.com/fiona-castrates-autists/:

"The neurodiverse front group Autistic Rights Together led by Irish nut Fiona O’Leary is trying to discredit the documentary Vaxxed: From Cover-up to Catastrophe by making tenuous associations with a water purifier given as a treatment to autistic kids with gastrointestinal illnesses. Yet these same people who claim to stand up for autistics by protecting them from “dangerous” medical practices support them mutilating their own genitals to undergo “sex-reassignment surgery”."

Can someone point out how I'm misrepresenting Jake? Does he not equate the surgery to genital mutilation?

I wrote that Jake claimed men have higher IQs than women. Here's Jake on the subject at ht_tp://www.autisminvestigated.com/autistic-women-dykes/:

"That autistic women are much more likely to be dykes is not a huge surprise in light of how Asperger Syndrome has an even more disproportionately higher male-female ratio than the autism spectrum as a whole. This fact is likely due to Asperger’s diagnostic criteria restricting its diagnosis to people with average or above-average IQs. Men vastly outnumber women in above-average intelligence."

Again, can someone point out to me how I'm misrepresenting Jake? Does he not write that "Men vastly outnumber women in above-average intelligence"?

Am I in Crosby's Labyrinth? I'm in Crosby's Labyrinth, aren't I?

@ 122 (brian)

For anyone who missed the whole Wakefield thing, this in a nutshell is what happened.

He was hired by a lawyer (at an hourly rate) to find a new syndrome, with a specific pathology, and with the first symptoms closely following MMR.

So with the lawyer and a campaign group, he admitted a disparate group of children with developmental disorders, had them subjected to a barrage of tests, in a hunt for said syndrome.

Trouble was, there is no syndrome, and he got what you'd expect recruiting in the way he did: a bunch of constipated kids.

So, setting aside the findings of a child psychiatrist (kids not "regressive" and pathologists (no enterocolitis), he changed the results and reported a new syndrome of regressive autism and enterocolitis, with the first symptoms 14 days after MMR.

And, just for a laugh, here is one of Wakefield's own submissions to his GMC case, as presented on his behalf by Kieran Coonan QC:

“We say that the reality of the position is that heads of charge 3 and 4 amount to an allegation of fraud against the Legal Aid Board whether or not the prosecution is prepared to characterise it as such.”

Sadly for the twerp, the finding was proven, and stands unchallenged by anyone but twerps, in English law, with nothing from ANY judge setting it aside. Indeed, the judge who criticised the GMC for failing to set out its reasoning in its findings against Wakefield's clinical accomplice, pointed out that Wakefield's Lancet paper carried a false claim of ethical approval. That alone would be enough for retraction, and that alone would be enough for any person with an IQ above Mr Crosby's wrist circumference, to know that The Lancet has never, and will never, say anything to the effect that Wakefield has been "exonerated". The claim is simply a lie.

By Brian Deer (not verified) on 03 May 2017 #permalink

Jake: "The Lancet acknowledged Wakefield's exonerated."

Money quote from a person identified as Lancet's ombudsman on Jake's blog:

"Having considered all of the relevant material, I can see no sufficient reason for reinstatement of the Wakefield paper. I do not believe that COPE’s guidelines have been violated by retraction of the paper in question, or by failure to reinstate it."

How on earth is this supposed to constitute "exoneration" of Wakefield?

The next task for Autism Investigated should be to investigate the hallucinogens apparently being slipped into Jake's water supply.

By Dangerous Bacon (not verified) on 03 May 2017 #permalink

The Lancet acknowledged Wakefield’s exonerated

You keep using that word. I don't think it means what you think it means.

By Eric Lund (not verified) on 03 May 2017 #permalink

Jake: "Of course, Orac doesn’t give a sh*t about evidence he just acts as cheerleader to anything that portrays child-poisoning vaccines as safe. He has lots of suffering on his hands in his decade of iatrogenic blogging."

Your ranting, combined with your repeated false claims that Wakefield was "exonerated", just makes the fact that you have zero credibility even more obvious (it looks like everyone knew that already anyway).

Jake-"iatrogenic blogging"? Really? You must not know what "iatrogenic" means, Jake. The definition of "iatrogenic" is "induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures".

Are you trying to suggest that some "medical treatment or diagnostic procedure" that Orac received led him to start blogging? Because, you know, that's what your comment would suggest. Like I said, Jake, with each post you seem less and less credible.

@Ren
Yes, there's a lot of overlap between anti-vaxxers and conspiracy theorists, in my experience. In at least some cases, it seems that opposition to vaccinations stems from a paranoid worldview.

"The definition of “iatrogenic” is “induced inadvertently by a physician or surgeon"

-You're right, with Orac it's intentional.

By Jake Crosby (not verified) on 03 May 2017 #permalink

Somehow the Gnat believes that he received an email back, that the Lancet somehow agreed with his position - when you read the email that was sent, it said nothing of the sort.

@DB - exactly, I have no idea how Jake considers that an "exoneration" or agreement. It's exactly the opposite.

Jake, do you not care about how many people may die from measles (or suffer life-altering complications from measles) because they listened to you and the other anti-vaxxers? You realize that measles is a potentially fatal illness, don't you? That is why spreading blatant misinformation about vaccination is so irresponsible (to put it mildly).

Up is down, left is right, and black is white - the Gnat is through the looking glass people!

I'd say that the Gnat has entered Don Quixote territory, but he's gone far beyond even that at this point.....it's more "ranting and raving in Daddy's basement" time.

At least Don Quixote was harmless entertainment. The Gnat is just sad and falling further and further down the rabbit hole.

From Jake's blog, where he publicly posts emails he receives, so be careful about emailing him:

Dear Mr Crosby,

Thank you for your letter of June 13, 2015, in which you request that the Lancet Editor reinstate the retracted paper Ileal-lymphoid-nodular-hyperplasia, non-specific colitis and pervasive developmental disorder in children.

In the retraction statement, the editors of The Lancet stated that “several elements of the 1998 paper by Wakefield et al are incorrect. In particular….’” The retraction then mentions the enrolment [sic] procedure and ethical clearance, but implies that there remain other elements on which the decision was based.

Having considered all of the relevant material, I can see no sufficient reason for reinstatement of the Wakefield paper. I do not believe that COPE’s guidelines have been violated by retraction of the paper in question, or by failure to reinstate it.

I do not believe there is justification for any further debate about this extensively discussed article.

Yours sincerely,

Prof Malcolm Molyneux, Lancet Ombudsman

Where in that email does the ombudsman even mention the "exoneration" of Andy?

What he does say, quite politely, is that Jake should leave him alone. Yet another slap-down from the science community which Jake seems to take as a badge of honor. Imagine living in that reality...

"Dude, your bridge design would collapse and kill people."
"Nah, you're just working with big steel to prevent me from building my bridge out of nothing but concrete. See, everyone? They said my bridge would collapse. Therefore, it must be able to stand first. So my bridge stands!"

Deer: "So, setting aside the findings of a child psychiatrist (kids not “regressive” and pathologists (no enterocolitis), he changed the results and reported a new syndrome of regressive autism and enterocolitis"

So you are accusing him of fabricating the pathology results.

"pointed out that Wakefield’s Lancet paper carried a false claim of ethical approval."

So that's what you're hanging your hat on now. Not that the work done in the paper was unethical (it wasn't, as ruled by the judge), but that it appeared to suggest that clinical investigations were ethically approved research procedures. Either way, the work done was still ethical and the retraction is still discredited.

How do I cover this on my blog? How about...

BRIAN DEER ADMITS LANCET PAPER ETHICAL

By Jake Crosby (not verified) on 03 May 2017 #permalink

He said: "The retraction then mentions the enrolment [sic] procedure and ethical clearance, but implies that there remain other elements on which the decision was based."

In response to his: "2012 High Court decision in favor of Dr. Wakefield’s colleague Prof. John Walker-Smith “would kill the GMC findings on which your journal’s retraction was based”"

So while he alluded to "other elements" which he refused to name and are not mentioned in the retraction statement (therefore making them useless) to justify the ongoing retraction, he clearly contrasted them to the overturned reasons - i.e. the GMC ruling against Wakefield.

By Jake Crosby (not verified) on 03 May 2017 #permalink

How on earth do you get that from what BD wrote?

Seriously, do you have some kind of reading comprehension issue? Perhaps you have dyslexia?

Obviously, he just didn't bother to name all of the various reasons & wrote just enough to tell you to f@ck off, in the most polite way possible.

Jake is so adept at spinning things to what he wants we should hook him up to the power grid and end our dependence on coal once and for all!

By JustaTech (not verified) on 03 May 2017 #permalink

Maybe if we annotate the email for Jake?

"Dear Mr Crosby," <-- Common greeting. Means the email is addressed to you.

"Thank you for your letter of June 13, 2015, in which you request that the Lancet Editor reinstate the retracted paper Ileal-lymphoid-nodular-hyperplasia, non-specific colitis and pervasive developmental disorder in children." <--- He's thanking you for your concern. He's also pointing out when you sent your letter and what paper you're talking about. For reference, this is Wakefield's fraudulent case series.

"In the retraction statement, the editors of The Lancet stated that “several elements of the 1998 paper by Wakefield et al are incorrect." <--- There are several elements in Wakefield's paper that are incorrect.

"In particular….’” The retraction then mentions the enrolment [sic] procedure and ethical clearance, but implies that there remain other elements on which the decision was based." <---- There are two main reasons for why it was incorrect. First, the enrollment procedure. Wakefield had kids volunteered from a party by their parents. Remember from your epidemiology training that this is selection bias, Jake.
Second, ethical clearance. While ethical clearance was given, it was given based on incorrect information from Wakefield.
There are other reasons why the paper is incorrect, the "other elements on which the decision was based." Basically, even if he had no recruitment issues and no ethical clearance issues, the paper would still be incorrect due to those other elements.

"Having considered all of the relevant material, I can see no sufficient reason for reinstatement of the Wakefield paper. I do not believe that COPE’s guidelines have been violated by retraction of the paper in question, or by failure to reinstate it." <--- He then went to look at the whole of the evidence against Wakefield, and he doesn't find a reason -- a single damned reason -- why the paper should be reinstated. Furthermore, the retraction of the paper doesn't violate COPE's guidelines. Failing to reinstate it doesn't violate COPE's guidelines.

"I do not believe there is justification for any further debate about this extensively discussed article." <--- In other words, please go do something more useful with your time and respect his time.

"Yours sincerely," <--- This does not mean that you own him, by the way.

"Prof Malcolm Molyneux, Lancet Ombudsman" <--- His name and what he does there at The Lancet.

Now, please tell me where he states that Wakefield has been exonerated?

"Wakefield had kids volunteered from a party by their parents."

The Lancet paper had nothing to do with any party, which shows you know nothing about the case. Just stop commenting, you're an embarrassment to Johns Hopkins.

By Jake Crosby (not verified) on 03 May 2017 #permalink

"Just stop commenting, you’re an embarrassment to Johns Hopkins."

#Triggered

I'm not afraid of being wrong, Jake. If it had nothing to do with any party, then kindly tell us how the children were recruited. Feel free to use Wakefield's version of events or the true version of events. Your choice.

See, Jake. Adults tell each other they're wrong all the time, but they usually follow up with explanations of why they're wrong. You, on the other hand, go on with a fallacious statement that I'm an embarrassment to Johns Hopkins. Dude's been dead for a while. I doubt Mr. Hopkins gives a damn about who I am. ;-)

"#Triggered" - For a guy triggered as often as you are, you clearly don't know how to use the word correctly.

"Jake. If it had nothing to do with any party, then kindly tell us how the children were recruited. Feel free to use Wakefield’s version of events or the true version of events."

Wakefield's version is the true version, and it's also described in the appeal decision which you obviously had not read.

By Jake Crosby (not verified) on 03 May 2017 #permalink

FYI, regarding a birthday party: ht_tp://briandeer.com/wakefield/birthday-blood.htm

Blood from "healthy" (because autism is a disease!) children came from a birthday party. I have to hand it to Wakefield, though. He avoided the collider stratification bias by not recruiting from the hospital.

"Wakefield’s version is the true version, and it’s also described in the appeal decision which you obviously had not read."

Dude tells us what the correct version is, then goes on to not explain it, or even paraphrase it. That's par for the course of Jake Crosby, the great communicator.

This reminds me of a story of this guy I used to know. Jack was his name. He was a bad seed. Jack thought that he could gaslight everyone around him, pull one over on them, deceive them and make them think they were wrong when they were clearly right and he wasn't.

One day, Jack had to sit in front of a panel of three PhDs and defend his thesis. Jack tried to pull one over on them but was surprised and incensed that they didn't believe his lies. For three hours, he tried to force his ideas on them. They denied him the honor of being called a doctor.

To this day, Jack still applies to work at health departments in the area, citing his non-existent degree. He's done it so often, and public health is so small, that we know his game. Just for kicks, someone will invite him in for an interview, especially when HR pushes for him to be interviewed because he's threatened all sorts of legal action against them if they don't.

We get to sit there and marvel at the mind of this guy who thinks he can fool us into thinking that he knows even a slice of what he's put on this CV. See, it was easy for Jack to do math for biostats. It was easy for him to BS his way through a term paper, or to choose the right definitions for the right words.

But then came time for the thesis, to actually get his hands in the dirt and work as an epidemiologist. Not only was he asking the wrong questions, Jack had the wrong answers in his head before he asked those questions. No one believed him, because you can't fool everyone.

I hear Jack works at the nearby coffee shop as a waiter. Maybe I should go get some coffee.

Now, please tell me where he states that Wakefield has been exonerated?

Jake, Ren asked a simple and direct question. Could you please respond?

Oh, there's also another question: Are you still in graduate school? If so, could you please share the gist of your thesis project and the name of your advisor?

Thanks.

Jake, I think you should reconsider that headline. That kind of thing didn't work out so well for the National Enquirer, when they implied Carol Burnett did and said things she didn't say or do.

Jake - are you still at UT Austin?

It really shouldn't matter to us whether or not Jake is in a PhD program, or how he got in.

What matters is that we correct all the misinformation he puts out, so that the innocent bystander knows that, while he may have found a way to get into a PhD in epidemiology program while denying basic tenets of epidemiology, he is still wrong in many of his assertions. He still hasn't answered my question of where in that email he received did the ombudsman say Wakefield was exonerated. His criticisms of sound epidemiological studies is not the methodology but the apparent conflicts of interests he sees everywhere.

That is what we should worry about. That is what we need to confront Jake with. He'll work on ruining his chances at a job in public health all on his own, apparently.

Deer: “So, setting aside the findings of a child psychiatrist (kids not “regressive” and pathologists (no enterocolitis), he changed the results and reported a new syndrome of regressive autism and enterocolitis”

So you are accusing him of fabricating the pathology results.

Wakefield fabricated pathology results. I did not realise that this was in dispute.

By herr doktor bimler (not verified) on 03 May 2017 #permalink

Everyone's methodical patience with Jake is admirable - although I'm torn between exasperation and pity for such a screwup.

Continually feeding with his own rage about being "austist" and "vaxxine damaged" instead of confronting his condition, coping with it and growing, and progressing, (as other young people I know) is its own punishment.

By Jane Ostentatious (not verified) on 03 May 2017 #permalink

I know what you mean, Jane.

I wasn't diagnosed until I was an adult. All the red flags were there, but Asperger's wasn't known in the US when I was a kid. They didn't know what to diagnose me with at first.

For me, the diagnosis was a relief. I finally understood why I had such difficulties. It made it easier for me to work on interpersonal relationships once I knew and life got better.

I'm not damaged. I just process things differently. I can only think Jake sees himself damaged, and hence his rage against the machine, if you will. It's a shame and I'd feel sorrier for him if he weren't so unrepentantly obnoxious.

In response to his: “2012 High Court decision in favor of Dr. Wakefield’s colleague Prof. John Walker-Smith “would kill the GMC findings on which your journal’s retraction was based””

Dropped a stitch there, Jake.

So let me get this right: I point out that a judge ruled that Wakefield's paper carried a false statement of ethical approval, and Mr Crosby says he will blog me saying that this as an admission that Wakefield's paper was ethical?

It's the same phenomenon as when The Lancet told him that it would (obviously) not restore Wakefield's paper. Mr Crosby blogs that as The Lancet exonerating Wakefield.

I don't think I've seen anything quite like this behaviour before, at least in such a stark written form. I really fear for his future ability to find employment and hold down a job.

I know that there is a school of thought that wants to add an alleged condition with features of this nature to the autistic spectrum, but it would be very hard to live or work with someone who operated in such a manner.

There's kind of a moral issue raised in just using this for baiting or entertainment value, but it really is very difficult to get your head round.

By Brian Deer (not verified) on 03 May 2017 #permalink

Jakrosby @60:
“there are the ilk that you’ve decided to align yourself with…ultra-right wing racist xenophobes”
Some accusation to make against a Jewish scientist’s autist grandson.

Wait, was it Non-sequitur Day? Why did no-one tell me?

By herr doktor bimler (not verified) on 03 May 2017 #permalink

"I know that there is a school of thought that wants to add an alleged condition with features of this nature to the autistic spectrum"

It's unfair for anyone to suggest that this is an autistic trait. Such confabulation and avoidance of reality are however common features on the antivax spectrum.

By Dangerous Bacon (not verified) on 04 May 2017 #permalink

More replies I posted on AI - because I don't trust Jake any further than I could throw him.

(Reply to Lucretia)
Nope, sorry. No crickets. However, since I work for a living and have a life outside dealing with Jake’s confabulations, I didn’t see this right away.

And no, thimerosal has not been proven as “way more toxic and persistent in the brain”. I’d love to see your link – was it Geiers, who lied, or one of the other quacks? How come you don’t link to the full Rhesus monkey study that shows that isn’t so? After all, the anti-vaxxers were so excited by the preliminary study that seemed to support their ideas, but they got terribly quiet when the full study didn’t. Real studies show that thimerosal is broken down quickly and excreted with no issues. But feel free to link to your proofs.

I’m not lying, my dear. I’m of the generation where we got a LOT more thimerosal in our bodies through open wounds (Merthiolate was very popular, and we also played with it, painting our faces and bodies to play Indians). We also played with elemental mercury in labs and when home thermometers broke.

Enjoy your work.

Reply to Doug Troutman (who referenced the Burbacher study - which I couldn't recall the name of when I wrote the above comment)
Yeah the ant-vaxxers didn’t like the full study results because they didn’t show what the preliminary tests did.

Veteran anti-vaxxer Mark Blaxill (the co-author "The Age of Autism" and Editor-at-Large for the crank web site where Jake had been tolerated as a feisty little lapdog) summed it up for Jake:

"Your interpretation of events is so radically wrong and the key facts you use to support your interpretation are incorrect in so many key respects, it’s not worth arguing with you anymore."

Panacea - exactly! I'm probably am high functioning myself (never diagnosed - being retired now) and have a young relative doing well in graduate studies who was diagnosed. Instead of fulminating over being damaged, he is progressing constantly! Its been beautiful to watch. OK, he's no party animal or likely to be voted "most popular", but neither ard most people.

And guess what? Even has a girlfriend. Taking a couple of feminist courses may have helped, as well as having an intelligent, kind but firm working mom who guides him to do his best.

By Jane Ostentatious (not verified) on 04 May 2017 #permalink

@Lyin' Smear said:
"I point out that a judge ruled that Wakefield’s paper carried a false statement of ethical approval, and Mr Crosby says he will blog me saying that this as an admission that Wakefield’s paper was ethical?"

I don't think I need to explain this to you because you know you're lying, but just to illustrate what a liar you are - a legal decision is to be accepted in its entirety. So if you cite the judge's decision relating to the Lancet paper, then you accept it applies to the Lancet paper.

Therefore, you must also accept this decision, that the paper was accurate:

“157. …Thus construed, this paper does not bear the meaning put upon it by the [GMC] panel. The phrase “consecutively referred” means no more than that the children were referred successively, rather than as a single batch, to the Department of Paediatric Gastroenterology.”

And this decision, that the work described in the paper was in fact ethical:

“158. …The [GMC] panel’s finding that the description of the patient population in the Lancet paper was misleading would only have been justified if its primary finding that all of the Lancet children were referred for the purposes of research as part of Project 172-96 is sustainable. Because, for the reasons which I have given, it was not, this aspect of its findings must also fall.”

It is no wonder the Lancet didn't cite your example, because they know it would serve no grounds for further retraction. So they instead acknowledged the GMC findings being overturned and Wakefield's subsequent exoneration, but then just pretended there were entirely different reasons for keeping the paper retracted.

So to answer your question, Lyin', yes.

By Jake Crosby (not verified) on 04 May 2017 #permalink

A judge's decision quashing sanctions against Walker-Smith had no bearing on sanctions against his colleague Andrew Wakefield.

Those sanctions and the GMC panel ruling against Wakefield stand. He has not been "exonerated". He remains in disgrace and unable to practice medicine.

Jake's logic is similar to someone looking at a bank robbery case where one perpetrator is serving a 30-year sentence, and another had his conviction thrown out, arguing that the convict remaining in jail has been "exonerated".

Surely you cannot be this stupid.

By Dangerous Bacon (not verified) on 04 May 2017 #permalink

Um, how does that decision show that Wakefield is not guilty of fraudulently manipulating his data when the clear evidence of Wakefield's duplicity was not even considered in Walker-Smith's appeal--or, indeed, in the GMC hearings? (Once again, Jake: you don't change the data when you revise a manuscript.)

To further clarify my analogy - it's like arguing that a convicted bank robber doing time is innocent because somebody else's conviction was overturned on appeal, AND claiming that means the bank robbery itself never happened.

Well, maybe a few pointless insults by our resident logician will clarify matters.

By Dangerous Bacon (not verified) on 04 May 2017 #permalink

If anybody holds any residual doubt as to how disordered this individual is, here is the judge's words on Wakefield's false claim of ethical approval:

'The wording in the published paper which neither Dr. Murch nor Professor Walker-Smith saw before publication was,

'"Ethical approval and consent

Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust, and parents gave informed consent."

'This statement was untrue and should not have been included in the paper.'

And, of course, there's our old favorite, which I assume Mr Crosby accepts, along with the rest of the judgment:

"There is now no respectable body of opinion which supports [Wakefield's] hypothesis, that MMR vaccine and autism/enterocolitis are causally linked."

By Brian Deer (not verified) on 04 May 2017 #permalink

I'm assuming that Andy has refused to take his licence back now that he has been exonerated? I'm surprised at his chivalry. Anyone else would have published those grovelling letters of apology from the GMC.

By NumberWang (not verified) on 04 May 2017 #permalink

If anybody holds any residual doubt as to how disordered this individual is, here is the judge’s words on Wakefield’s false claim of ethical approval:

No worries, we've all been watching Jake's mental gymnastics for years now and the noticeable decent they've taken over the past couple of years.

By Science Mom (not verified) on 04 May 2017 #permalink

Jake the gnat, I understand you moved you PhD work to the University of Berkeley (of course this is not Cal Berkeley).

Surely you cannot be this stupid.

CHALLENGE ACCEPTED

By herr doktor bimler (not verified) on 04 May 2017 #permalink

@ Lyin' Smear #171:

And why does the judge believe the statement to be untrue? Because the investigations were unethical? No. Because they were clinically indicated and therefore not research but still ethical? Yes. Looking forward to featuring you in my post.

@ Camille #173: You've always been a complete basket case, whether as a mom or as a diva...

By Jake Crosby (not verified) on 04 May 2017 #permalink

Camille? I thought Science Mom was Emily. Now I'm all confused.

Oh now I'm Camille? You're even more dumb and paranoid than I thought Jake. But what a trashy comment about someone I consider a friend, real class act you are Jake.

By Science Mom (not verified) on 04 May 2017 #permalink

Camille? I thought Science Mom was Emily. Now I’m all confused.

Apparently I'm Dorit, Allison Singer, Camille and Emily. I know it's tough to keep up with the mental contortions of these anti-vaxx loons.

By Science Mom (not verified) on 04 May 2017 #permalink

I don’t think I’ve seen anything quite like this behaviour before, at least in such a stark written form. I really fear for his future ability to find employment and hold down a job.

Don't worry about The Gnat. He has rich parents. He'll be fine, financially. I'm also sure that some antivaccine foundation will hire him someday to churn out bogus epidemiological "studies" linking vaccines to autism.

It's quite fascinating really. He gets absolutely nothing right, ever.

Mitting J:

"Dr. Wakefield's purpose was undoubtedly research;
Professor Walker-Smith's may have lain anywhere on the spectrum."

By Brian Deer (not verified) on 04 May 2017 #permalink

. . . Q In fact, as we have seen, [Child 12] did indeed end up having an MRI and lumbar puncture despite your express instruction that he should not?
A. [Walker-Smith] Yes, astonishingly he did.

Q Do you have any explanation how that came about, given your instruction?
A [Walker-Smith] None at all.

Walker-Smith ordered that Child 12 was NOT TO HAVE lumbar puncture because it was NOT clinically indicated. Wakefield, who was not supposed to be involved in patient care and who had no experience in pediatrics, without the senior clinician's knowledge or permission explicitly countermanded Walker-Smith's explicit order for his own research purposes and ordered neurophysiology tests above his signature in the chart for that child, who then had the lumbar puncture that was not clinically indicated.

Ethical? Clinically indicated?

BTW, Jake, if you ask your advisor if it's appropriate to alter the data between drafts of your paper in an effort to reach your predetermined conclusions, he or she will tell you that that constitutes research fraud.

@ brian #182

Do you know, despite having probably been there, and having followed the thing so closely, I never spotted that instance with Child 12.

There is probably the clearest evidence of a child being assaulted in the course of Wakefield's research. I just looked at the transcript, and it seems beyond dispute.

The mother, Rochelle Poulter, should have sued the Royal Free. Instead of that, she got bamboozled by the likes of Isabella Thomas and Rosemary Kessick - other mothers working with Wakefield, who set themselves up as ringleaders. I would think that the hospital would have had no choice but settle, as they did with Jack Piper, who was seriously injured. Wouldn't have been much money, but it would have been one hell of a message about researching on autistic children.

By Brian Deer (not verified) on 04 May 2017 #permalink

BTW, Jake, if you ask your advisor if it’s appropriate to alter the data between drafts of your paper in an effort to reach your predetermined conclusions, he or she will tell you that that constitutes research fraud.

His answer to that could be rather telling (and perhaps just the tip of the iceberg) as to why he has yet to reach PhD candidate status.

By Science Mom (not verified) on 04 May 2017 #permalink

Reading Jake's #67, I could hear the sputtering and smell the ozone from the crossed wires in his head through the internet.

(It's just a series of tubes, remember) </Republican science>

By The Very Rever… (not verified) on 04 May 2017 #permalink

#167. Sticky keys....

By The Very Rever… (not verified) on 04 May 2017 #permalink

Have just been having a gander at AOA, this bit stood out as being potentially wonderfully wrong:

"The BMA is an exceptionally powerful trade union representing doctors. If vaccines cause autism, this will be very bad for the BMA’s members. So, the BMA hired Brian Deer to write a hit piece for their trade journal."

Feel free to correct me if I'm wrong, but doctors under the NHS don't get involved with vaccines.

You get a letter, you book an appointment with a nurse, ya get jabbed.

Nobody pays, doctors don't make any profits, the idea of them hiring mr De Beer so they can add to their workload and make loads of Autistics is is is.... I can't think of anything that stupid.

"He gets absolutely nothing right, ever."

I positively drool at the idea of a stock market analyst who is wrong 100% of the time. That would be worth anything. Simply do the opposite and you'll soon be fabulously rich.

Similarly with Jake and vaccine matters this trait is very useful for evaluating arguments. Being persistently and consistently wrong 100% of the time is truly underappreciated. Jake, I salute you.

Just in from HHS:
Health and Human Services Secretary Tom Price, M.D., issued the following statement applauding passage of the American Health Care Act by the U.S. House of Representatives:

“The status quo is failing the American people. Premiums are skyrocketing; choices are narrowing or vanishing; and patients do not have access to the care they need. Today, the House of Representatives has begun to deliver on President Trump’s promise to repeal a broken law and replace it with solutions that put patients in charge. This is a victory for the American people.

“The American Health Care Act is focused on patients. It is the first step toward a patient-centered healthcare system that will provide Americans access to quality, affordable healthcare coverage, empowering individuals and families to choose the coverage that best meets their needs, not what Washington forces them to buy, and equipping states to address the diverse needs of their most vulnerable populations. As Congress continues its work, the team at HHS will continue to support the reform effort by reviewing and initiating administrative actions to put patients, families and doctors in charge of medical decisions, bring down costs, and increase choices.”

Rich @188: It passed the House?
Crap.

We are so dead.

Is autism a pre-existing condition?

By JustaTech (not verified) on 04 May 2017 #permalink

What an utter farce.

Hopefully the Senate will change it so much, House GOPrs can't reconcile it and it'll die.

The house passed it and Rump and cronies have been sipping or smoking something since it passed.

The Teapublicans are having a party. Apparently it's time for celebration when you can really screw over the poor, who have no right to exist and wouldn't be sick anyway if they lived good lives as, for example, Mo Brooks does, having been conceived immaculately, by a virgin mother and having lived a blameless life ever since.

My daughter will die without psychiatric medication that she cannot afford by herself. But I understand; taking care of the old, the sick, the lame and the halt, is not economically sound. We should just all die off.

This takes us back to the days when you could buy a BS policy that only covers you for certain things, has high deductibles, and caps off lifetime expenses. Watch a bunch of fake insurance companies pop up and try to sell these predatory policies.

Also, change jobs? You're still covered for your preexisting condition, but the new insurance company can charge you as much as they want. Right now, they would have had to cover you at the same price as your previous insurance company.

Get ready to go back to the dark days of more people losing everything over otherwise simple diseases.

Republican Health Care for the poor: Take 2 APCs (all purpose capsules) and don't call us in the morning.

Is autism a pre-existing condition?

Indeed it is. In fact, since the evidence suggests the neurological changes that later manifest as ASD begin to develop in utero, ASD pre-exists the administration of the vaccines that loons have long blamed for the condition. Bummer about the insurance, though.

So Jake is now doing video versions of his blog post. It isn’t an improvement.

That was painful. There's nothing so compelling as "these people can't be telling the truth. They can't."

^ It's cute that Jake is now apparently an environmentalist, Tridrumfialism notwithstanding.

^^ Oh, just by the by, Jake, I'm not seeing the part where "the Maryland Medical Board [sic]" "as part of their investiation of [Mark Geier]* was "successfully sued" and "the Geiers won" (PDF). Could you let everyone know how that partial remand worked out?

Oh, and please do recall that "a legal decision is to be accepted in its entirety."

* The incident referred to was actually that he had continued to prescribe while his license was suspended.

"... a legal decision is to be accepted in its entirety"

Bwahaha! Surrre it does - not.

I'm still awaiting the decision of the Alberta Court of Appeal on their hearing of the appeals of the Stephans (killed their young son Ezekiel through quackery). I strongly suspect there will be a dissenting opinion on at least one point of law, which of course means no acceptance of entirety.

I've read lots of rulings on appeals where some points of the lower court are upheld and others overturned. Court of Queen's Bench judges chuck out rulings of provincial court judges. Court of Appeal judges overrule QB judges. The Supreme Court of Canada ... well, you get the point. Canadian courts are modeled on the courts that processed Wakefield..

@Roger Kulp #199

Our good friends at AoA say it's been published in a peer-reviewed journal, and it seems it has. Of course, it's a pay-to-play peer reviewed journal (we know it's peer reviewed, because they say so). As near as I can tell, they paid $2k for the privilege, which is more than MJD paid, so obviously it's a higher impact journal.

http://www.ageofautism.com/2017/05/pilot-comparative-study-on-the-healt…

@Jake:

And why does the judge believe the statement to be untrue? Because the investigations were unethical? No.

Yes they were. They did not have the proper approvals.

Because they were clinically indicated and therefore not research but still ethical? Yes.

They were not clinically indicated, they were research, and they did not have proper ethics approval, so they were unethical.
You really don't get it. You are distorting and ignoring relevant facts and your argument is wrong.

By Julian Frost (not verified) on 04 May 2017 #permalink

I take it the V - UV pulled from Froniersw in Public Health is the same one that's resurfaced at Journal of Translational Science?

By Rebecca Fisher (not verified) on 04 May 2017 #permalink

resurfaced at Journal of Translational Science

J of Translational Science? From the bottom-feeding third-tier OMICS-wannabees at OAText?
Jeffrey Beall's assessment of their publication standards and peer-reviewing is archived here:
https://web.archive.org/web/20161227042023/https://scholarlyoa.com/2015…
-- various commenters in the comment thread document the couple of ex-OMICS scammers who run it.

If it's from OAText, it's not a journal, it's a jizzmop.

By herr doktor bimler (not verified) on 04 May 2017 #permalink

@ Julian, # 204

The subtlety is that Walker-Smith was a clinician, so he could at least argue that clinical care was his primary motivation. In fact, it wasn't. There are masses of documents, including his autobiography, and formal statements issued through the Lancet in response to my first reports, making is crystal clear that they were conducting clinical research.

However, the way the GMC operates, the doctors were able to change their story after the GMC prepared its case, and now the clinicians argued that the research project was never carried out. Walker-Smith then proceeded to retrospectively diagnose clinical indications for colonoscopy, even for kids he'd never seen before they were scoped. That's why the hearing went on for so long, when it was originally scheduled for 16 weeks.

The GMC panel's central failing (as the judge makes clear) was to fail to set out in their findings a clear train of reasoning by which they came to their conclusions. This doesn't mean that they didn't have reasoning, just that they failed to set it out, merely giving one-line decisions as the GMC had done for many years. There was a court of appeal ruling on precisely this point in between the time the GMC reached its conclusions and when it issued its strike-off sanctions.

There were a few factual things that Mitting disagreed with, some of which could have been appealed. For example, he concluded that, since the panel said that "consecutive" had a certain meaning for the "ordinary reader", he, the judge was an "ordinary reader" and he read it differently. The GMC could easily have appealed on the basis that it had plainly meant the ordinary reader of The Lancet: which would be a doctor or scientist, not the ordinary "man in the street" that Mitting meant.

The panel could have reconvened after the judge's ruling, supplied its reasoning in more lengthy statements, and struck Walker-Smith off again. However, he was 73 by this time, and there would be real issues concerning risk to his health by continuing to pursue him. The judge commended them for this decision.

None of this is true for Wakefield - a laboratory researcher with no rights to clinical practice - whose own legal team recommended that he not be supported in an appeal. Since he wasn't a clinician, he had no analogous defences to Walker-Smith, and there were four charges of dishonesty found proven against him, and none against Walker-Smith. There was also him buying blood from children at a birthday party, and ordering tests on children when he was not authorised or qualified to do so.

The irony of Mitting's judgment is that he fell into the same trap as the GMC. The material is so extensive and technical that he failed to set out the background to his own decisions, and rulings handed down from the court of appeal about the GMC's approach to charges. By failing to cite any precedents whatsoever (which is very unusual in court judgments), he cut corners in such a way that non-lawyers would find it hard to understand quite what he was talking about: especially with regard to the reasoning issue. He would have done well to look at the work of more senior judges who have looked at such issues, and cited their precedents, so people could follow the thread.

Nevertheless, I'm a professional journalist, and am professionally obliged to respect courts (which have always been very good to me, never criticising me or my work in any way whatsoever). In this case, my respect includes certain knowledge (including with an opinion from leading counsel) that the Mitting judgment has no application to Wakefield, who would never be allowed his license back, no matter what. His striking off is final, irrevocable, and his conduct at the time and subsequently means the chances of him ever being readmitted to the register is less than zero.

By Brian Deer (not verified) on 05 May 2017 #permalink

None of this is true for Wakefield

As Justice Mitting made abundantly clear in the judgement he handed down.

This is one of the most striking things about those who claim the challenge by Walker-Smith exonerated Wakefield. Mitting makes it quite clear that the judgement he makes about Walker-Smith does not extend to Andrew Wakefield. It is almost as if the Wakefield apologists have completely failed to read the judgement or are lying about it.

One other point of notice is that comparing Walker-Smith's responses to the GMC fitness to practice panel and the claims made in his appeal, it is clear that the truth changed between the two events. There is no doubt in my mind that Walker-Smith tossed Wakefield under the bus to protect himself. Given the known duplicitousness of Wakefield, it is difficult to know quite how far Walker-Smith was involved in the exercise and how much Wakefield was pulling the wool over his eyes, but I am unconvinced by Walker-Smith's claims in his appeal.

By Chris Preston (not verified) on 05 May 2017 #permalink

It is almost as if the Wakefield apologists have completely failed to read the judgement or are lying about it.

Can't it be both?

@DangerousBacon #168

Jake’s logic is similar to someone looking at a bank robbery case where one perpetrator is serving a 30-year sentence, and another had his conviction thrown out, arguing that the convict remaining in jail has been “exonerated”.

Or, as I like to say:
Charles Manson has been exonerated (because Squeaky Fromme got parole).

@Brian Deer #183

Do you know, despite having probably been there, and having followed the thing so closely, I never spotted that instance with Child 12.

I have pointed this out before.
Walker Smith's instruction that the child should not have a lumbar puncture (coupled with Wakefield's deliberate countermanding of this) was a crucial point in Walker Smith's favour when Justice Mitting was considering whether WS was acting in the childrens' best clinical interests, and not "doing research".
Walker Smith was quite happy to rely on examples like this of his clinical concern, but the reality was that WS clearly knew that these kids were being investigated for research reasons.
This one exceptional example provided "exoneration" for WS, while at the same time digging a deeper hole for Wakefield.

Going through the transcript of the proceedings, WS pretty much did everything he could to throw Wakefield under the bus during the trial.

I really loved the part where WS's attorney told the Judge that the Autism-MMR hypothesis was wrong & "settled science."

Walker-Smith also issued a statement regarding his appeal, on 12 February 2012, in which he said that the charges he'd faced "related to entirely different issues to those that concerned Dr Wakefield."

By Brian Deer (not verified) on 05 May 2017 #permalink

It is almost as if the Wakefield apologists have completely failed to read the judgement or are lying about it.

It's the latter, and there's no "almost" about it.

I was trying to figure how how Whole Foods had opened a supermarket in Somalia...

By Joseph Hertzlinger (not verified) on 06 May 2017 #permalink

"and there were four charges of dishonesty found proven against him, and none against Walker-Smith. There was also him buying blood from children at a birthday party, and ordering tests on children when he was not authorised or qualified to do so."

-All overturned, by extension of the W-S appeal.

By Jake Crosby (not verified) on 07 May 2017 #permalink

Young Master Crosby: "All overturned, by extension of the W-S appeal."

Not for Andy! The order only applies to Walker-Smith.

Jake said "-All overturned, by extension of the W-S appeal."

Jake, I think you made a mathematical error. In order to apply the result of one appeal to another, in the judicial system, you must apply the legal constant: 0

In this case, the result of the W-S appeal (R1) is multiplied by LC and the product of THAT calculation is used to determine the impact on other cases.

R1 x LC = 0.

After checking the above formula several times, I see that the W-S appeal has zero impact on clearing Andy's name.

I realize that your training is in the epidemiological field, and not the legal field, so it's no surprise that you were not aware of this quirk in legal quantification.

Hope this helps!

I realize that your training is in the epidemiological field, and not the legal field...

After Jake gets his PhD there at UT, maybe mommy and daddy will buy him a legal degree. After all, we know he isn't going to work anywhere ever.

And just think - Doctor Jacob L. Crosby, Esq. Who better to take down Deep State Big Pharma.

All overturned, by extension of the W-S appeal.

I hope you didn't actually get charged by Patti "Can't Win" Finn for that pearl of wisdon.

^ Meh, blockquote fail again.

Woah... check out Jake's fanboi Hans Litten on Jake's latest post. I can't decide if Jake is leading or following Hans around the U-bend.

-All overturned, by extension of the W-S appeal.

I wonder if this will also work on my library fines.

By herr doktor bimler (not verified) on 07 May 2017 #permalink

Jake, let me spell this out for you.
1) John Walker-Smith appealed his conviction and striking off, and only his. He did not appeal the findings against or sentences of Andrew Wakefield or Simon Murch. The appeal thus only ruled on Walker-Smith's conviction and striking off, not on Wakefield's conviction or striking off.
2) John Walker-Smith threw Wakefield under a bus, claiming that he (Wakefield) had deceived him (Walker-Smith) about the nature of what they were doing. This makes things worse (not better) for Wakefield.
3) Walker-Smith's own lawyer in the appeal labelled the MMR causes autism hypothesis as discredited.

By Julian Frost (not verified) on 08 May 2017 #permalink

It would probably be good to put together a list of all of the times that during W-S's appeal, his testimony or provided evidence directly contradicted Wakefield's.

Better yet, also include the times in which W-S through Wakefield under the bus, directly, as well.

To all anti-vaxxer:

From the "Illustrated Textbook of Paediatrics" Tom Lissauer, Graham Clayden (2nd ed) 2002, Mosby (an affiliate of Elesevier Sciene limited) Chapter 6 page 76 Child abuse... Types of child abuse
Physical abuse.....
Neglect : Cross neglect of a child`s developmental needs may present clinically as
1) failure to thrive
2) inadequat hygiene,....
3) poor development of emotional attachment to the child`s care-giver
4) delay in development and speech and language
5) POOR ATTENDANCE FOR IMMUNISATIONS AND SCHOOL .......

so children not properly immunised are neglected children, a form of child abuse.

By WolfgangM (not verified) on 08 May 2017 #permalink

Poor Gnat. His train of thought runs orthogonally to the tracks of reality.

All overturned, by extension of the W-S appeal.

Jake, how do you think WS's "exoneration" excuses Wakefield of the unconnected dishonesty charges, which were all proven? Some of these related to disappearance of research funding (IIRC), and one related to the birthday party.

To refresh your memory, Wakefield got his wife to issue invitations to thier son's friends - over the phone she said that Andy would like to take blood samples from them for a study he was carrying out. This was grossly unethjical, both in the way it was "consented", and in the way in which it was conducted.

Are you now saying that WS came along to the birthday party and was complicit in Wakefield's little vampire fest?
You must be, since I don't know how else you think WS's "exoneration" makes Wakefield's actions honest and ethical.

Regarding 3rd paragraph & "Whistleblower":

The " small subgroup (African-American boys)" with the "3.4-fold increased risk of autism"?

That's your affected Somali group; the children over-represented in the SPED programs & more profoundly affected than their white ASD peers.They are not "only a small sub-group"; they are somebody's child.

You are aware;that the scientific community had been suspecting & researching a genetic suseptibility to toxicity from the MMR in the Somali immigrants since 1997, correct?

Which pre-dates Wakefield.

And I assume you are aware that in 2001 they found that they had misidentified a certain allele that is linked with toxicity exacerbation from the MMR?

From the PubMed abstract:

"We report the existence of class I HLA allele A*0103 in an ethnic group (Somali) where this allele has not been reported. This allele was discovered in a study to examine the relationship between HLA alleles and humoral antibody response to measles vaccine among recent immigrants from Somalia to Olmsted County, Minnesota."

Could this potentially explain why 66% of these cases have resulted in hospital admissions when historically it's 10% & under?

Was this the issue that was confounding Thompson's work in the first place?

By christine kincaid (not verified) on 13 May 2017 #permalink

And I assume you are aware that in 2001 they found that they had misidentified a certain allele that is linked with toxicity exacerbation from the MMR?

From the PubMed abstract:

There is nothing in that paper about "linkage with toxicity exacerbation from the MMR". Nothing about "a genetic suseptibility to toxicity from the MMR".

By herr doktor bimler (not verified) on 14 May 2017 #permalink

I don't have access to the full paper, but there's this from the abstract:

"Our data are significant because it demonstrates that many of the previously typed A*0101 individuals are actually A*0103 as the SSP or sequence-specific oligonucleotide probes method cannot distinguish between the two alleles."

One supposes that if there actually was a link with "toxicity exacerbation" from the MMR, _that_ would have been cited as significant.

Oh, and the hospitalization rate during the recent California measles outbreak was 20%. Are we to believe that a mystery allele was operating there too?

By Dangerous Bacon (not verified) on 14 May 2017 #permalink

But according to Google, if you put "measles", "vaccine" and "Somali" in the search box, and spend long enough looking, there's definitely a connection.

By Brian Deer (not verified) on 14 May 2017 #permalink

Ms. Kincaid: "The ” small subgroup (African-American boys)” with the “3.4-fold increased risk of autism”?"

No. That "data" was on children who were vaccinated much later than the schedule, like closer to three years old. This is because they were low income, and had not been vaccinated. But it turned out they were diagnosed with autism, and then needed to be vaccinated to access the public school special ed. program.

Plus out of the who study population in Georgia, that was less than ten kids. The only thing that "whistleblower" paper proved is to provide the MMR vaccine when it is recommended, at about fifteen month.

"You are aware;that the scientific community had been suspecting & researching a genetic suseptibility to toxicity from the MMR in the Somali immigrants since 1997, correct?"

Really? Where is that citation?

And while you are at it, please find the verifiable documentation dated before that autism increased in the USA during the 1970s and 1980s coincident to the use of the MMR vaccine since 1971.

Was this the issue that was confounding Thompson’s work in the first place?

In addition to the foregoing, given the likely Somali contribution to the 1996 MADDSP catchment, no.

There is nothing in that paper about “linkage with toxicity exacerbation from the MMR”.

I presume this paper is being used as a hook to references 4–7.

^ blockquote fail

"The ” small subgroup (African-American boys)” with the “3.4-fold increased risk of autism”?

That’s your affected Somali group; the children over-represented in the SPED programs & more profoundly affected than their white ASD peers.They are not “only a small sub-group”; they are somebody’s child."

No, the study in question used birth records from children in the state of Georgia. Black people are not all a genetic, ethnic, cultural, or social monolith. There is a lot of variation within people of African descent as there is for people of European, Asian, and South American descent. In other words, not all Black people are alike.

Make inferences about Somali-American children based on Black children in the American South at your own peril.

Chris (#32),
Thank you for the clarifying information regarding the Thompson data.

I will admit that I have not invested much time into becoming familiar with the methods used by Thompson's group for that study, as I find the "conspiracy theory" link distracting. Which is why I ended my post with a question vs a statement; it wasn't a rhetorical question, it was a literal question.

I don't read Wakefield either, again; too distracting.

I neglected to include the actual link because I had noted other posters who indicated that citations were leading to prolonged "awaiting moderation" status & as a first time poster I didn't want to complicate the matter.

https://www.ncbi.nlm.nih.gov/pubmed/11182232

Is mult-linking done here? I don't believe I've seen more than one link per post so I will wait to link the 1997 study.

By christine kincaid (not verified) on 14 May 2017 #permalink

Mr. Deer (#31),

Oh ... I used PubMed basic search with keywords " allele-antibody-Somali".

Which resulted in a whole 4 studies; with the 2001 study being #4.

So it didn't take very long at all. I don't type "vaccine" into Google searches, as a rule; unless I include it with more specific keywords & type "pdf" at the end. Otherwise I find it counter-productive.

Or, are you being sarcastic? I'm not very good at identifying sarcasm & less so online than face-to-face. And I'm terrible at it face-to-face

By christine kincaid (not verified) on 14 May 2017 #permalink

You are aware;that the scientific community had been suspecting & researching a genetic suseptibility to toxicity from the MMR in the Somali immigrants since 1997, correct?

Evidence for this, please. There is no indication of such a suspicion or such research in Poland &c (2001).

By herr doktor bimler (not verified) on 14 May 2017 #permalink

Is mult-linking done here?

No more than two links per comment to avoid automatically entering the moderation queue.

^ Oh, and you could just skip the links and provide the PMIDs. Or actually construct an argument, rather than alluding to one.

That paper is essentially a correction of a previous study about certain genetic sequences and measles immunity. Then I poked about on papers that include the lead author's name:
http://www.mayo.edu/research/faculty/poland-gregory-a-m-d/bio-00078220

He studies immune responses, so the papers were on the variation of immune responses and genetics, with a goal of improving vaccines. This is an issue because some people lose their immunity even after being vaccinated, and even getting the disease. For instance I got mumps twice as a child, others who frequent this blog have also had issues with maintaining immunity.

His research has absolutely nothing to do with autism.

Though there is a large research project that is trying to recruit 50,000 families. There was a very good Story Collider by its scientific director:
https://www.storycollider.org/stories/2017/5/11/maternal-instinct-pamel…

Ren (#36)
Thank you also, for the information regarding the subjects involved in that study.

Regarding: "Black people are not all a genetic, ethnic, cultural, or social monolith." Agreed, you are correct.

However, given that finding a certain agent to be oncogenic in a hamster indicates the need to determine if that agent is oncogenic in humans:

Questioning the possibility of a pharmacogenetic similarity between two groups that share the same continent of origin can't possibly be an irrelevant question.

Opinions will vary, I suppose.

I do find it somewhat validating to find a more recent study from 2006, titled " 13th International Histocompatibility Workshop Anthropology/Human Genetic Diversity Joint Report" ... has identified that same allele ( HLA-A*0101/A*0103) to be occuing with a high frequency in two homogeneous populations of Kenya (Luo and Nandi).

And, the same study, interestingly, asserts those two Kenyan populations to be "close to African-Americans at HLA-A and C".

By christine kincaid (not verified) on 14 May 2017 #permalink

His research has absolutely nothing to do with autism.

Tish, tosh.

There's a new entry in the antivax literature due to come out in July. It's Dara Berger's book "How To Prevent Autism - Advice From Medical Professionals".

At least, I'm making the logical assumption it'll be drenched in antivax hoo-hah, given Berger's history (including a recent lengthy AoA rant on Pro-Vaxxer Bullies) and seeing that two of those "medical professionals" are non-MDs James Lyons-Weiler and Stephanie Seneff. And it has the enthusiastic endorsement of one of today's top medical experts on autism:

"Through an intimate reveal of details about her own health and her family's health tragedies and triumphs, Berger teaches the reader to build their own guidelines about how to proceed through pregnancy and through your child's formative years with knowledge-based caution. This mama bear breaks down the medical jargon and teaches things that the average parent has never been taught. How to Prevent Autism is a must-read for anyone concerned about the neurodevelopmental health of their next generation."

- Jenny McCarthy

https://www.amazon.com/How-Prevent-Autism-Medical-Professionals/dp/1510…

I can hardly wait to get my hands on a copy.

By Dangerous Bacon (not verified) on 14 May 2017 #permalink

Tish, tosh.
From a cursory glance at some of those links, it looks as if professional troll Lawrence Solomon is the source of the idea that "all black people look the same, therefore Thompson = Somalia", and found a few comments from Dr Poland that could be changed in meaning by surgcal extraction from their context. Then AoA contributors decided to be pukefunnels.

By herr doktor bimler (not verified) on 14 May 2017 #permalink

Narad, consider the source. That one is bonkers.

Then AoA contributors decided to be pukefunnels.

The power of Angell compels you!

This is a link to a 2009 study on the "mystery allele", as named by "DB".

I notice that HLA-A*0101(0103?) is not linked with Measles in this study but instead with Hepatitis B & Rubella.

http://vaccinesafetycommission.org/pdfs/30-2010-toxicology-interindivid…

Also, to DB; While I don't remember seeing a rate of 20%, I ended up not including Disneyland as an example because I was finding so many inconsistent rates, depending on where they were stated.

Even so, 66% is still unusual & concerning.

By christine kincaid (not verified) on 14 May 2017 #permalink

@ Narad (#44)

What is "tish tosh" & why does it link to AoA? I didn't find any of the allele studies on or from AoA.

Wouldn’t a scientific consensus that found in favor of: “Genetic factor + Vaccine = Encephalopathy” invalidate the otherwise valid diagnosis of Encephalopathy as a “Table Injury”? Why would AoA want THAT?

@Chris (#50)

Yes, it's complicated. Thank you for the video; I'm watching it in "pieces".

By christine kincaid (not verified) on 19 May 2017 #permalink

@ Narad (#44)

What is “tish tosh” & why does it link to AoA?

Protip: Figure out to whom I was replying and try to sort out why before going leaping and bounding across the lea.