Unethical is too mild a word

Am I going to face the wrath of the anti-vaccination kooks for linking to this? Bring them on. Orac has an article that thoroughly disgusted me: a report on the infamous MD, Andrew Wakefield, who published an article in The Lancet that claimed to have found a link between the measles-mumps-rubella (MMR) vaccine and autism. I had no idea that it had such a strong effect.

Wakefield's work for the lawyers began two years before he published his now notorious report in The Lancet medical journal in February 1998, proposing a link between the vaccine and autism.

This suggestion, followed by a campaign led by Wakefield, caused immunisation rates to slump from 92% to 78.9%, although they have since partly recovered. In March this year the first British child in 14 years died from measles.

Orac has a timeline that also includes this fact: in 2003, there were 4204 cases of mumps; in 2004, 16436; in 2005, 56390. That's in addition to the death from measles. That's an awful lot of misery. What did Wakefield get out of this? Was it the satisfaction of advancing the cause of science? Of revealing the truth? Of combating autism? It looks like the rewards were a little less lofty and a lot more venal than that: £435,000. He's got a little consulting gig now, getting paid £1000 per day to testify against the wickedness of vaccinations for legal firms out to sue pharmaceutical companies.

Wow.

It got me wondering how much you'd have to pay me to make 50,000 children sick, and maybe kill a few. There isn't any sum you could funnel to my bank account to get me to do that, but Wakefield would do it for the low sum of about a million dollars. Who knew evil could be had so cheaply?

Another thing that appalled me was that one of the referees for one of his papers was paid £40,000 for his review. I thought we were supposed to do this anonymously, and for free! Next paper, I should call up the author and get bids on a positive review…and if ever I should do that, strip me of my degree, fire me from my job, and throw me out on the street in disgrace. The "scientists" who perpetrated this fraud are vermin, and ought to be similarly drummed out of the ranks.

One set of things not mentioned, though, are the identities of the lawyers and the law firms who threw millions of pounds at scientists to corrupt them, and gin up the grounds for a lucrative lawsuit. There should also be an ethics investigation of those people, and a loss of their right to practice law in any way.

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This whole thing blew up rather noisily in the Uk some years ago. Naturally the tabloids had a field day and as ever, no matter how many 'sane'reports came out later the scare mongering continued and the public only believed the initial report, not all the subsequent ones.

Conspicious attempts by the goverment to restore confidence in the MMR vaccine floundered (who believes the government? or government scientists?) and the whole thing draaged on rather badly.

Still, I was under the impression that the whole thing had blown over and that MMR use was back into the high 90%s. This is quite a shock to me. I am also shocked about the numbers quoted for reviews. How on earth did that happen?

By Dave Hone (not verified) on 02 Jan 2007 #permalink

I'm guessing that Captain Fishsticks (Craig Westover) will write yet another op-ed column pointing out how science has lost most of its humanity.

Of course Westover happens to be one of those people who took Wakefield's work and ran with it in the pages of the St. Paul Pioneer Press claiming there was a concrete link between the use of thimerosal (which contains mercury) in vaccines and an increase in the occurance of autism.

In my humble opinion then, Westover has also profited from the spreading of incorrect information. It would be nice if he'd reconsider his opinions about science in light of his own part in contributing to such ignorance. But I'm not holding my breath.

Wasn't thimerasol use discontinued? Was that for no good reason?

Nance

By Nance Confer (not verified) on 02 Jan 2007 #permalink

"How did that happen?" Because, at the risk of stereotyping, a shocking proportion of the current generation of UK mums are self-obsessed hippie arsewits who view a woeful ignorance of science as some sort of badge of pride. The sort of smug idiots who tell you with a grin that they won't give their kids food containing 'chemicals'.

I've been flogging on and on at a friend who now has three kids under five about this; her attitude is that the functionally non-existant probability of one of her kids 'developing' autism as a result of the MMR vaccination somehow far outweighs the very real risk to the population as a whole...

Wasn't thimerasol use discontinued? Was that for no good reason?

Scientifically, it was indeed for no good reason that thimerosal was discontinued. There is no sound epidemiological evidence linking mercury in thimerosal used in vaccines to autism. However, as a public policy matter, the U.S. decided to remove it, and, other than the flu vaccine, no childhood vaccines since early 2003 have had thimerosal in it. This was done mainly as a public relations tactic to "boost confidence" in the vaccine and hopefully forestall a decrease in vaccination rates, but it backfired. Predictably, the antivaxers pointed to this action as "evidence" that there was a problem.

I should take this opportunity to clarify one point. The MMR vaccine never contained thimerosal. Ever. Nor have Varicella (chickenpox), inactivated polio (IPV), and pneumococcal conjugate vaccines. However, given the ignorance out there and the hysteria fueld by Wakefield, many parents mistakenly believe that MMR had thimerosal in it.

At every DFL (Minnesota Democratic-Farmer-Labor Party) gathering I attend, I get one of these petitions about vaccines causing autism shoved in my face. And I get the same stunned reaction when I refuse to sign -- like I'm the ignorant one that isn't up on the issues or that I must be some right-winger.

One reason I was so happy to discover PZ's blog is the relief it is to find another political progressive that is also pro-science and pro-evidence.

Standing ovation for this post, PZ.

By Melissa G (not verified) on 02 Jan 2007 #permalink

I'm embarrassed to say that I read about the mercury = autism vaccination thing a while ago and believed it. I mean, a real scientist and real magazines and newspapers said it! It must be true. Sites like this have been helpful. Luckily I haven't had any kids yet so I didn't do anything stupid.

One set of things not mentioned, though, are the identities of the lawyers and the law firms who threw millions of pounds at scientists to corrupt them, and gin up the grounds for a lucrative lawsuit. There should also be an ethics investigation of those people, and a loss of their right to practice law in any way.

Obviously PZ, you've had little legal "experience" (which may or may not be a good thing). First, legal ethics are established within the legal profession. They are in practice more like "guidelines" rather than any "code". Any violation of "ethics" would have to be determined by the legal profession itself. Need I say more? Ok, the very type of ethical violation you seem to be complaining of is encouraged - cultivated - by current legal practices. It's about "winning", and nothing else. If you can find an "expert" to support your argument and increase you chances of prevailing over your adversary, you are in fact doing exactly what is expected of you as a lawyer. In fact, if you can find a judge to assist in the process (not really so hard to do), that's OK too because you are simply doing your "job". There are no hard and fast rules about this stuff. Anyway, how can you complain about someone doing what they are supposed do? It really sucks though, doesn't it.

The Daily Mail journalist Melaine Phillips has been one of the most outspoken supporters of Andrew Wakefield, and from her regular newspaper column has done much to fan the flames of the MMR vaccine hysteria. She also happens to be a passionate global warming denialist and also likes to write in support of ID and against those evil 'dogmatic Darwinists'. It's interesting how these irrationalisms all run together.

By Tony Jackson (not verified) on 02 Jan 2007 #permalink

As a child, I was allergic to eggs and chicken feathers, so I could not get the MMR shot. Consequently, I gained immunity to measles, mumps and rubella the old fashioned way: I contracted measles, mumps and German measles.

I was very young when I got GM, but I remember being sick with the other two.

Frankly, even as a young child, I'm pretty sure I would rather have had the shot if the shot wouldn't kill me. With modern technology, there's even an MMR shot available now that egg-allergy folks can get.

The strange thing is, it's not the children that are really at risk. Getting one of those three diseases as a child is unpleasant, and there's some serious health risk, but it's not the end of the world....

... but not getting immunity as a child and contracting any of those diseases as an adult is brutal, and can lead to things like "testicles shrivel" as well as death, etc.

How anyone can deny their child the protection is beyond me.

At every DFL (Minnesota Democratic-Farmer-Labor Party) gathering I attend, I get one of these petitions about vaccines causing autism shoved in my face. And I get the same stunned reaction when I refuse to sign

I am surprised (and disappointed) to read that, Sonja. I don't think I've ever encountered such a petition, though I can imagine some people that I know signing it, sadly.

It seems to me that there was a parent of an autistic child who was himself paying a lab to conduct a double-blind experiment to test the whole idea of austism being caused or exacerbated by heavy metals (not necessarily just mercury). The results were due in October 2006. I have not heard anything about it, but then I've been busy and didn't keep up.

I didn't necessarily "believe" in the mercury connection, but I didn't disbelieve in it; I didn't have enough information to form an opinion, but any link seems dubious to me, and at any rate, I knew there wasn't thimerosal in the shots.

And who are these lawyers who pay people to spread pseudoscience? It reminds me of Wells and his destructive AIDS "theory". It makes me sick.

Actually, measles and such can be serious: Even in developed countries, measles can kill. It's already done some of that in the UK as a result of the hysteria.

I remember reading reports of that article when it first came out and feeling sick to my stomach. As the parent of an autistic child, I would hate to think that I'd condemned my child to a lifetime of problems because of a medical treatment.

Of course, as I dug more into the story, I realized how much his so-called science was getting a drubbing. But somehow the debunking never gets nearly as much press as the crazy accusations did in the first place!

Too bad every parent of an autistic child didn't get a lumbar puncture performed on their child. My daughter had an immune deficiency at time of live virus vaccination, which the doctors had not discovered. 21 days after the MMR/ varivax she suffered encephalitis, complete with erythema multiforme, and seizures. The ER assured me it was not vaccine related, said it was viral, performed no tests and sent us home.

6 months later my daughter stopped growing, and was dx'd with autism. She has Oka strain varicella in her csf. She had no immune response to any vaccine we have tested her for.

It is sad that more children die in the US annually from the MMR than from any of the diseases it protects children from.

Regardless of how Wakefield acheived his results, it calls into question the safety of live virus vaccines. Much more research (aside from looking at numbers) nees to be performed. I personally know 2 parents who have sucessfully gained compensation for their autistic children in vaccine court, as the vaccine strain measles were found in their csf.

Wasn't the OPV changed to IPV in 2000 simply because it was causing VDPV in immunocompromised children? In fact, the only cases of polio we have had in our country in the last decade were from the vaccine.

Medicine is not perfect, it is as evolving as humankind. Clearly, we can work towards a safer vaccination schedule.

Stanton said -
Most likely because these people are gullible.

Actually, it has a lot more to do with who is telling them. Until reading Orac about vaccines, I thought that they did, on very rare occasions, cause autism. That I alos thought that the minor risk (of a horrible disease) was outweighed by the benifit of the vaccines for children, didn't stop me from being terrified that my healthy child might hit the wrong side of the percentages after his vaccines.

This has nothing to do with gullability when your average Joe is told by scientists and even their pediatricians or regular doctors (such as ours), that this is a risk. I go to doctors, because I assume they know a lot more about medicine than I do, I trust what they say for the same reason. Does that make me gullible? No, it means that I trust what people with a lot more education, when they are discussing issues covered by their training.

Ancarett, I'm really sorry to hear you thought you might be to blame for your child's autism, even briefly. One of my huge problems with the pseudoscience in alternative medicine is how often the groundless claims made by unthinking (or deliberate) practitioners actually blame the victim--it's cruel, even on top of being unfounded.

Examples of what I'm talking about (in addition to making parents feel guilty over routine child care) include Louise Hay's claim that birth defects are karma from previous lives, claims that you can cure yourself of cancer if you just try hard enough to get the right attitude/personality, and just about anything else that makes getting sick or not getting well some kind of character flaw on the part of the patient. It's a continual source of amazement to me how people can commit such cruelty, all the while seeing themselves as some kind of advocate for patients.

Great post!

By Christian Burnham (not verified) on 02 Jan 2007 #permalink

Monica:

It is sad that more children die in the US annually from the MMR than from any of the diseases it protects children from.

Yeah, life was ever so much better for kids before there were vaccines. Nothing like childhood diseases to make you really glad to be alive.

Wake up, please.

Monica:

It is sad that more children die in the US annually from the MMR than from any of the diseases it protects children from.

Citation please?

Thank you Orac and Skeptico.

We vaccinate but, of course, I've seen all of these reports in the news and wondered.

Any opinions on the chicken pox vac (my understanding is that it "wears off" and so we'll have a crop of 20-year-olds with the chicken pox if we vaccinate now) or the new HPV vac?

Nance

By Nance Confer (not verified) on 02 Jan 2007 #permalink

He's got a little consulting gig now, getting paid £1000 per day to testify against the wickedness of vaccinations for legal firms out to sue pharmaceutical companies.
Well... somehow I don't think that his career as an anti-vax "expert" witness is going to last much longer, even if he's active on cases right now. I'm sure that the UK has some case law similar to Daubert and defending counsel wouldn't have to do too much to get Wakefield's testimony tossed out. One of the good things to come out of this story, in my opinion.

It is sad that more children die in the US annually from the MMR than from any of the diseases it protects children from.

Actually, it's not sad at all. 10 kids dying of vaccine-related complications is *way* better than 10,000 dying of the diseases those vaccines would have stopped.

There's a reason that those diseases don't kill very many people in the US: they have a very low incidence because almost everyone is vaccinated against them. Without that protection, the diseases would be a lot more common and therefore a lot deadlier (just as they were a few centuries ago, and still are in areas that don't have as much access to the vaccines).

This is not to say that we shouldn't continue to work on the vaccines and try to reduce the incidence of complications, but refusing to use them until they are absolutely perfect would be insane. Vaccines prevent a LOT more health problems than they cause, and while there is some room for improvement, in their current state they are much better than nothing.

Warren, never have I said to stop vaccination, or that the disease is preferrable. But we need to make a safer alternative than to shoot children with 4 live viruses at once, regardless of their immune function.

I sometimes get the "if you're so smart, why are you rich?" and there's two parts that make up the answer.

1) I'm pretty lazy, and perhaps too timid.
2) I have ethics.

It is so easy to make obscene amounts of money nowadays -- simply be a televangelist, or a AGW guy, or an anti-vaccine guy. The only reason I don't is because I'm not a degenerate scummy piece of human filth like those people are.

And Monica, I second Azkyroth's call for a cite, but also want to note that the way you wrote that up has the truthiness factor writ large; you are claiming that NOW few children die from those diseases than from vaccines but implying that fewer children died previously from those diseases than from vaccines now. The second part, the implication, is incredibly foolish nonsense, which you may well have incorporated from some source without thinking it through, but the first part may be true (where's that cite? should be easy to find if true). The reason the first part could/may/might be true is that vaccines are effective; few children die from those diseases NOW because we have ways of preventing that, ways that people like you, well intentioned or not, want to stomp out so that children in the future will die in horrific numbers. Nice.

http://www.spiked-online.com/index.php?/site/article/416/

is a nice summary of the personal injury lawyer Richard Barr and his history of involvement in lucrative but ineffective litigation.

While he deserves the ethical scrutiny that PZ calls for, the clueless members of the Legal Aid Board/Legal Services Commission that wasted GBP 15 million on quackery should be named in public.

By David vun Kannon (not verified) on 02 Jan 2007 #permalink

My daughter has a vaccine injury, I have been kicked out of 2 doctors offices for suggesting such a thing, and have been lectured by dozens of doctors. It took 17 months before we found someone who did the right testing.

If a doctor had considered what I had first suggested when my daughter had a reaction, she could have begun varicella antiviral therapy. Now, she has a lifelong developmental and growth disability.

I am not against vaccines, but I am against our one size fits all vaccine policy, and against vaccines which are quick to market. The US is guinea pigs, look at the rotovirus vaccine. That was a big hit.

I am also against a vaccine injury compensation program that is near imnpossible to gain compensation from.

True, 10 deaths per yr are better than an epidemic of measles, but it is UNFAIR that the law in thge US does not allow more than $200,000 compensation to the families of those who's loved ones were sacrificed so that the US can maintain it's high level of herd immunity, yet people can sue for millions for hot coffee.

Azkyroth, take some time, and compare the MMR related deaths in the vaccine adverse event reporting system www.medalerts.org/vaersdb/
and the CDC's own MMWR (Morbidity and Mortality Weekly Report), which lists infectious diseases and their rate of occurence for any given week.
www.cdc.gov/mmwr/

... yet people can sue for millions for hot coffee.

Let's just nip that one in the bud, shall we?

And Monica -- as to the central matter at hand, it is precisely and emphatically the question of relative risk and benefit that is important here. Everyone who learns of your daughter's experience must feel tremendous sympathy for both of you -- how could we not? But when you accompany that account with

Regardless of how Wakefield acheived his results ...

and

It is sad that more children die in the US annually from the MMR than from any of the diseases it protects children from.

you start to erode that sympathy. A safer, more just world is what we all want; where we differ is in how to achieve it.

I never stated that I feel Wakefiels was right in what he did, but what he FOUND is critical, and his studies need to be replicated.

And I feel it IS`sad that the vaccine kills more children in our country than the disease. Pharmeceutical companies are in no rush to come up with a safer plan.

It is ridiculous that these 4 live viruses are given at once. It is also ridiculous that to request these vaccines seperately, insurance will deny payment, forcing a parent to pay upwards of $600 for these vaccines.

Pharmaceutical companies were also against a black box warning on the OPV- live virus containing oral polio vaccine.

It was not until parents of immune deficient children who contracted VDPM- (vaccine derived poilio myelitis) from this live virus vaccine lobbied the government that a safer "killed" virus version- IPV- inactivated polio virus was included in the current US pediatric vaccination schedule.

We are now able to use a killed version, as we have not had a case of wild virus polio in over 2 decades.

Other countries, which have had cases of polio, must still use the OPV until polio is no longer a threat.

Look up info on the endgame strategy for polio eradication.

It is time the US moves to an inactivated measles vaccine. As I have stated before, 10 deaths are too many, especially if the death was your own child.

Also, in the late 90's we moved to the DTaP, as the DTP was causing neurological problems in many children.

To think we cannot improve our current policy is absurd.

I am in favor of herd immunity more so than the average parent, as my daughter has not been able to build antibodies against the vaccines she has received. She has no immunity to these viruses, and must rely on herd immunity for protection.

But for God sakes, break up the vaccines, we are throwing WAY too many viral insults at our babies immature immune system. In a country as advanced as ours, it is appalling that we only have the 36th lowest infant mortality rate.

In no time in history has a baby had to build as many immune responses as one does today. Too many immune responses in a close proximity throw people into autoimmune disorder.

A child has had 54 immune responses from vaccination by 18 months in the US. Compounded with the fact that childhood vaccines have (since 1991) been mandatory by 18 months of age, is the fact that we are adding more vaccines all the time.

It is time we adjusted this schedule, and offered safer alternatives.

If you actually read the article, Monica, you'd realize that Dr Wakefield never offered an actual, viable alternative to vaccines.

Stanton, I never said Wakefield did offer an alternative, although there has been also been great speculation that he had applied for a patent of another vaccine. As a person who has received Google news alerts about Wakefield for over a yr now, I can tell you much of what you read about him is purely speculation, on both sides of the argument.

An alternative to the live measles virus exists, in fact, we discontinued using it in the 70's, as measles was still too prevalent, and inactivated virus vaccines are not as effective in gaining herd immunity as live virus, or attenuated vaccines. I think it is time we move back to this vaccine.

Actually, it's not sad at all. 10 kids dying of vaccine-related complications is *way* better than 10,000 dying of the diseases those vaccines would have stopped.

Exactly. Even if MMR did cause autism at the rates claimed, if I were responsible for small children I'd still make sure they were vaccinated.

As I've written before, here's the "childhood disease" toll in the sibship that produced my mother (10 births between 1908 and 1925):

1 death from whooping cough
1 death from diphtheria
1 serious lifelong disability because of anoxia caused by whooping cough
1 severe but non-fatal case of diphtheria

And these were four separate events. (For example, the death and the disability from whooping cough happened during separate outbreaks, about 10 years apart.) That's what life was like for working-class American families ninety years ago.

Two kids dead, one in a wheelchair all his life, and a fourth who came close to death and was sick in bed for weeks.

Please, please, please. Never again.

Monica:

But for God sakes, break up the vaccines, we are throwing WAY too many viral insults at our babies immature immune system. In a country as advanced as ours, it is appalling that we only have the 36th lowest infant mortality rate.

There are a couple problems here. For starters there's something suspiciously like "Won't someone PLEASE think of the children!" combined with a deliberate conflation of infant mortality rate with the prevalence of childhood vaccination.

To say this is disingenuous of you is being charitable.

You might think it's "absurd" to vaccinate with multiple viruses at once -- but have you considered the practicality of alternatives? That is, is it more reasonable to expect parents to drag their kids to the doc four times in a row to spread out the vaccinations? (Using what money, precisely? Insured, on the dole or out of pocket, those visits cost someone something.)

Of course, we could have vaccination through GM food. But then, too many people are against that as well.

All of this is on par with the person insisting he'll never wear a seat belt because of the 2% or so collision survivors who lived because they didn't buckle up.

As I said earlier, wake up, please.

The papers over here in the UK tend to go loopy when a story like this comes out, showing at best ignorance of the scientific method and how medical trials etc actually work, and at worst a willful manipulation and sensationalisation of reports which bear little resemblance to the headlines the next day.

The Daily Mail claims every day that either "X Causes CANCER!!!" or "Is Y the new Superfood?", liberally sprinkled with MRSA stories, all designed to keep the masses in a perma-hysteria.

But then we have people like Dr Ben Goldacre at the Guardian (www.badscience.com) </shameless plug>... Are you guys familiar with 'Dr' Gillian McKeith?

By psycotic_furby (not verified) on 02 Jan 2007 #permalink

I feel many of you do not understand my stance. I am not anti vaccine. The diseases they protect us from are horrible, and we do not want to see them return. My grandfather lost 5 siblings to whooping cough and measles during the depression. These diseases are deadly.

But, as the discovery of penicillin has saved many lives, many have died from penicillin allergy, and we have discovered safer alternative antibiotics for those people.

We had successfully eliminated smallpox and polio without today's aggressive policy. Why do we feel it is now necessary?

Is it a surprise that big pharma contributes largely to republican campaigns that for 10 yrs have turned a blind eye to their irresponsibility and marketing?

Healthcare is no longer about wellness, it is about business.

Our wonderful president included, upon signing the "Biodefense and Pandemic Vaccine and Drug Development Act of 2005". As a result, families of patients who are killed or injured due to a defective or dangerous vaccine, drugs or devices that fit within this category will have no recourse, no ability to file a claim or lawsuit, no way to collect any compensation even if the drug company or health care provider was negligent, reckless or in some cases intentionally harmful.

It also accelerated approval of any drug, biological product, device or research tool that the government determines to be a national security or pandemic priority, severely weakening the normal safeguards that prevent unsafe vaccines, drugs and medical devices from reaching consumers.

What big pharma company is going to want to do any more research and clinical trials than what is required by law?

"That is, is it more reasonable to expect parents to drag their kids to the doc four times in a row to spread out the vaccinations? (Using what money, precisely? Insured, on the dole or out of pocket, those visits cost someone something.)"

so, convenience and money are more important than our children's welfare?

If I had known what could happen, I would have rather paid each month, out of pocket, and visited the doctor each month, than to have my daughter suffer how she has. I was never given a choice.

Warren, I hope you never have to watch your child have a vaccine reaction, stop growing, and suffer facial tics, seizures, and a lifelong disability for which compensation may never be made.

If that happens, and your child is that small percentage, you too will say that even a small percent, is unacceptable.

I'm pretty sure it is being said in an ironic way.

if you could not detect the iorony, forgive me, I mean, that man who has destroyed the country I love dearly, George W Bush

The papers over here in the UK tend to go loopy when a story like this comes out, showing at best ignorance of the scientific method and how medical trials etc actually work, and at worst a willful manipulation and sensationalisation of reports which bear little resemblance to the headlines the next day.

This may be an utter (lack of) shock to you, but it's just like that in the US, too.

But for God sakes, break up the vaccines, we are throwing WAY too many viral insults at our babies immature immune system. In a country as advanced as ours, it is appalling that we only have the 36th lowest infant mortality rate.
I suspect that those 35 also use the same mmr vaccines

You can't really expect individuals who have a choice to put their own children at risk *just* for the sake of herd immunity, however indignant this might make the public health specialists. Given that the risks of an adverse effect, while very small, are never going to be zero the rational (if cynical) parent should try to persuade everyone else to vaccinate their children so that the risk of catching the disease is small enough so she needn't have to do her own.

That could explain some of the heat around the debate a little while back around whether the children of certain UK Government Ministers had been vaccinated. Because they might be assumed to be well placed to influence such matters, it rightly became a public rather than a personal issue.

For most people though regional vaccine take-up rates are what they are, so a wholly rational parent, if such a creature exists, will work the odds according to the best evidence available. Less than 90% take-up eh? Hm. Those of us who are not experts are wholly reliant on people who are trained to assess these things to advise what is best evidence.

On the face of it if Dr Wakefield has not compromised any claims he might have had to being a reliable person, then at least he's got a good deal of explaining to do.

Some people are being rude to Monica while missing her main point, which she keeps carefully repeating, apparently to no avail. (I detected sarcasm in her "wonderful president.") She is saying that there is plenty wrong with current vaccine policy, and that the system can be improved.

To add to Monica's point, consider the reporting of adverse events. When parents call their family doctors to report an adverse event, doctors typically tell them that the event is "normal" and not to worry about it. It is generally agreed in the medical community that because of this, adverse events are widely under-reported. This means that the statistics used to support vaccine safety are not valid.

Relying on over-worked family doctors to do medical research is unwise; proper long term vaccine safety studies need to be performed before we can be sure that vaccines are safe.

Many other issues can be raised here, and perhaps usefully discussed. (For instance, the dearth of long-term safety and efficacy studies, the unusual protection granted to vaccine producers, etc.) It is not a simple case of black-and-white, as some commenters imply.

By Santo D'Agostino (not verified) on 02 Jan 2007 #permalink

Also, Monica, if you took a class on virology, pathology, or even just read about polio and smallpox, these two particular diseases were eliminated because of an intensely aggressive vaccination program.

Also, to note, there are many children who are contraindicated for certain vaccines. Take primary immunedeficiency for example, the NIH says children with PI, or a family history of PI should not receive live virus vaccines, until proper immune function can be established.
http://www.nichd.nih.gov/publications/pubs/primary_immuno.cfm

What many people fail to realize, is that many of our doctors practice one size fits all cookie cutter medicine, even with vaccination.

Doctors are also interested in the bonus they get from the government for high vaccination rates.

They do not get these if a child is contraindicated for vaccination.

umm, who ever said I believe in God?

Gav, it seems to be the difference between a perceived risk and a proven one. Correct me if I'm wrong (which I may well be) but Wakefield's findings have not been recreated, and the MMR vaccines don't contain mercury, or any other substance alleged to cause autism.

Parents should be able to make informed decisions, but based on the facts. The risk IMHO is that if parents make the decision not to vaccinate based on unfounded fears, on the assumption that the rest will pick up their slack, we run the risk of not reaching the levels necessary for herd immunity, and thus the unvaccinated kids will be at more risk.

By psycotic_furby (not verified) on 02 Jan 2007 #permalink

Stanton, the vaccine policy 20 yrs ago did not include as many vaccines, or vaccines delivered as young as they do now. Check the CDC's website on vaccine history
http://www.cdc.gov/nip/vaccine/vacc-timeline.htm

And thank you Santo, atleast someone is smart enough to believe that big corporations and our government could be *gasp* irresponsible.

To think, my daughter's doctor to this day REFUSES to file a report with the vaccine adverse event reporting system on my daughter's behalf.

DR Krigsman at Wake Forest University replicated Wakefield's findings last spring

Also, a recent genetic study (the most promising to date) shows a genetic variant associated with the MET gene is common in children with autism and appears more frequently in families that have more than one affected child.

This same gene is also responsible for immune system regulation, and GI function.

http://www.medicalnewstoday.com/medicalnews.php?newsid=54747

how did this turn into bash monica day? her child had a bad reaction, a rare one. she is not against vaccinations. i'm glad she is speaking up.

my kid is in high school. just before christmas, the principal alerted the whole school that one child has been diagnosed with whooping cough, which is fairly contagious and can be very serious. i'm almost 50 years old, and i can't recall such a notice in my entire life. it's possible that part of what is going on here is that parents have refrained from vaccinations-- the school is in berkeley. we also learned that the immunity wears off over time, and got a non-emergency recommendation of a booster vaccination. the real recommendation was to watch for symptoms of whooping cough, which i'm guessing none of us parents has ever seen.

DR Krigsman at Wake Forest University replicated Wakefield's findings last spring

umm, did you read Oracs post?

Arthur Krigsman, Business partner of Andrew Wakefield: £16,986. His unpublished 'papers' have been cited numerous times by Wakefield and supporters as evidence Wakefield was right, conveniently forgetting they were a) unpublished and b) written for his boss. According to Brian (see link in Aitken paragraph), in December 2004, he left Lennox Hill hospital, New York,after a lawsuit, which was followed by an ethics inquiry. In August 2005, he was fined $5,000 by the Texas Medical Board for misconduct. Gotta try and recoup some of that money somewhere eh?

What I find odd about Wakefield, again, it is hard to discern fact or fiction with this man, is that The General Medical Council decided in July that it will not proceed with charges against him.

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_articl…

If there was no merit to his research, and they truly felt he was at fault, why would they have dropped charges?

In a country as advanced as ours, it is appalling that we only have the 36th lowest infant mortality rate.

The reason for this is the US's appalling lack of universal health care. An embarrassment for the whole world. Look at the other 35...

In no time in history has a baby had to build as many immune responses as one does today. Too many immune responses in a close proximity throw people into autoimmune disorder.

Incorrect. There are indeed vaccines that can cause autoimmune diseases -- but that's because those particular vaccines are similar (on the molecular level) to some of your own proteins. For the same reason there are also infections that can cause autoimmune diseases. I study molecular biology, I've had my head filled up with far more immunology than I was ever interested in; I can't think of a reason why "too many immune responses in [...] close proximity" could cause autoimmune reactions.

On another note: Peanut Gallery, don't you notice your comment is entirely off-topic in this thread? Maybe read the original post again and then tell me what it has to do with religion.

By David Marjanović (not verified) on 02 Jan 2007 #permalink

one child has been diagnosed with whooping cough, which is fairly contagious and can be very serious. ... it's possible that ... parents have refrained from vaccinations-- the school is in berkeley.

We had a similar situation with pertussis in Boulder when parents of children at a Waldorf school declined vaccination in keeping with Rudolf Steiner's belief that "children's spirits benefited from being tempered in the fires of a good inflammation."

btw, there have only been 2 documented cases of autism among the amish, who do not vaccinate. those 2 cases involved children adopted after immunizations.

Thus proving adoption causes autism

We had successfully eliminated smallpox and polio without today's aggressive policy. Why do we feel it is now necessary?

Erm, both of those were eliminated because of immunizations. I don't see your point.

My point is that a 3 month old baby should not be forced to mount an adequate immune responses to 14 viruses in one day. We effectively eliminated polio and smallpox without giving as many vaccines at once.

My point is that a 3 month old baby should not be forced to mount an immune response to 14 viruses in one day. We effectively eliminated polio and smallpox without giving as many vaccines at once.

Don't stop there, Monica -- what conclusion should we reach from the Amish factoid?
If it's that the Amish are free of autism because they don't vaccinate, don't forget to propose any alternative explanation of the data that might occur to you.
In any event, I will see your Amish and raise you five peer-reviewed studies.

"btw, there have only been 2 documented cases of autism among the amish, who do not vaccinate. those 2 cases involved children adopted after immunizations."

You're wrong, but I'll bet that you don't care about the facts.

BTW, since thimoseral has been eliminated from vaccines since 1996. How do you explain the NEGATIVE correlation between thimoseral dose and PDD (which includes autism) in a study with actual controls?

http://pediatrics.aappublications.org/cgi/reprint/118/1/e139.pdf

I never once claimed (nor has Wakefield) that Thimerosal causes autism.

Actually, thimerosal was not phased out of most childhood vaccines until 2002, and it today's flu vaccine, licensed for pediatric use in the US, still contains thimerosal.

Consequently, my child was born in 2003, and has never had a thimerosal containing vaccine, yet developed autism at 17 months.

David, for your clarification, the DTaP is 3 viruses(diptheria tetanus pertussis), the PCV is 7 variations of the pnumococcal virus (now we are up to 10 viruses), then you add Hepatitis B, Polio, and Haemophilus
influenzae type B3

That is 14 seperate immune responses and is totally unnatural for a 3 month old immune system.

That is 14 seperate immune responses and is totally unnatural for a 3 month old immune system.

Just how do you know that? Do you think kids are naturally brought up in a sterile environment or something?How many "seperate immune responses" do you think you might be experiencing right this moment?

hmm, a 3 month old typically will not encounter 14 such hostile viral insults in one day. These are major viruses that we vaccinate against for a reasson. Pertussis is not an average cold. Polio and diptheria are not your everyday immune insults.

Thanks monica. The PCV as I understand it isn't seven (or ten) viruses though, it's actually a conjugated polysaccharide (or sugar) of the molecules that make up the surfaces of the various pneumococcal bacteria. The immune system then develops antibodies that will react against the actual bacteria. FYI - for the PCV vaccine, about 10%-20% of children develop redness, tenderness, or swelling where the shot was given and about 10% may experience a mild fever. This isn't natural, but it does seem to be an acceptable risk considering the risks of an acutal infection to the infant.

monica, the CDC's schedule you provided the link to does not actually show what you're claiming. (That is, 14 hostile viral insultes in one day.) At most, it's more like six or seven. (Note that I am not counting the PCV as seven separate vaccinations, as that is not what is actually being administered.)

Monica, are you asserting that it's the immune response of the body being subjected to "14 viruses" at once that's causing the autism? Since you seem to be discounting the thimerosal as the cause.

I am sorry, the PCV is 7 various strains of a bacteria, which is just as much work for an immune system as a virus.

And yes, seven bacterias seem to be an acceptable risk, but combined with immune responses to the viruses.

monica, to reiterate here, the PCV vaccination isn't made of of actual bacterial "strains". It's a long chain sugar that mimics the outer coating of several types of pnuemococcal bacteria. Perhaps PZ (or Orac) might help explain better than I what is involved with the body's immune response mechanism, but my own short and unsweet version is that the the PCV vaccine stimulates an immune response that results in the production of several kinds of antibodies that can then combat an actual bacterial infection. Our bodies do this sort of thing all the time, as PZ earlier said, so I'm not sure what the sheer number of antibodies involved has to do with the potential for an adverse response to the vaccine. If anyone can enlighten me, please consider yourself thanked in advance!

#1- I am not stating that this is exactly what causes autism. I feel there are subgroups, who present quite differently, physically and behaviorally. I do not speculate to know, by and large, what causes autism.

I simply feel that we are cramming way too many vaccines at once into an infant.

I also know what I saw happen to my daughter.

#2- My daughter has had a physical reaction (seizures, erythema multiforme, and 104.7 seizures), to live virus vaccines. After this reaction, she was gone. No talking no eye contact, no nothing. Self abusive behavior began. 4 months later, my daughter was diagnosed with autism. Then we noticed she stopped growing, something had caused an infection in her pituitary gland.

We have since learned that she has not formed an immune response to any vaccines, and her csf was pos for oka strain varicella.

monicaq:

hmm, a 3 month old typically will not encounter 14 such hostile viral insults in one day. These are major viruses that we vaccinate against for a reasson. Pertussis is not an average cold. Polio and diptheria are not your everyday immune insults.

The pertussis, polio and diptheria vaccines are not pertussis, polio, and diptheria. Now I suspect that the vaccines are not just like any old antigens--they're supposed to trigger significant immunity. But they're not the same thing as serious infections.

By Andrew Wade (not verified) on 02 Jan 2007 #permalink

btw, there have only been 2 documented cases of autism among the amish, who do not vaccinate. those 2 cases involved children adopted after immunizations.

Ah, you've apparently been reading Dan Olmsted's shoddy reporting and his passing of canards like this one. Prometheus over at the now apparently defunct blog Photon in the Darkness addressed this very canard. From my perspective, besides the fact that there are no epidemiological studies that actually support Olmsted's bloviations with regard to the Amish, even if it were true that the Amish have a much lower rate of autism than we do in the rest of the U.S., it would not necessarily implicate vaccines

Consider this question: Why does Olmsted immediately jump to the conclusion that it is vaccines that would be responsible for such a difference? It couldn't be, for example, the lifestyle differences or environmental factors? Or what about genetics? The Amish are a highly inbred group, and the latest science strongly suggests that autism is mostly genetic in etiology; the frequency of autism-causing alleles could be much different in the Amish than in the rest of the population.

But, of course, no. It has to be the vaccines, doesn't it? It's always the vaccines with antivaxers like Olmsted. They don't even consider other possible explanations for differences in autism incidence, and they don't even bother to check their figures to see if there actually even is a real difference in incidence. Why? Because they just know it's the vaccines. And, just to pre-empt where you're likely to go next if you like to cite Olmsted, let's deal with the case of the For example, he claimed that a group of children taken care of by alternative medicine-loving doctors at a practice known as Homefirst in the suburbs of Chicago had lower rates of autism based on no science but "memories" of the doctors, none of whom bothered to consult their records. I've covered this canard in depth before.

That's "deal with the case of the altie practice in Chicago that he likes to cite."

I hit "post" too soon again...

Monica, I feel deeply saddened by what happened to your family. Without access to the medical records I can't say, but it does sound like your daughter had a rather extreme reaction to the vaccination procedure.

However, that still does not explain why you believe:
...that we are cramming way too many vaccines at once into an infant.

It doesn't appear that this is based on anything except your own emotional response to your daughter's plight. While I appreciate that, I don't see any evidence that the number of vaccinations performed today has any detrimental effect on children in general.

While it's better for the herd to require vaccinations, it is still true that children are injured by the insult to the immune system that Monica has described. A high fever is bad for a developing brain, at minimum; we don't know how often children respond to live vax with potentially damaging fever because pediatricians often don't accept that any reaction is a reportable event.

My daughter's 48 hours of fever, accompanied by seizures and catatonia, after her 2 year shots were treated as anomolous events by her doctor. These events are still unexplained after shooting our entire MSA for that year on diagnostics. While I can't prove causation, she got 6 shots and then in less than two days developed a life-threatening fever and lost the ability to speak overnight. No one else in our household had any illness and she hadn't been exposed to anyone with a viral illness. Where did that pesky viral exposure occur? I can't prove definitively that it came through a needle, but there is no other credible explanation.

The level of incivility being displayed toward a parent whose child has suffered one of those adverse reactions is just appalling. Monica isn't entitled to make any old unsourced assertion without being questioned in the name of her child's disability, but she has been nothing but rational. No one knows what causes autism, and a lot of parents want something to blame. This causes bad people to exploit their pain for money...nothing complex is going on here. Why project the anti-science stupidity of a few onto the first person who says, 'A vaccine crippled my child'?

Monica, my 7 year old is speaking, beginning to read and wrote her own letter to Santa. Fight like hell for your child to receive rehab services, because they can make a difference. Keep in mind that medical science can't yet ID a cause for your child's autism; her doctors can't tell you what she will never be able to do.

By AnotherFather (not verified) on 02 Jan 2007 #permalink

Life imitates art:

Harry Lime, speaking to Holly Martins: "You know, I never feel comfortable on these sort of things. Victims? Don't be melodramatic. Tell me. Would you really feel any pity if one of those dots stopped moving forever? If I offered you twenty thousand pounds for every dot that stopped, would you really, old man, tell me to keep my money, or would you calculate how many dots you could afford to spare? Free of income tax, old man. Free of income tax - the only way you can save money nowadays."

Sometimes, you don't need a war to profiteer. All you need is a good cooked up scare, and you can even be the one yelling "Fire!" in the theater. All you need is to be correctly positioned to reap the benefits of the panic or unease you create.

The real problem is that a lot of peole WANTED their children immunised, but in the previous, SEPARATE injections/dosages, rather than in one giant "Setp Function" immunisation.

The Brit government deliberately took the separate immunisations off the available list.

There IS a problem - that of the rapidly growing numbers of allergies to all sorts of things.
My suspicion, and that of some immunologists (I believe) is that overdosing v. small children all at one go, may be at least partially responsible for this.
But almost no-one seems to be looking at the real problem.

I didn't know that the ghastly Melanie Philips ( a well-known kook) and the Daily Nazi (Sorry that should read "Mail") were involved in this.

Here, a LOT of people WANT immunisations, but don't want MMR-all-in-one-go. But it isn't available - any more.

By G. Tingey (not verified) on 02 Jan 2007 #permalink

A high fever is bad for a developing brain, at minimum; we don't know how often children respond to live vax with potentially damaging fever because pediatricians often don't accept that any reaction is a reportable event.

1. The odds of getting a damaging fever are higher with the disease than with the vaccine.

2. Aren't they required to report adverse conditions? After all, they have to keep measuring the odds.

The level of incivility being displayed toward a parent whose child has suffered one of those adverse reactions is just appalling. Monica isn't entitled to make any old unsourced assertion without being questioned in the name of her child's disability, but she has been nothing but rational.

She hasn't been rational. Just look at some of the vague claims she's been making about alleged immune system stress or whatever. She's also cited typical anti-vaxxer canards about autism.

Yes, she's been though a lot of nastiness. That, however, does not make her fallacies vanish.

To Bronze Dog:

Yes, family doctors are officially required to report all adverse events, but it is widely acknowledged in the medical community that adverse events are extremely under-reported. (Relying on what amounts to anecdotal evidence from over-worked family doctors instead of doing proper research is appalling.) This means that available data on the frequency and severity of vaccine side effects is unreliable.

Hence any arguments about vaccines doing more good than harm, etc., are invalid. Until we get proper long-term studies on vaccine side effects, no conclusions about risk/benefit can be made.

If any immunologists reading this would correct me if I am wrong (i.e., point to such LONG-TERM studies) I would be grateful.

By Santo D'Agostino (not verified) on 03 Jan 2007 #permalink

Santo D'Agostino:

(Relying on what amounts to anecdotal evidence from over-worked family doctors instead of doing proper research is appalling.)

Who is doing that? I thought it was de rigeur to put a vaccine through carefully observed clinical trials before widespread use. I assumed that the data on the frequency and severity of vaccine side effects came from those trials, do you know otherwise?

Hence any arguments about vaccines doing more good than harm, etc., are invalid.

Nonsense: the benefits of vaccination are enormous; even if the appearant increase in autism and allergy incidence were entirely caused by vaccination, vaccination would still be a net win. (It is true that some specific vaccination programs would not be worthwhile in this scenario.) In short: we don't need to know much about the risks to know that vaccines do more good than harm.

If any immunologists reading this would correct me if I am wrong (i.e., point to such LONG-TERM studies) I would be grateful.

I'm not an immunologist, and I'm not familiar with the literature, but google is your friend:
Unintended events following immunization with MMR: a systematic review.
Now, I do think that research dollars could be better allocated, and I am deeply concerned about conflict of interest (hence bias) in studies funded by pharmaceutical corporations, and in the information they are feeding doctors. But good research costs money, and high taxes are not popular.

By Andrew Wade (not verified) on 03 Jan 2007 #permalink

I'm not so familiar with the anti-vaccination crowd, but I have a sneaking suspicion that "it is widely acknowledged in the medical community that adverse events are extremely under-reported" may be analagous to "many scientists doubt evolution".

Would you be rational if your child was disabled for life from a vaccine they should have never had?

Of course I am not too rational, I am angry, I have genuine hatred towards those in power in our country, because as autism keeps rising, they are sitting on their hands. The only government funded studies done so far (correct me if I am wrong) have been simply looking at VAERS, which is horribly unreliable, to quote the study you referred to Andrew- "The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. "

Largely inadequate.

And if you think that causing autism is preferrable to a delayed vaccination schedule, I have a couple things for you to think about. The lifetime care of an individual with autism averages 2 million. Who is going to pay for that? Sadly, you taxpayers will, especially as all these children grow into adulthood, as they will need lifelong care.

I also welcome you Andrew, to come meet my daughter. Hold her arms so she will not bite them when she is angry. Watch my georgeous little baby try to gouge her eyes because she is angry that she cannot tell me she wants a drink. Tell me that what has happened to her is preferrable to a delayed vaccination schedule.

Or maybe you can change the diaper of my friend's 12 yr old, because he has not mastered toileting, maybe you will be lucky, and get there on a day when he smears his feces on the wall, or the couch, and you can clean it up.

How insensitive you are to make such a comment.

I will reiterate what I have stated before-

I am not against vaccination, I am just against the way the US now vaccinates its children, and does little to moniter the safety of these vaccines.

Our government also does little to compensate those who have been injured by a vaccine. Roughly only 25% of vaccine injury cases filed with the (vicp) vaccine injury compensation program are rewarded.

Do you know what the vicp is and why it was established? Too many vaccine injury cases stood to bankrupt pharmaceutical companies, so this program was established as a "no fault" system in 1988. http://www.hrsa.gov/vaccinecompensation/

Our government also does little to help those with autism. Currently only 7 states mandate insurance companies to cover therapy for these children. My husband's insurance offered our daughter 30 hours of therapy for her lifetime. It is reccomended that children with autism have 30 hrs each week! My daughter receives 10 hrs each week. That therapy costs anywhere from $110- 150 per hour. I must rely on medicaid for her therapy to be covered. So, in essence, each of you is paying for her therapy with your tax dollars. Multiply that times one out of every 166 children in our country, and you are forking out alot of dough.

Maybe you would like to continue to foot the bill for this epidemic Andrew, as you have stated good research costs money, but, what funds could find the cause of autism are a drop in the hat compared to the financial burden our country will bear supporting those with autism throughout their lifetime.

At a time when our president has thrown billions into Iraq, and our space program, the number of children with autism continues to rise about 17% each year nationally. Instead of adequate research into the cause, he has passed laws allowing shorter clinical trials for vaccines, and any medicine to be used in a "pandemic".

I encourage each of you to find a local autism support group, attend a meeting and ask the parents why they think their child has stopped talking around 18 months. My story is truly not that unique.

I encourage each of you to find a local autism support group, attend a meeting and ask the parents why they think their child has stopped talking around 18 months. My story is truly not that unique.

This made me remember one article on autism I read a while ago: http://www.discover.com/issues/apr-06/departments/vital-signs/ I fear that link will not work, due to my inability to figure out this comment system, so here is the quote that stood out to me:

About 25 percent of children with autism develop language normally but then lose the ability to speak sometime between 16 and 30 months of age. The condition, called regressive autism, is not known to many physicians, so they may worry about a rare degenerative disorder instead.

So yes, your experience is not unique, and it also has nothing to do with vaccines.

My daughter's experience has everything to do with vaccines, read more of the posts. The chicken pox vaccine overreplicated in her dysfunctioal immune system, and infected her brain.

There is no other way to explain how the oka strain (vaccine strain) virus entered her cerebral spinal fluid, other than by vaccination of an immune compromised individual with a live virus vaccination.

And it is no coincidence that her facial tics, regression, and stunted growth happened after she had a reaction to this vaccine, including erythema multiforme (rash), high fever, and seizures.

I have one child with Aspergers, one with PDD-NOS. No, I can't see a vaccine link. They were different from day one. Even post-Minamata studies have shown no increase in autism from exposure to methyl or ethylmercury. Instead, you have mercury poisoning, which is a clearly different disease. I also know many more children will have autism if German measles makes a comeback-chance of neurological damage from rubella in the first month of pregnancy is more than 90%.
Vaccines make much less money than all-natural herb supplements. Most drug companies were ready to pull out of the market entirely when the Waxman bill was introduced. I am sorry that compensation is not being given to kids with likely vaccine injuries. Do you think the hordes of Kirby and Wakefield followers are making it easier or harder for them to get compensation?

monica,

I apologize for my insensitive tone. And I do not think that "causing autism is preferable to a delayed vaccination schedule". But I see no reason for thinking that a delayed vaccination schedule would reduce the incidence of autism, and a delayed schedule has risks of its own. I am not familiar with the evidence behind your statement that "too many immune responses in a close proximity throw people into autoimmune disorder." In fact, my reading tells me that a lack of challenge to the immune system is suspected of contributing to autoimmune diseases; it would not surprise me if inoculate babies with carefully selected organisms became policy sometime soonish.

While I doubt your figures on the cost of autism (the 1 in 166 figure counts people with a very wide range of symptoms), I do think a large research program on autism is well-worthwhile. (I am a big fan of scientific research in general). Unfortunately, I am not the average voter. You may be right that such a program comes out "in the black" even with a narrow financial accounting, but I do not think that even that will impress voters much. I hope I am wrong.

BTW, we probably can improve our vaccination schedules. That I do not dispute. (I am actually in a different country, Canada.)

I wish you and your daughter well.

By Andrew Wade (not verified) on 03 Jan 2007 #permalink

You can find statistics of what is paid in "vaccine court" here http://www.hrsa.gov/vaccinecompensation/statistics_report.htm

An average of 75% of the cases presented are dismissed. I don't feel that Kirby or Wakefield have done much to make this more difficult. Parents of children paralyzed by the (no longer in use since 2000) live virus polio vaccine have had similar struggles with vaccine court.

The burden of proof lays on the family. Even doctors have a difficult time grasping the idea that a vaccine can injure, and refuse to test for it.

If my daughter had the proper testing the day of the reaction (the ER ASSURED me that it was NOT vaccine related) they could have started her on a common anti-viral, and she would not have the brain damage she now has.

Doctors are just as blissfully ignorant as the public in thinking vaccine reactions are extremely rare, and rule the possibility out without adequate testing.

Yes, she's been though a lot of nastiness. That, however, does not make her fallacies vanish.

Precisely. Although one can feel sympathy for the parents of autistic children who believe it was vaccines that caused their children's autism, that these parents and their children have suffered does not immunize them from criticism when they start spouting nonsense in the form of antivax canards.

Monica is making a common mistake among parents who mistakenly blame vaccines for their child's autism: Confusing correlation with causation. Autism diagnoses, by the very nature of the disorder, just happen to be made frequently not long after children have received their scheduled vaccinations, making it appear to parents as though vaccines "caused" the autism. That's why we do epidemiological studies, and epidemiological studies have repeatedly failed to find a link between either thimerosal in vaccines and autism or between the MMR and autism. Most recently, a large and well-designed study from Canada failed to find a link between either MMR or thimerosal-containing vaccines and autism.

Several years ago, the hypothesis that thimerosal-containing vaccines and autism or MMR and autism, although implausible scientifically, seemed worth investigating. No well-designed epidemiological study done by reputable scientists since then has shown any link. The only studies that purport to show links are poorly designed hack jobs by people with an ideological or vested interest in promoting a nonexistent link between vaccines and autism--people like Mark and David Geier or Andrew Wakefield, for example.

The hypothesis that either thimerosal in vaccines or MMR contribute to the development in autism has been tested multiple times over the last 8 years with epidemiological studies with enough numbers and power to detect even a fairly weak correlation. No correlation has been found, and, barring some surprising new science, we can say with a great deal of confidence that vaccines do not contribute to autism or ASDs.

Andrew,

Thanks for the linked article on MMR safety studies. It made interesting reading. The authors outline a number of serious problems with the reviews that they analyze, which leads them to conclude that the evidence for the safety of the MMR vaccine is limited. One of the problems they identify is:

"As MMR vaccine is universally recommended, recent studies are constrained by the lack of a non-exposed control group. "

The lack of a suitable control group is a problem with many vaccine safety studies.

The authors follow up their concerns for the lack of safety evidence with the following strange comment (later on the same page, p 3959):

"The safety record of MMR is possibly best attested by its almost universal use and its evaluation cannot be divorced from its effectiveness and the importance of the target diseases."

Combining the authors' concerns about the lack of evidence of MMR vaccine safety with the knowledge that the vaccine adverse event reporting system is essentially unscientific (depending on observations of parents and periodic visits with family doctors, rather than proper systematic observation by medical researchers), it is hard to understand how they could then state that MMR must be safe because it is widely used.

This is a recurring theme in vaccination discussions. We don't really know whether they are a good solution to the problem, but the problem is so serious that we use them anyway. This is not good scientific thinking.

My own view is that we need to drastically improve the procedures for evaluating the safety of vaccines. However, as vaccines become nearly universal, the possibility of performing properly controlled studies diminishes, which may leave the safety of vaccines permanently in doubt.

DrFrank: You might consider reading Andrew's linked article, as it may change your suspicions.

All the best,
Santo

By Santo D'Agostino (not verified) on 03 Jan 2007 #permalink

Showing rigorously at a high confidence level that a vaccine is likely to be safe is never a trivial problem. It is not, however, impossible, as Arthur Allen has discussed in some detail. Even when a vaccine is intended for universal use, it is still possible to find a control group -- though it may require a clinical trial spread across several countries. And even when adverse events are extremely rare, it is still possible to achieve the statistical power to detect them -- though it may be extremely expensive ($800 million for the ROTATEQ trial cited by Allen).
The real problem is not scientific or logistical; it is social and political. Our minds are just not well adapted to balancing the risks of terrible events with tiny probabilities. The National Vaccine Injury Compensation Program works very well to balance the public's interests against those of injury victims, but that is of little comfort to the parent of an injured child. The rest of us need to keep trying to understand the problem and work toward a just solution. In my view, Andrew Wakefield and the Geiers have done nothing but exploit the victims, and that ain't part of the solution.

Maybe many of you will have had to walk in my shoes to understand what I am conveying. My daughter was diagnosed with autism shortly after she had encephalitis from a live virus vaccine.

Encephalitis often mimics autism.

The only reason we have had tests done to find the cause of my daughter's neorological disorder is because I have had to spend many hours researching online.

When a child is diagnosed with autism, doctors do not perform ANY tests to rule out other possibilities.

Yes, my daughter meets the DSM criteria for autism, but she also had a vaccine reaction, one that her doctor still refuses to acknowledge, or report. (that is now an issue for our attorney)

Doctors are labeling everything as "autism" without ruling out other possibilities. What my daughter has is encephalopathy, and the symptoms are vey similar to autism. Hey, if it quacks like a duck...

It is appalling that routine labs and MRIs are not performed when a diagnosis of autism is given. The diagnosis is made soley by observation.

jre,

Thanks for the link.

You say that the real problem is not scientific, but there is a scientific element to the problem that I have mentioned in several comments. Since the adverse event reporting system relies on essentially unsystematic anecdotal evidence, safety statistics (such as the ones quoted in the Slate article you linked to) are unreliable. We need reliable safety studies in order to really know what the dangers are.

I agree with you that these problems need to be better and more widely understood so that study designers can produce good results.

All the best,
Santo

By Santo D'Agostino (not verified) on 03 Jan 2007 #permalink

Surely there must have been other "social forces" at work with regard to those vaccination rates. One person doing so much harm?

QrazyQat: I've noticed that too. I am constantly confronted with ways that could result in me being fantastically wealthy. But, despite my current situation, I decline them. Glad to see others have principles too.

No one else in our household had any illness and she hadn't been exposed to anyone with a viral illness. Where did that pesky viral exposure occur?

How did you determine that she hadn't been exposed to anyone with a viral illness?

Santo D'Agostino,

Since the adverse event reporting system relies on essentially unsystematic anecdotal evidence, safety statistics (such as the ones quoted in the Slate article you linked to) are unreliable.

If they are if they are derived from VAERS or equivalents.
I've done some digging, and to my surprise the figure for the Measles vaccine side-effect given in the article does appear to derive from something like VAERS, and is about five times lower than the actual rate of that side-effect. The reason I know this is because "reliable safety studies" have in fact been done, and I found some:
diopathic thrombocytopenic purpura and MMR vaccine
A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines.

By Andrew Wade (not verified) on 03 Jan 2007 #permalink

I don't know of any medical procedure that doesn't pose SOME risk. (Auscultation? Patient interview? Margaret Wise Brown dropped dead after she did a high leg kick to show her doctor how well she was feeling. The kick dislodged a thrombus, and then her head exploded.)

We can never eliminate risk completely, and we can never predict EVERYTHING that can "go wrong". It is cruel to counter any single tragic instance with statistics, and no consolation at all, but we have no better way of knowing if something is worth doing. Statistics show clear benefit of vaccinations.

But I'm confused about what the whole issue is about now. I thought that originally Monica claimed vaccination had caused her daughter's autism; now it's encephalitis. I suppose the point is that whatever the daughter's condition, it was brought on by vaccination? I can only repeat what I said above... It is beyond dreadful to be the one in the minority of "statistical victims", it is important to see what we can learn from the occurrence, but in the end it is true that nothing will prevent ALL such future events.

This is not exactly on topic, but Santo reminds me irresistibly of HIV denialists, and Jehovah's Witnesses' stand on transfusion, same wording even. I wonder.

Orac writes:

Consider this question: Why does Olmsted immediately jump to the conclusion that it is vaccines that would be responsible for such a difference? It couldn't be, for example, the lifestyle differences or environmental factors? Or what about genetics? The Amish are a highly inbred group, and the latest science strongly suggests that autism is mostly genetic in etiology; the frequency of autism-causing alleles could be much different in the Amish than in the rest of the population.

But, of course, no. It has to be the vaccines, doesn't it? It's always the vaccines with antivaxers like Olmsted. "

Maybe Olmstead is on to something.

Maybe it is lack of vaccines that cause polydactlyism?

By Stuart Weinstein (not verified) on 03 Jan 2007 #permalink

Autism is a neuropsychiatry disorder that impairs a child's ability to communicate and interact with others. The prevalence is about 65 cases per 10,000 people (about 1 child in 155) making autism one of the most common childhood disorders. The Psychiatry Department at The Montreal Children's Hospital sees about 350 new cases of autism each year. However, Dr. Fombonne stresses that there is no demonstrated autism epidemic. He attributes the rise in autism rates to a broader definition of autism and greater awareness of the disorder.
*******
That's from the abstract(?) linked at Orac's writeup on the Canadian study.

And it states what I have wondered about and suspected for a while now.

Does this make sense or is there really some epidemic out there?

Nance

By Nance Confer (not verified) on 03 Jan 2007 #permalink

Sounds like a Sharon or a Wagner post.

monica i read your posts with interest (and a great deal of sympathy)but infants have much more attacks to their immune systems than just 14 in one day ...im assuming you never took microbiology

By brightmoon (not verified) on 03 Jan 2007 #permalink

im in my 50s ..i REMEMBER getting the measles at age 5 (they didnt have a vaccine then )i dont think i'd EVER been that sick before or since .....i basically lined up outside the doctors office before it opened to get my kids that MMR .....they werent gonna get measles

my much much older cousin had had measles when she was a child ......it crippled her ......i'd originally believed that she had had polio until my kids were born then my mom told me - after i'd had my kids vaccinated

i also caught rubella and chicken pox ...chickenpox aint fun either ..my oldest also caught it ...the pox put holes in the soles of his feet ..he wasnt able walk or to go back to school until they healed ..that took about 3 weeks ....

By brightmoon (not verified) on 03 Jan 2007 #permalink

"In fact, my reading tells me that a lack of challenge to the immune system is suspected of contributing to autoimmune diseases; it would not surprise me if inoculate babies with carefully selected organisms became policy sometime soonish."

nah just let'em play in the dirt and stop using those weird antibiotic soaps ...i figured out that too clean wasnt good when my kids were little ....lots of cheap play clothes

Andrew,

Thanks for the links, I will have a look at them later today.

Lola,

No, I am not an HIV denialist, nor am I a JW. (The latter possibility is particularly amusing, since I regularly confront JWs and other religious fanatics with what is by now a finely honed routine. I question them incessantly, with variations on the theme of "How do you know that?")

I simply have an issue with VAERS. It's unscientific, and it needs to be reformed.

All the best,
Santo

By Santo D'Agostino (not verified) on 04 Jan 2007 #permalink

I feel that this "debate" has gone far from conveying the mesaage I was originally intending.

I encourage each of you to have your child immunized, but if you, or your child has a Primary Immunedeficiency, or you suspect that you might, live virus vaccines should NOT be used. This is NOT junk science, this is according to the NIH and the CDC. This is also something most doctors have little knowledge of.

According to the National Institutes of Health (NIH)-
"Children with PI diseases, especially those with defective T cells, X-linked agammaglobulinemia, and ataxia telangiectasia should not receive live virus vaccines, such as the oral polio, measles, and chicken pox (varicella) vaccines. It is not even safe to give live virus vaccines to children suspected of immunodeficiency until a definitive diagnosis is rendered. There is a risk that such vaccines could cause serious illness or even death."

http://www.nichd.nih.gov/publications/pubs/primary_immuno.cfm

My Primary Immunedeficiency had gone undiagnosed for 12 yrs. In a 12 yr span, I was hospitalized, requiring IV antibiotics to clear infections 23 times. I have always had a high white blood cell count. My doctor had me tested for HIV 4 times, saying, he had only seen my rate of infection in HIV patients. When the tests kept coming back negative, he just shrugged his shoulders. I simply thought I had bad medical luck. Had I been properly diagnosed, my daughter would have been spared.

Many Primary Immunedeficiencies go undiagnosed for yrs. Some people do not even have symptoms until adolescence or older (as in my case, I was 21 when my immune system started failing) Most Primary Immunedeficiencies have only recently been discovered, due to extensive reasearch into the immune function in HIV.

According to the Immune Deficiency Foundation, the average time between onset of symptoms of Primary Immune Deficiency, and diagnosis is 9 YEARS.

What I find sad, is that with our current vaccination schedule, many Primary Immunedeficiencies are NOT diagnosed before vaccination with live virus vaccines. If live virus vaccines are given to these individuals, not only can it do harm, but they are often useless, as these individuals cannot usually create antibodies to the viruses in the vaccines.

T H E 1 0 W A R N I N G
S I G N S O F P R I M A R Y
I M M U N O D E F I C I E N C Y *

1. Eight or more new ear infections within a year.

2. Two or more serious sinus infections within a year.

3. Two or more months on antibiotics with little effect.

4. Two or more pneumonias within a year.

5. Failure of an infant to gain weight or grow normally.

6. Recurrent deep abscesses in the skin or organs.

7. Persistent thrush in mouth or on skin, after age one.

8. Need for intravenous antibiotics to clear infections.

9.Two or more deep-seated infections such as meningitis, osteomyelitis, cellulitis, or sepsis.

10. A family history of primary immunodeficiency.

*Courtesy of The Jeffrey Modell Foundation and the American Red Cross.

Please, when you vaccinate your child, be EDUCATED. I wish I had been.

More information on Primary Immune Deficiency can be found at
http://www.primaryimmune.org/
http://www.jmfworld.org/
http://www.usidnet.org

Andrew,

I have now looked at the first study to which you linked. It is interesting, but there are a few comments: 1. It is funded by vaccine manufacturers; 2. It looks at only one possible illness, and so one cannot conclude that the vaccine is safe based on this study.

When I clicked on your second link an error message resulted, so I was not able to read the paper you intended to link to.

Wishing you all the best,
Santo

By Santo D'Agostino (not verified) on 04 Jan 2007 #permalink

Santo D'Agostino,

I have now looked at the first study to which you linked. It is interesting, but there are a few comments: 1. It is funded by vaccine manufacturers;

Yup. There's a conflict of interest there. Without increased public funding there's not much that can be done about that.

2. It looks at only one possible illness, and so one cannot conclude that the vaccine is safe based on this study.

Sure. But there are other studies for other side effects. They complement VAERS, which is useful for finding rare side-effects, but not very useful when it comes to determining how common they are. Whereas narrow studies such as this one are not useful for finding side-effects, but are good at measuring their frequencies once suspected.
I'm not entirely sure what sort of reforms you're advocating. Clinical trials (with controls) are already commonplace; they're just not very good at finding very rare side-effects.

When I clicked on your second link an error message resulted, so I was not able to read the paper you intended to link to.

Sorry, Pubmed is being difficult. This link should work. But only the abstract is available; it looks much like the other study I linked to.

By Andrew Wade (not verified) on 04 Jan 2007 #permalink

Andrew,

The second link did indeed work.

What I suggest is something along the lines of "active surveillance" as recommended in the last sentence of the second linked paper's abstract. Relying on parents to call up their family doctors when there are signs of problems, at which point the doctors often say "That's normal, don't worry." is clearly inadequate and the resulting data is not scientifically valid. We need trained medical researchers monitoring the babies and infants, not untrained parents and overworked family doctors.

The problem is that many vaccines have been pushed on the public before safety and efficacy data are available. Where I live, in Ontario, Canada, flu vaccines have been heavily advertised as absolutely essential, as well as safe and effective. However, hard results backing up the claims are lacking.

All the best,
Santo

By Santo D'Agostino (not verified) on 04 Jan 2007 #permalink

Sweet Merciful Non-Existent Deity! Someone get the triclosan, this 'uns gonna need a month of scrubbing to get the woo-stank out.

Santo -
What flu vaccine do you believe has been "heavily advertised as absolutely essential, as well as safe and effective" while "hard results backing up the claims are lacking"?
To the best of my knowledge, both Health Canada and the US FDA require clinical evidence of safety before any vaccine is approved for use by the public. For background on the US clinical trial system, look here.

I have 2 unvaccinated children, aged 11 and 13, so I've read this
thread with a good deal of interest. For the first two years of
college I was in the pre-med track with the idea of becoming
veterinarian; I know that the earth revolves around the sun, why the
sky is blue, and that single-celled organisms are the `oldest' and
most genetically varied.

And, people, if your goal is to all congratulate yourselves on how
much more clever you are than all those stupid ignorant women who just
so stubbornly refuse to bow to the great white god medicine to get
their kids vaccinated, congratulations. If, on the other hand, you'd
actually like to convince parents to take the risk of vaccinating
their children, the overall tone leaves something to be desired.
Monica is to be congratulated for persisting in spite of the
nastiness, even if some of her cites are flawed.

But you know what? I have yet to find a website anywhere that spells
out in plain language and clear statistics (say, # per 100,000
children) the risks, the uptake, and the benefits of each vaccine. As for
long term risks, like increased likelihood of asthma or allergies?
Forget it, as Santo D'Agostino has noted, those studies haven't been
done.

I'm getting really tired of the old argument that the average person
(read ignorant woman in this case, of course) is too dumb to look at
charts and decide, `ok. There's a 1 in a 100,000 chance my child
could become a vegetable from this vaccine, but a 1 in a thousand
chance she could catch the disease, and a 1 in 10,000 chance the
disease could kill. Oh, and 1 in 100 chance that the vaccine won't work. And, and by the way, because it's a matter of public policy, and too much of a political hot potato, we haven't funded the studies to determine what long-term ill effects the vaccines have. Hm. Guess the kid gets the needle.'

No, I'm just supposed to take your word for it. Lots of folks on the
seed websites and other science blogs have taken endless amounts of
trouble to explain evolution and debunk ID at all levels of sophistication, but so far as vaccines are concerned, we're supposed
to take the word of the CDC and their inpenetrable gobbledegook that
the risks aren't worth worrying about---when in fact there are real
risks. Throw in the condescending and misogynistic slurs against
moms, and yeah, you've made a real persuasive case, guys.

I initially decided not to vaccinate because home birth and
breastfeeding, promulgated by the lay midwife who saved me from a
cesearean---no hospital would've let my kid fart around for 12 nights
being born, but that's exactly what she did--which provided clearly
superior outcomes for mother and child than hospital birth and bottle-feeding would've. So when she advocated for skipping vaccination, and gave me some books on the subject--the most convincing written by a parent who struggled through hundreds of medical journal articles, I made the best judgement I could.

I've struggled with that decision for a decade, before finally making
the decision to take them in for their shots. Wanna know what finally
convinced me? The cervical cancer vaccine. Our dear government can
hardly be bothered to advance the cause of a immunisation that mostly
protects teenaged girls from the consequences of pre-marital sex, and
this side-effect is so unpopular I concluded the benefits must
actually be on the up and up.

But there's more than a bit of holding my nose and jumping into the
unknown: I presume and hope that the risks will be lower with the
shots. I *hope*. A little politeness and whole lotta clear and
collated numbers would be a help in upping those numbers.

That's my .02.

By woodland sunflower (not verified) on 06 Jan 2007 #permalink

woodland sunflower said: "But you know what? I have yet to find a website anywhere that spells out in plain language and clear statistics (say, # per 100,000 children) the risks, the uptake, and the benefits of each vaccine. "

For your reading pleasure:
http://www.metrokc.gov/health/immunization/compare.htm

I believe the main point of this blog posting is that some of the information many parents were basing their immunization decisions on was a flat our lie. A lawyer paid an unscrupulous doctor to cook up some research to support what turned out to be a failed lawsuit.

You do understand the whole MMR scare was based on a lie? Because of that lie a child died, and some more have been disabled with blindness? How am I supposed to be polite about those facts? How can I not be apalled by the lies that has caused unnecesary suffering? Or the fact that the mumps epidemic that hit universities and colleges in the UK is being imported to the USA? Or that one young lady in Indiana was the cause of over 30 other people getting measles (with at least a couple being hospitalized).

All because a lawyer paid Wakefield for specific "research" results, and even provided the test subjects.

There is more:

http://www.guardian.co.uk/medicine/story/0,,1983942,00.html ...
Begin Quote
The doctor who sparked the controversy over the safety of the MMR vaccine has dropped a two-year libel action against Channel 4, a fortnight after a high court judge ordered the disclosure of confidential documents to his opponents.
Andrew Wakefield sued Channel 4, 20-20 Productions, and reporter Brian Deer over a November 2004 Dispatches programme MMR: What They Didn't Tell You.

Lawyers estimate that the Medical Protection Society, the doctors' defence body which funded the libel claim, faces a legal bill of more than £500,000 for its own and the other side's costs of the case, which was due to go to trial next October......
End Quote

But you know what? I have yet to find a website anywhere that spells out in plain language and clear statistics (say, # per 100,000
children) the risks, the uptake, and the benefits of each vaccine. As for long term risks, like increased likelihood of asthma or allergies?

Isn't the risk comparison really different than this, though? In the absence of any vaccine .... in a world in which vaccination was never invented but everything else is the same ... wouldn't various infectious diseases be the main cause of death? Wouldn't a child's chance of getting a fatal illness that kills the child before adolescence be enormously high?

I remember my daughter's pediatrician once making this remark: "I'm a pediatrician. That means I don't deal with really sick people." She meant (as she went on to explain) that kids in modern western society, relative to other groups of people (other age groups, etc.), just don't get that sick that often compared to the "good old days."

So making the comparison of what one child faces in terms of risk with or without vaccination for a particular disease is only part of the story. Those few who choose to not vaccinate are, in a sense, freeloading on those who do. Or do I have this completely wrong?

In a country as advanced as ours, it is appalling that we only have the 36th lowest infant mortality rate.

The reason for this is the US's appalling lack of universal health care. An embarrassment for the whole world. Look at the other 35...

In no time in history has a baby had to build as many immune responses as one does today. Too many immune responses in a close proximity throw people into autoimmune disorder.

Incorrect. There are indeed vaccines that can cause autoimmune diseases -- but that's because those particular vaccines are similar (on the molecular level) to some of your own proteins. For the same reason there are also infections that can cause autoimmune diseases. I study molecular biology, I've had my head filled up with far more immunology than I was ever interested in; I can't think of a reason why "too many immune responses in [...] close proximity" could cause autoimmune reactions.

On another note: Peanut Gallery, don't you notice your comment is entirely off-topic in this thread? Maybe read the original post again and then tell me what it has to do with religion.

By David Marjanović (not verified) on 02 Jan 2007 #permalink

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By Mike John (not verified) on 16 Dec 2009 #permalink