survey

Quackery

Children's Medical Safety Research Institute

Anthony Mawson

antivaccine

https://leftbrainrightbrain.co.uk/2014/01/22/a-vaccinated-vs-unvaccinat…

Categories

Physical Sciences

Hi Orac:

In a recent post, you cited the "thoughtscapism" blog article on "vax-unvax" studies.

Orac sattes: " it is a myth that there are no studies comparing the health of vaccinated children compared to unvaccinated children. In fact, there have been several. It turns out that they don’t show what antivaxers think a vaxed/unvaxed study will show. Basically, all of the vaxed/unvaxed studies not done by antivaccine-friendly scientists or quacks have shown either no differences in the prevalence of neurodevelopmental or chronic diseases between vaccinated children and unvaccinated children"

The studies cited did not actually look at neurodevelopmental or chronic disease outcomes (except for asthma and allergies). No vax-unvax study has ever looked at utism ADHD etc. All the alleged vax-unvax studies have severe problems that render the results irrelevant to the CDC vaccine schedule and how vaccines are used today.

The studies you cite are debunked here: http://vaccinepapers.org/alleged-vax-unvaxed-debunked/

Go look. Its clear these vax-unvax studies are not as you describe.

I've seen your "rebuttal" before and laughed. Part of the reason is that, yes, such studies have problems, but for some reason you seem to think the Mawson study as having "strengths and weaknesses" (as you put it in the comments) when in fact it has zero strengths that I've been able to find and glaring weaknesses that make it so bad that it's basically useful for nothing more than lining a bird cage. As for bias, you seem oblivious to the bias in the Mawson study. As for the third study, I like Matt Carey's take on it:

And then:

http://scienceblogs.com/insolence/2016/10/21/are-unvaccinated-children-…

You see healthy user bias everywhere, whether it actually exists or not. :-)

hi Orac

The Mawson study has a few strengths that make it unique:
1) comparing fully vaccinated with zero-vaccine groups. And by fully vaccinated, I mean the US CDC schedule. Not a wimpy schedule with just a few vaccines. There is a large difference in vaccine exposure in the compared groups. None of the vax-unvax studies you cite (via the thoughtscapism blog) do this.

2) Looking at a variety of long term neurodevelopmental and immune outcomes. None of the thoughtscapism-cited studies do this either.

3) Good matching on socioeconomic status and income. The Bloom (Philippines) study is terrible in this regard. That all subjects were homeschooled adds to the matching.

4) The substantial size of the study. 666 subjects isnt too shabby. The KIGGS study had only 50 subjects with zero vaccines age 6+. The bloom study had only 85 fully vaccinated subjects.

Of course I agree there are weaknesses, like the fact is a survey and that parents were not interviewed. But I you have not explained in detail why this is such a fatal problem. All studies have weaknesses and I just dont see how the survey issue is a big enough problem to make it as terrible as you say. You are overreacting.

Healthy user bias IS everywhere in vaccine world. HUB explains why observational (i.e. nonrandomized) vaccine safety studies consistently fail to detect adverse outcomes.

Did you see this new result with the DTP vaccine? 5X higher mortality Orac. And it was a great study with randomization.

http://vaccinepapers.org/high-mortality-dtp-vaccine/

HUB also explains why all the MMR-autism study results are wrong. Its a systematic source of bias that affects MMR studies particularly strongly. Thats because infants injured by the first 6 months of vaccines dont getr MMR. The parents stop vaccinating after their terrible experience. These vaccine-injured children are used as controls in the MMR studies.

OOOOOPS!

"...we can be pretty sure that history repeats itself and when medical history textbooks are rewritten a long time from now, there will be names of medical heroes like Semelweiss in there, people who challenged orthodoxy and went where no one wanted to go."

I can be even more sure that medical history texts of the future will not be loaded with fulsome praise of John Brinkley (who implanted goat testes into men to improve their virility), or the people who challenged "orthodoxy" by doing wholesale lobotomies for mental illness, or the antivax quacks like Mark Geier who've inflicted chemical castration drugs on autistic boys.

"Orthodoxy" (a.k.a. evidence-based medical practice) of the future is extremely unlikely to remember Mawson and his cheerleaders kindly.

Silly Gnat.

You say 'silly', but downright disgusting is more like it.

Check out this new comment on his blog -
http://www.autisminvestigated.com/new-american-measles/#comment-275013

I'm pretty sure we have a darn good example of Jake's editing here - as in editing a comment to say something the poster never said, or ever thought.

WTF? Thanks for bringing that to my attention Johnny. What a shitweasel Jake Crosby has become.

There have also been at least three studies that addresssed neurodevelopmental issues and vaccination rates. They found no difference.

A. A relatively small study looked at rates of ASD among vaccinated and unvaccinated siblings.
http://www.ncbi.nlm.nih.gov/pubmed/23045216

B. Smith and Woods looked at on schedule vaccination in the first year and neurodevelopmental outcomes.
http://pediatrics.aappublications.org/content/125/6/1134.abstract

Destefano looked at rates and ASD.
http://jpeds.com/webfiles/images/journals/ympd/JPEDSDeStefano.pdf

The recent meta analysis also looked at vaccines.

https://www.ncbi.nlm.nih.gov/m/pubmed/24814559/

None are perfect, but there is data on that, and it will take more than a fatally flawed study to counter that.

I'm still trying to figure out the hypothesis. Unless the claim is that even one vaccine somehow does something irreversible besides generate immunity, what's the supposed difference between vaccinated and unvaccinated children?

I'm getting bored with the zombie metaphor, so I came up with one of my own.

Anti-vaccine studies are like a clown car act, where the clowns trip around trying to get the car restarted. All cheer when the car rattles off, but the car still runs into the scenery as it putters away.

While I like the imagery of a clown car to describe an antivaccine study (and indeed have referred to antivaccine blogs as "clown cars" in the past), I'm having trouble visualizing how this metaphor works... :-)

@Christine: The thing about clown cars is that they usually contain several more clowns than you would expect to fit in a car that size. Which, come to think of it, works as a metaphor for the anti-vax crowd.

Orac writes,

It looks as though the check has finally cleared.

MJD says,

An "open access" journal publication is simply a means of getting information into the public domain.

For some, it's not about "ego".........it's about connection.

I've been there (i.e., pay to publish) and would like to connect again if I had something to share that was worth the effort and expense.

Open Access Publication = Sharing is caring

@Eric Lund: I think it actually works literally rather than a metaphor. They ARE a bunch of clowns and there are always more of them than one might think possible.

I think it is time for us to develop our own bottom feeding science journal. We could call the journal, JUICES: Journal of Unreliable, Irresponsible, Crazy, Ethereal Studies.

If I don't comment again today or tomorrow morning, my next comments will be from Chiang Mia, Thailand.

So, the VP troll above thinks this is a legitimate study, even though no attempt was made to actually confirm any of the survey answers?

It's selection bias at its worst.

3) Good matching on socioeconomic status and income. The Bloom (Philippines) study is terrible in this regard. That all subjects were homeschooled adds to the matching.

It doesn't "add" to the matching, it reduced the external validity.

4) The substantial size of the study. 666 subjects isnt too shabby. The KIGGS study had only 50 subjects with zero vaccines age 6+. The bloom study had only 85 fully vaccinated subjects.

Is "not to shabby" scientific vernacular? Cough*sample power*effect measure*cough.

Of course I agree there are weaknesses, like the fact is a survey and that parents were not interviewed. But I you have not explained in detail why this is such a fatal problem.

The fact that you can't see how a survey, with the type of questions asked and no verification, is problematic emphasises why you have no credibility critiquing anything. Your bias is very obvious.

A survey, at best, can only be the least effective, least accurate kind of study. One that is internet based allowing no way to verify anything takes the 'least' status to zero.

To start digging, you then get it retracted from a crappy journal, then reopened (when the check clears?).

It "isn't too shabby," because the "survey" has conclusions that he agrees with.

Exactly.

Thanks for bringing that to my attention Johnny.

Well, take a look at this - http://www.autisminvestigated.com/vaccinated-unvaccinated/#comment-2750…

Again, nobody that knows you thinks it's really your words.

It makes sense, really. Jake can't go with science, because he knows there isn't any that supports his position. He can't hang where free comments are allowed, because he's a gutless wimp who can't handle the meanies who tell him the truth. He can't turn to friends, because he's pissed off all the other AV communities so he doesn't have any (well, he has Hans and Rose, but I have no evidence they aren't socks). All he can do is stay in his safe space, and when something comes his way that shatters his little bubble, he has to defuse it the only way he knows how.

@Johnny and Science Mom: That's exactly why, if I bother to post on Jake's blog, I make sure I cross post the comment here. So that it can't be toyed with. AND...if there's a comment over there that *isn't* cross-posted here, then it's not from me, it is a sock. (Though, TBH, I can't be bothered to check out Jake's blog on any regular basis, because his writing is terrible.)

@Fake Science Mom, Does the gnat think he can draw blood with this (mis)appropriation of your nym? His readership won't know and their numbers must be frightfully small to make this sort of idiocy seem reasonable.

That comment and the others have a distinct whiff of a recently departed sock from here. Perhaps Jake can find the stones to clarify and remove those comments if he wasn't the perpetrator. Not holding my breath though.

I admit I hadn't considered that they were flat out sock-puppet entries. Knowing that Jake edits comments, I figured that was the case here. I wouldn't put it past He Who I Will Not Name As Long As He Doesn't Post Here, and I agree that Jake will probably be disinclined to do anything about it. I'd even go so far as to say that it probably brings a big grin to his face.

@MJD:

An “open access” journal publication is simply a means of getting DISinformation into the public domain.

FTFY.

666 subjects isnt too shabby.

I missed this the first time around, but does the Mawson et al. survey really have 666 subjects? That number would be somewhat ironic, given the likely religious orientation of many of the participants.

And just to emphasize the point: Having larger numbers helps reduce the statistical errors in your result. The relative statistical error is proportional to 1/sqrt(N). But it does nothing to help your systematic errors. If your survey methodology is designed to prove your point, your results will be just as bad with N=20,000 as with N=20. Garbage in, garbage out.

So, the VP troll above thinks this is a legitimate study, even though no attempt was made to actually confirm any of the survey answers?

A survey in which anyone could participate (nothing restricting it to parents who had been sent invitations), and which had been announced on antivax forums well ahead of time.

I am sure this low life was just performing a study on how to change behavior in teenage girls:

In May 2017 the Chiropractic Commission charged chiropractor Derek Hayden (CH00034208) with unprofessional conduct. Charges say Hayden had a sexual relationship with a teenage patient he had been treating since she was 9-years-old. The patient allegedly lived in Hayden’s home for more than a year. Charges say the goal was to correct the patient’s behavioral problems, but Hayden lacked a license as a counselor or any other kind of mental health professional. Hayden allegedly gave her signature authority to one of his bank accounts. Hayden allegedly didn’t keep adequate records of his treatment of the patient.

Mawson's other OAText paper also de-retracted. The one on prematurity, with the eyebrow-raising report that premature birth, in the absence of vaccination, is *not* a risk factor for neurological problems.

Mawson’s other OAText paper also de-retracted. The one on prematurity, with the eyebrow-raising report that premature birth, in the absence of vaccination, is *not* a risk factor for neurological problems.

And with author affiliations still wrong.

This really does have shades of the grifters at OAText finding a way to improve their personal liquidity.

I admit I hadn’t considered that they were flat out sock-puppet entries.

My immediate reaction was that this was Travis. Jake doesn't use language like that. When he edits my comments, he does so by taking some stuff out so he doesn't have to respond to it, not completely changing the wording. Or in Becky's case, he renames her as Brian Deer.

Oh yes, the PDF has not changed; it is still date-stamped "28th April". And its temporary disappearance is not explained by the rationale offered by CMSRI for the disappearance of the vaccine / non-vaccine paper ("the editors took it down while they investigated the retraction of its earlier version in Frontiers"). Leaving us with the "ransom demand" explanation.

The Mawson study has a few strengths that make it unique:

I am laughing so hard that the tears are dropping on to the keyboard.

The Mawson study has exactly 0 strengths (actually come to think of it, there might even be negative strengths). This lack of strengths start with the way the data was gathered: by internet survey that anyone could fill in, targeted at an unrepresentative group of the population but that anyone could fill in, promoted widely among the anti-vaccine groups, where participants were encouraged to recruit other participants, and where reporting of vaccination and health conditions was completely unverified.

There is an old statistics saying, more recently co-opted by people in computers, that goes: Garbage in, garbage out. The data for the Mawson papers was garbage of the lowest order - so putrid that no one else would touch it.

Here we have the council do hard rubbish pick ups, where you put out all your large pieces of rubbish to be collected. There is a thriving scavenger business where people go and search through other people's rubbish for metal, bits of furniture that might still work and other gems before the council picks it up. Many of the piles of hard rubbish decrease significantly in size before the pick up, but not ours. It seems we put out true junk* for collection. Mawson's data set reminds me of our junk.

*We have another old saying that goes: Stuff is the junk you keep and junk is the stuff you throw away. My wife accuses me of failing to properly distinguish between junk and stuff.

If there is such a difference in ascertainment (ascertainment bias), then why does the unvaccinated group have far higher rates of vaccine-preventable diseases?

If the respondents are lying, then again why did they report such high levels of vax-preventable diseases?

So the argument here is that the respondents just made everything up?

Thats it?

Sounds like a conspiracy theory to me.

Why are these not strengths?

These characteristics are objectively better than the KIGGS and 2 other alleged vax-unvax studies cited by Orac.

1) comparing fully vaccinated with zero-vaccine groups. And by fully vaccinated, I mean the US CDC schedule. Not a wimpy schedule with just a few vaccines. There is a large difference in vaccine exposure in the compared groups. None of the vax-unvax studies you cite (via the thoughtscapism blog) do this.

2) Looking at a variety of long term neurodevelopmental and immune outcomes. None of the thoughtscapism-cited studies do this either.

3) Good matching on socioeconomic status and income. The Bloom (Philippines) study is terrible in this regard. That all subjects were homeschooled adds to the matching.

4) The substantial size of the study. 666 subjects isnt too shabby. The KIGGS study had only 50 subjects with zero vaccines age 6+. The bloom study had only 85 fully vaccinated subjects.

ANY survey is objectively worthless as a scientific study. A survey previously advertised in the antivax swamp, where every brain-dead denizen thereof was encouraged to respond to it and lie their a$$es off--yeah, that's a strength.

I've encountered imbeciles online before--but you're the godd@mn ultimate.

Vaccine Papers, epidemiology, how much? For that matter, who were the epidemiology-trained researchers in that survey? (To call it a cross-sectional study is like calling your site an informational website.)

I've judged better 3rd grade science fair projects than the unverifiable nonsense of Mawson. A quick search on Facebook for when Mawson oh-so-unscientifically trolled for his survey participants shows posts like this from 2012 ( http://tinyurl.com/kcqwgky ) where a home school group soliciting participants notes:

No information is requested that could personally identify anyone. We are requesting only state and zip code of residence. Responses to the online questionnaire are dumped anonymously into a database from which no individual can be personally identified.

So, no way to monitor that no one is spiking the responses with fake answers, and no way to verify the reliability of what was submitted. No conclusions can be drawn from Mawson's nonsense when there are no means to verify the authenticity and reliability of responses. His work has all the validity of a Facebook poll.

In the 'Comparison; paper:

A search of VAERS for “Cases where age is under 1 and onset interval is 0 or 1 or 2 or 3 or 4 or 5 or 6 or 7 days and Symptom is otitis media” [63]

Note that Ref. 63 is not to the VAERS database, but to the NVIC version of it, the one that facilitates dumpster-diving by bypassing the 'data quality' caveats.

2) Looking at a variety of long term neurodevelopmental and immune outcomes. None of the thoughtscapism-cited studies do this either.

Some would call that "p-hacking". Or "fishing expedition". Not normally regarded as a 'strength'.

Is “not to shabby” scientific vernacular? Cough*sample power*effect measure*cough.

VP has previously demonstrated his grasp of these concepts by using a sample-size calculator to assert that if there were not 98% an ASD risk due to vaccines (leading to N = 2000 or something similar), the jig was up.

"So, no way to monitor that no one is spiking the responses with fake answers, and no way to verify the reliability of what was submitted. No conclusions can be drawn from Mawson’s nonsense when there are no means to verify the authenticity and reliability of responses. His work has all the validity of a Facebook poll."

This is a reasonable criticism and definite weakness of the study. But does it rise to the level of justifying complete dismissal of the results?

I tend to not think so, because I dont think that hundreds of people will make up nonsense to spike a survey like this. This is some research on this issue (human behavior in survey research). From what I have read, people generally dont act this way.

A strength of the study is the large difference in vaccine exposure in the compared groups. It was FULL vs ZERO vaccination.

no other study has such a large differential in exposure. I think thats valuable.

by comparison, the Smith/Woods study often cited by vaccine promoters compared groups receiving:

10.1 vs 11.8 vaccines
7.4 vs 11.8 vaccines

its not reasonable to expect this small exposure differential will create observable effects.

Also, we dont know the dose-response curve for vaccines and adverse outcomes. For all we know, the dose-response may be relatively flat in the 7-12 vaccine range.

"VP has previously demonstrated his grasp of these concepts by using a sample-size calculator to assert that if there were not 98% an ASD risk due to vaccines (leading to N = 2000 or something similar), the jig was up."

You are referring to my analysis of the Gadad study. Please explain why I am wrong.

With an assumed 2% autism rate from vaccines, and dichotomous endpoint (autism Y or N), and conventional alpha 0.05 and 80% power, 387 monkeys per group would be needed, or 774 total. Its basic biostatistics.

http://vaccinepapers.org/gadad-et-al-2015-pnas-journal/

Hello gang,

Just a quick note to tell that if my comments in the last few weeks sounded depressive, that's because it dawned on me that I am. I along with my cousin have been taking... scratch that... trying to take care of a soon to be 44 years old brother who's aspie, with SMH issues, 2nd grade high school and the hyperactivity of 10 cheetah at a bare minimum.

The good part of this period of the year is that I'll be scheduled for an interview with professor Erin Barker of Concordia university for a job in her lab. She, incidentally, studies parenting stress for parents of autistic child and/or SMH issues.

Alain

If there is such a difference in ascertainment (ascertainment bias), then why does the unvaccinated group have far higher rates of vaccine-preventable diseases?

If the respondents are lying, then again why did they report such high levels of vax-preventable diseases?

So the argument here is that the respondents just made everything up?

Thats it?

Sounds like a conspiracy theory to me.

Let me put this in words of one syllable or less for you.

"There is no way of verifying that any of the data provided was correct"

Analysing junk gibes you junk with a 100% probability.

I am sorry that there are a few long words in there, but checking the meaning of words - even the short ones - with a dictionary is sure to help you understand them.

hi Orac:

Will you be writing any more articles about aluminum adjuvant? It seems you covered the Al adjuvant issue lightly in part of a post a few years ago, focusing on the ecological study by Shaw. I have not seen you address the experimental results, or new papers showing that Al is more toxic than previously believed (e.g. showing harm to animals at 3.4 mg/kg/day, a vaccine-relevant dosage).

An important new paper was published on Al adjuvant toxicity, described here:

http://vaccinepapers.org/al-adjuvant-causes-brain-inflammation-behavior…

I encourage you to write about the new reports on aluminum adjuvant.

[D]oes it rise to the level of justifying complete dismissal of the results?

I tend to not think so, because I don't think that hundreds of people will make up nonsense to spike a survey like this.

Thank you Vaccine Papers. You've just confirmed your ignorance. In a sample size as small as the one in this, you don't need "hundreds of people" to submit fake answers to skew the results. 34 would be enough to do it.
One last thing. How do we know that Mawson didn't cherry pick the answers?

Why are these not strengths?

Here let me help you.

1) comparing fully vaccinated with zero-vaccine groups. And by fully vaccinated, I mean the US CDC schedule. Not a wimpy schedule with just a few vaccines. There is a large difference in vaccine exposure in the compared groups. None of the vax-unvax studies you cite (via the thoughtscapism blog) do this.

There is no way of verifying that the "unvaccinated" group had received no vaccinations or that the "vaccinated" group had received any or all of the vaccinations mentioned.

2) Looking at a variety of long term neurodevelopmental and immune outcomes. None of the thoughtscapism-cited studies do this either.

There is no way of verifying that any of the children involved had, or did not have, any of the neurodevelepment and immune outcomes mentioned.

3) Good matching on socioeconomic status and income. The Bloom (Philippines) study is terrible in this regard. That all subjects were homeschooled adds to the matching.

There is no way of verifying that any of the socioeconomic status data were correct.

4) The substantial size of the study. 666 subjects isnt too shabby. The KIGGS study had only 50 subjects with zero vaccines age 6+. The bloom study had only 85 fully vaccinated subjects.

There is no way of verifying that all of the children in the study were homeschooled or lived in the four states mentioned. Indeed there was no way of verifying that these children actually existed.

Always happy to help.

ok fair enough. Since Mawson cannot prove these things didnt happen, reasonable people can disagree. I think its unlikely that the results were spiked, but thats merely an opinion based on subjective information. I think its likely that vaccines cause the adverse effects Mawson reported (in view of other science).

Are there any other vax-unvax studies I dont know about? And by vax-unvax, I mean zero vs substantial vaccine exposure comparison. Not necessarily the full schedule, but preferably pretty close, and including several aluminumn-containing vaccines. The current CDC schedule has 11 Al adjuvanted vaccines in the first 6 months, and 16 vaccines up to 2 years.

Analysing junk gives you junk with a 100% probability.

There has to be a pony in there somewhere!

Anyone that has researched enough (and isn't a paid shill), know that unvaccinated kids are healthier than vaccinated kids. It's obvious. How do I know that we are winning this argument? This used to be one of the only places that you could go to read about the topic on an ongoing basis... Now, it's everywhere! You are losing and will be seen as frauds and morons for years to come. Congrats!

VP: "I think its unlikely that the results were spiked..."
Based on what? Internet polls are notoriously inaccurate.

Real studies find no vaccine/autism link. Money would be WAY better spent actually looking for and at the real causes, not beating this dead horse.

This used to be one of the only places that you could go to read about the topic on an ongoing basis… Now, it’s everywhere!

That's because years ago, most people were unaware of the existence of your mentally diseased little cult. I would mention the existence of antivaxers to people and they would be either horrified or disbelieving. It is difficult to believe that such a cabal of evil miscreants could exist, but you do, and now that the light of publicity has started shining on you, you're scurrying like the roaches you are to escape it.

I don’t think that hundreds of people will make up nonsense to spike a survey like this.
In other news, when P.Z. Myers invites his readers to crash an on-line poll, the results are still plausible.

How do we know that Mawson didn’t cherry pick the answers?
I am confident that Prof. Mawson is treating his data honestly and with integrity. The problem is just that the data are crap.

Well, then you clearly don't get how life works when it comes to other open-ended polling activities like the TV show American Idol where fans can vote multiple times for their favorite performer--and do all the time.

And go onto Facebook and search "Vaccination Status and Health Outcomes among Homeschool Children" and look at where it popped up back in 2012 when the survey was available to anyone who had the link. That link shows up on all kinds of anti-vaccine web sites and Facebook pages with open solicitations for people to go fill it out. If you don't think AVers didn't swarm all over that like flies on dog poop, then I've got some ocean front property here in Arizona I'd like to sell you.

No. Sorry. From Square One, Mawson's 1st grade science fair project was fatally flawed.

"Woe to you, oh Earth and sea, for the Devil sends the Beast with wrath
Because he knows the time is short
Let him who hath understanding reckon the number of the Beast
For it is a human number, its number is six hundred and sixty six..."

Sorry, couldn't help myself, given the number of participants...

And to discussion at hand. @VP

I tend to not think so, because I dont think that hundreds of people will make up nonsense to spike a survey like this. This is some research on this issue (human behavior in survey research). From what I have read, people generally dont act this way.

Looking at the topic of the poll - would you agree that many people feel very strongly about the issue? I think we can agree on this point. Some, the community here would eve say most, of the people on the anti-vaccine side held rather radical beliefs, up to the government conspiracy and oppression. Even in this very discussion we have Joe, who accused everyone who does not think that unvaccinated children are obviously healther of being a shill.

Can you with any degree of certainty say, that among people who hold such strong opinions and who very much would like a study that proves them right, there are none who would falesly report in an internet poll or report multiple times?

Hell, we don't even need ideologically motivated sabotage - a bunch of trolls filling the poll for s**ts and giggles would render the whole thing worthless.

I don't understand a lot of science. But even a layman such as me can see how using only reliable data is the paramount. You wouldn't want engineers desiging next boeing to take measurements "by the eye". Or you would, if you are misantrophic enough and don't travel by plane. But I'd like to believe you wouldn't.

Anyone that has researched enough (and isn’t a paid shill), know that unvaccinated kids are healthier than vaccinated kids. It’s obvious.

Supporting evidence required. And no, the remainder of your comment is not good enough.

@Julian Frost: well, if Joe wants to believe that, then I have to wonder what my fully vaccinated AND UTD kids would have been like if we hadn't vaccinated them? Super people? They are healthy, confident, employed adults. As children, yes, they had colds, chicken pox (unfortunately the year before the vaccine was approved), GI bugs and other things we don't vaccinate against. Frequent ear infections as infants because of lousy genetics until they grew old enough for their eustachian tubes to be longer (can't blame vaccines - both my husband and his mother had the same thing at the same ages, and very different vaccine schedules).

IOW...Joe is full of it. And he insults all the very intelligent Joes I know who are also fully UTD with vaccines because I nag. :)

ok fair enough. Since Mawson cannot prove these things didnt happen, reasonable people can disagree.

In the real world, reasonable people with any limited level of expertise take one look at Mawson's pair of papers and recognise them as the junk they are. Based entirely on the methodology, but there are many other clear signs elsewhere in the papers - not forgetting the fact that they were published in the most predatory of predatory open access journals. There is nothing going for these two pieces of work.

Unreasonable people make excuses for Mawson and invent fairy tales where people with a vested interest are always completely truthful on anonymous internet surveys. The fact that you are spending so much effort making excuses for this study shows that you are completely anti-vaccine and stoop to cherry pick the the most massive colossal junk in order to support your precious pre-conceived notions.

This is the sort of thing that pretend scientists do.

VP: "The substantial size of the study. 666 subjects isnt too shabby."

It's...the Mark of the Beast! We've gone well beyond paid shills when antivaxers invoke dark powers like this.

Now if _this_ comment also goes into automatic moderation, I will know what evil force is behind it.

Yep. The only explanation for going on automatic moderation status is that Satan has assumed the body of Orac, or a troll was posting under my username/e-mail, or...could there be another dark reason?

I await the decision of the court.

A certain trolling sock puppet generator impersonated a number of regulars, and I was forced to put them into my automatic moderation filter. I've also done this with every new commenter for the last month or so, which is unfortunate but really helped me contain the problem. (One of his tactics was to start as a new commenter making a couple of reasonable comments and then going full nutjob after being out of automatic moderation.) These measures seem to have worked. It's been a while since our troll has made an appearance (at least as far as I can tell); so I might be able to start releasing the regulars. However, I've been very, very cautious because I've been burned before, prematurely thinking he had given up and gone away.

@ VP #49: If you want reliable data on a topic like this, you need medical records. You need documentation. You see, the problem is many "unvaccinated" kids got at least one vaccine, and many vaccinated kids either didn't get them on time, or are missing a few doses not because of any BSC AV nonsense, but because some parents just don't get it done when they should. You have to control for those confounding factors, and Mawson couldn't do that with the survey because he didn't verify anything.

Even if he treated his data with integrity, as HDB suggests (not sure if he's being satirical or not), if the data is crap, the results are crap. Garbage in garbage out as someone else noted.

"I think its unlikely that the results were spiked, but thats merely an opinion based on subjective information."

And that's why your thoughts on this are garbage. You are way too credulous for a scientific discussion.

Shifting the goal posts to aluminum isn't helping your case. There have been a number of well constructed studies. They've been discussed here many times. You are being disingenuous.

“VP has previously demonstrated his grasp of these concepts by using a sample-size calculator to assert that if there were not 98% an ASD risk due to vaccines (leading to N = 2000 or something similar), the jig was up.”

You are referring to my analysis of the Gadad study.

No, I'm referring to your performance here; I don't read your site.

With an assumed 2% autism rate from vaccines, and dichotomous endpoint (autism Y or N), and conventional alpha 0.05 and 80% power, 387 monkeys per group would be needed, or 774 total.

I'm not talking about monkeys, but it doesn't matter. That's a 98% attributable risk, you bonehead.

Its basic biostatistics.

Indeed.

I think its unlikely that the results were spiked

"Thinking" of this nature is incompatible with quality research. There must be reasonable supporting evidence, not conjecture.

... when P.Z. Myers invites his readers to crash an on-line poll ...

That's another of life's little pleasures I've let slip away. I haven't participated in pharyngulating a poll in ages.
I now refuse to participate in any sort of online or telephone poll for any purpose because of how badly designed nearly all of them are. Authoring a good poll is very difficult and it's my opinion that the number of people capable of doing it is vanishingly small. I once started to complete a survey from a provincial government agency and quit a very short way in because of how bad I thought it was. I mentioned this to the agency person with whom I had regular contact and her response was to agree entirely. She was a part-time lecturer in statistics.

@ #39 Herr Doktor Bimler

Note that Ref. 63 is not to the VAERS database, but to the NVIC version of it, the one that facilitates dumpster-diving by bypassing the ‘data quality’ caveats.

I took a moment to realize that NVIC was not National Vaccine Injury Compensation, but the "venerable" anti-vaccine organization of Barbara Loe Fisher, the National Vaccine Information Center. Of course they would strip away any warnings.

Some good news regarding antivaxers' attempts to frighten Somali-Americans into not having their children vaccinated.

"Local health officials are hosting forums in Columbus this week after a recent measles outbreak among Somali populations in Minnesota.

Columbus has the second-largest Somali population in the United States behind Minneapolis, and health officials fear a possible outbreak in central Ohio as families in both cities visit one another this summer...
Minnesota health officials link the high numbers of unvaccinated Somali children in their state with an aggressive campaign by anti-vaccine advocates several years ago that targeted Somali parents, saying that vaccinating their children would cause autism.

“This could happen in any community that is given misinformation,” said Jose Rodriguez, spokesman for Columbus Public Health.

Hassan Omar, executive director of the Somali Community Association of Ohio, said the community understands there are health risks. He said he hopes these events help to educate people, as well as break any stereotypes that residents might have about Somalis.

“Everybody is worried about this,” Omar said. “We don’t want there to be a stigma. We’re Americans, we’re Midwestern. We have children that are all up-to-date for vaccinations.”

http://www.dispatch.com/news/20170518/city-county-health-officials-to-h…

Note that Ref. 63 is not to the VAERS database, but to the NVIC version of it, the one that facilitates dumpster-diving by bypassing the ‘data quality’ caveats.

And includes foreign reports.

Alain -- best wishes to you. Adult care is hard.

Alain
Just a quick note to tell that if my comments in the last few weeks sounded depressive, that’s because it dawned on me that I am.

I am the world's worst on-line counsellor with the possible exception of Hannibal Lecter, so I will just say, "Look after yourself".

@ VP #4

This DTP study?

http://www.skepticalraptor.com/skepticalraptorblog.php/rfk-jr-and-vacci…

Yeah, it's got its own problems . . .

To follow up on Panacea @63: There are ways you could conduct a study like this with rigor and integrity. Looking at de-identified data from a insurance providers, for example. Granted, that would still miss things like illnesses that didn't require doctor's visits, but it would all be verified. Or maybe data from CHIP?

But asking people to provide you with data to support a position that they hold dear is by the simple facts of human nature going to result in skewed data, even if no one deliberately stuffed the poll.

There is an entire field of study around how to build rigorous, consistent, accurate and reliable health surveys. the survey used in this study fails pretty much every single principle of good survey design.

I am the world’s worst on-line counsellor with the possible exception of Hannibal Lecter, so I will just say, “Look after yourself."

What hdb said.

HDB@50: “There has to be a pony in there somewhere!”

Never say we’re not good to you.

Are there any other vax-unvax studies I dont know about? And by vax-unvax, I mean zero vs substantial vaccine exposure comparison. Not necessarily the full schedule, but preferably pretty close, and including several aluminumn-containing vaccines.

I suppose it's marginally amusing that ddanimal has a lopsided criterion here, in addition to failing to show back up with his slide rule* to tell everyone what 2% of 14.7/1000 is.

* Of course I had one.

Re: Vaccine Paper's comments
While part of the problem with the data in Mawson's survey is that there was no attempt to validate the responses, to confirm that the responses are accurate, there are worse problems than that.
Even if the respondents were completely honest, their responses may be subject to recall errors and subjective assessments.
And going even further, even if all the responses are objectively accurate, there could still be systemic biases caused by sample selection. Let me illustrate this point a bit further.

1) Pretend for now that we are doing this in the late 80s*. Let the response variables be whether someone receives an academic scholarship ("yes", "no") and whether someone comes from an extremely rich family ("yes", "no"). The question we ask is whether or not the family background is associated with obtaining an academic scholarship. This design is analogous to the Mawson study.
2) Since the extremely rich (by whatever criteria) is only a very small proportion of the population, we decide to choose a subpopulation in which the extremely rich is over-represented, let's say the Yale freshman class (this is analogous to the choice of restricting the survey to homeschooled children).
3) We conduct the survey, tabulate the data, and find that there is a statistically significant association between family wealth and receiving an academic scholarship. Specifically, the extremely rich have lower academic scholarship rates than the non-extremely-rich.
4) We conclude that in general, people from extremely rich families are less likely to get academic scholarships.
5) Problem: A better explanation is that the extremely rich are as or more likely to receive academic scholarships, but though they receive academic scholarships at the average rate at Yale, the poor kids appear to receive academic scholarships at a higher rate because the ones who didn't had to get an education elsewhere. Consequently, you obtain a spurious result due to the choice of an unrepresentative subgroup.
6) How does this connect to the Mawson study? One possible effect of choosing homeschooled students is that parents of unvaccinated children tend to prefer to homeschool all their children, while a large proportion of parents of vaccinated children only homeschool their autistic children (due to inadequate special education services). This is all the more salient because vaccination is required (in theory) for public education.

As for your comments for the Gadad study, your reliance on the sample size calculator was inadvisable. The calculator (based on my attempts to replicate the numbers) assumes approximate normality and two-tailed test, when the underlying distribution is quite non-normal (binomial with tiny p parameter) and the appropriate alternative hypothesis is one-tailed (autism is higher in the vaccinated group than the non-vaccinated group). Making the same assumptions and using an appropriate statistical test (Fisher's Exact), I reach 80% power at around n=335 each group.
This is of course not a defence of the Gadad paper. I think it's silly. Orac thinks it's unethical (http://scienceblogs.com/insolence/2015/09/30/three-dozen-dead-macaque-m…). What I am pointing out is that you don't know statistics as well as you think you do.

Dick

Thank you for the correction regarding the two-tailed test in the sample calculator I used for the Gadad study analysis. I edited the article accordingly. Can you link to a calculator that uses Fishers exact test?

"As for your comments for the Gadad study, your reliance on the sample size calculator was inadvisable. The calculator (based on my attempts to replicate the numbers) assumes approximate normality and two-tailed test, when the underlying distribution is quite non-normal (binomial with tiny p parameter) and the appropriate alternative hypothesis is one-tailed (autism is higher in the vaccinated group than the non-vaccinated group). Making the same assumptions and using an appropriate statistical test (Fisher’s Exact), I reach 80% power at around n=335 each group."

As for your comments for the Gadad study, your reliance on the sample size calculator was inadvisable. The calculator (based on my attempts to replicate the numbers) assumes approximate normality and two-tailed test, when the underlying distribution is quite non-normal (binomial with tiny p parameter) and the appropriate alternative hypothesis is one-tailed (autism is higher in the vaccinated group than the non-vaccinated group). Making the same assumptions and using an appropriate statistical test (Fisher’s Exact), I reach 80% power at around n=335 each group.

To detect a 2% difference from 1 in 68, I get around 2.6 million in each arm. Just sayin'.

@Narad #77
Oh, no dispute that the study was atrociously underpowered (as I said, it's silly). The first time I saw it, I was struck by how the paper failed to establish that the symptoms they were looking for actually occurred in macaques.

Unless you are talking about actual outputs from the calculator, in which case I'd check your input.

I'll take the opportunity to repeat this Tweet:
https://twitter.com/FoodSnoop01/status/862158228377014273
in which some racial-supremacist feckstick blames Google for taking down Mawson's paper. This is not just nutpicking because the AutismOne organisers -- that is, CMSRI and Generation Rescue -- Liked and retweeted the lurid conspiratorial fantasy. They own it.

Liz, HDB, JP,

Thanks. It took a heavy handed approach by my cousin (who's headed to Cuba in a bit over an hour) to fix the situation but the basic gist is that the brother will leave me alone for the week that the cousin is in Cuba and upon his return, there will be other fixes. He fail to do that, he's out of here.

Usual scenario: I'd work on my computer, with earphones cranking out music in full blast in my ears and the brother won't stop talking to me or asking questions despite me having told him 10 times to not bother me, I'm working and not listening. It might be difficult for him to uphold his promise but today, I went to the police station.

Unless you are talking about actual outputs from the calculator, in which case I’d check your input.

You can check the input yourself. Mind you, I'm not talking about whatever Gadad-paper "analysis" that he insisted I must have been referring to, but what's needed to signal a 2% difference in ASD diagnoses.* And 80% power wouldn't cut it anyway.

* I've been through this at painful length with Vapor Genie before, which is why I feel no urge to go looking for the comments. See Genie, Vapor.

FAO Orac, rather sad this, but inevitable, baby dies on a gluten free diet, parents owned a health food business and took the child to a homeopath. Let's spread the news and hope it never happens again.

http://www.independent.co.uk/news/world/europe/baby-gluten-free-diet-di…

[S]ome racial-supremacist feckstick blames Google for taking down Mawson’s paper.

BWAHAHAHAHAHAHA!!! Thanks for the laugh HDB,
@Jay #82, that is so sad. And some studies have pointed out that if somebody does not have a gluten allergy, a gluten-free diet is bad because it can leave out vital nutrients.

@Narad #81

Okay, yeah, you are taking 2% to mean a relative risk of 0.98, while VP is working with the assumption that the risk difference is 0.02. Naturally, the results are not comparable.

I would usually complain about binomial with small p is very skewed, violating the normality assumption yada yada yada, but when each outcome is expected to have at least 20,000 observations even I have to admit the deviation is going to be negligible.

@Jay & Julien --

What killed that poor child was his parents' self-diagnosing him as lactose-intolerant and denying him dairy. Still, it's a textbook case of parental stupidity ending in a fatality, and in a just world the homeopath would be up on charges as well.

http://scibabe.com/no-gluten-free-diet-didnt-kill-baby/

#85, Shay

Still, it’s a textbook case of parental stupidity ending in a fatality, and in a just world the homeopath would be up on charges as well.

Why would the homeopath be charged? In the few articles I've seen the homeopath told the parents to go see a real medical doctor. It is even mentioned in the SciBaby's "source" (the daily mail..............!).
I do not see a reason to hold the homeopath personal responsible for that death unless there is some source saying that the homeopath saw the baby before that point or knew about the baby condition.

Okay, yeah, you are taking 2% to mean a relative risk of 0.98

No, I'm taking it to mean a relative risk of 2%. But anyway, as the Cubs–Brewers game was postponed for no good reason, I went looking for the original exchange with VP* for context and couldn't find it here, which leads me to think that it must have been on Disqustink, which I'm really not going to root around in.

Along the way, though, I did glance at his Gadad entry. Recall his invocation of "basic biostatistics"** above, and then get this (italics added):

"But first, we need to describe some basic statistics.

"Statistics
"Determining the number of subjects necessary in a study depends a lot on how confident you want to be in the results. Highly reliable results require more subjects, of course.

"In these types of studies, there are two kinds of errors:

"Type 1: Observing an effect when its not actually there (false positive), and
"Type 2: Not observing an effect when it really is there (false negative).

"The chance of a type 1 error is also known as the 'p-value' (also known as 'alpha'). A p-value requirement of less than 5% (p=0.05) is standard in biomedical sciences."

The actual "calculation" is just painfully stupid – it's based on the assumption that there is zero ASD prevalence "incidence" in the unvaccinated, which means that no comparator group is needed. It gets worse:

"If the vaccines caused autism in 2% monkeys, it would not have been observed in the Gadad study. The vaccines would need to cause autism in at least about 38% of the monkeys for the Gadad study to detect it."

One does not need a sample-size calculator to determine whether one's monkeys might amount to an element of ℕ. He then starts babbling about Giardia, at which point I lost interest.

* Have "they" finally abandoned the Royal We?
** SYLLABLES IZ POW3R.

" ... the torch has been passed to a new generation of Americans ..." - JFK

Fifty years later, the reality is the fate has been sealed for a new generation of Americans ...

Strong protein sequence alignment between autoantigens involved in maternal autoantibody related autism and vaccine antigens
https://www.researchgate.net/publication/316785758_Strong_protein_seque…

https://www.researchgate.net/publication/316785919_Significant_protein_…

Troels: homeopaths don't give valid medical advice. It's quackery ie fraud. Hence, if you are a homeopath and dispensing fake medical advice, you are contributing to poor health outcomes and should be held accountable when your patient dies from treatable medical conditions like malnutrition.

#88, I agree with anything you said.
But my point still stands.
I've only read a couple of news article about this death and the articles are probably based on the same source.
Based on the articles I’d say it is not clear how many times the homeopath saw the child. My initial reading of the articles made me think that the homeopath only saw the child once. All we know is the last time the homeopath told the parent to see a real doctor.
If that was the only time the homeopath saw the child then he/she did the right thing regardless of his/her profession. I’d agree that if the homeopath should be charged if he/she knew (or should have known) of his malnutrition before that point, or if the homeopath in anyway directly contributed to this tragedy. But at the moment I've seen very little details about the homeopath's actions, so I remain cautious in making any conclusion about the homeopath.

Correction for the above comment:
"#88, I agree with anything you said." should be "#88, I agree with everything you said."
And
"All we know is the last time the homeopath told the parent to see a real doctor." should be "All I know is the last time the homeopath saw the child he/she told the parent to see a real doctor."

I don't want to joke about such a tragic event, but I've thought the same thing when "Homeopaths without Borders" have been jetting off to some disaster scene to dose starving, homeless people with distilled water--shouldn't the homeopathic remedy for "not enough food" be "a whole cr@pload of food"?

@Narad #87

Relative Risk is defined as P(D=1|E=1)/P(D=1|E=2), where both E (exposure) and D (disease) are divided into two categories. Let's say E=1 for Group 1 and E=2 for Group 2, then the above becomes [Group 1 Proportions]/[Group 2 Proportions], which given your inputs is 1.02. If we let E=1 for Group 2 and E=2 for Group 1, the relative risk is 0.98. There is no reasonable arrangement using the numbers you gave that would give a relative risk of 0.02.

I thought the assumption that the incidences are 0 vs 0.02 to be a bit odd too, but for all possible combinations (incidence group 1, incidence group 2) where the risk difference is 0.02, (0, 0.02) has minimal* variance. So using this assumption gives a conservative estimate of the type II error when the alternative hypothesis is Ha: p1-p2=0.02. Not that VP knew that, of course.

I stopped reading before getting to the other stuff you mentioned, being more interested in figuring out how the calculator arrived at the number it did (answer: by ignoring the invalidity of its assumptions).

*Sketch of proof:
Assuming X and Y are two stochastically independent random variables, var(X-Y)=var(X)+var(Y).
Now, suppose X' is the number of individuals with the outcome of interest in a given arm of study, then X' has binomial distribution with parameters n (number of individuals in the arm) and p (an unknown constant between 0 and 1, inclusive). X' has variance np(1-p). This sufficient when dealing with raw outcome numbers, as when the arms of the study are balanced, but people tend to prefer working with proportions for some reason, so let X=X'/n be the random variable representing the proportion of people with the given outcome in this arm, var(X)=p(1-p)/n. For any fixed value of n>0, var(X) has global minimums when p is restricted to the interval [0,1] when p=0 or p=1 (var(X) viewed as a function of p is a parabola with a global maximum at p=0.5).
It is obvious that the way to get both p1 and p2 as close to 0 as possible while fixing their difference at 0.02 is to have one of them at 0 and the other at 0.02. Alternatively, you could have one at 1 and the other at 0.98 and get the same var(X).
Quod erat demonstrandum.

"So using this assumption gives a conservative estimate of the type II error when the alternative hypothesis is Ha: p1-p2=0.02. Not that VP knew that, of course."

I was well aware of this, which is why I assumed 0 incidence in the control group. The assumptions I made were intended to be simple and conservative. You can quibble with the details, but they are inconsequential to the conclusion: that the Gadad study was extremely underpowered, and the results are therefore meaningless.

The obvious fatal flaws of the Gadad study have not stopped vaccine promoters like Offit from declaring the Gadad results as "CLEAR AND DEFINITIVE" .

Offit wrote this last year about Gadad:

"The vaccine–autism controversy teaches us that, although it is easy to scare people, it is much harder to unscare them. Even with papers as clear and definitive as that by Gadad et al. (1), it is hard to unring the bell."-Dr Paul Offit

Offit is way out of line here, right?

"“All I know is the last time the homeopath saw the child he/she told the parent to see a real doctor.”"

Correction noted -- still, the homeopath had a moral (if not professional) obligation to call the Belgian equivalent of CPS.

Relative Risk is defined as P(D=1|E=1)/P(D=1|E=2), where both E (exposure) and D (disease) are divided into two categories. Let’s say E=1 for Group 1 and E=2 for Group 2, then the above becomes [Group 1 Proportions]/[Group 2 Proportions], which given your inputs is 1.02.

Right, sorry; it's an attributable risk percentage [(RR − 1)/RR] of 0.02.

^ Um, "0.02 2%." Must not type after napping.

@ Vinu arumugham (#88),

Thank you!

@shay #94: I don't know if homeopaths/naturopaths are licensed in Australia (God I hope not) but if they are, yes they would be mandated reporters.

The invalidating factor of Mawson's study is that by not cross-referencing with medical records, they were not able to establish an actual cohort of unvaccinated children.

Most parents who decline vaccinations are unaware that their child has had one out of the three Hep B's; the "birth" dose.

Sometimes after the childbirth the nurse will mention the Hep B "will" be given.

Usually they just say; "We need to get baby cleaned up, get some measurements & we'll bring him right back to you!"

In my state, HepB is on all standing orders in all birth centers, for all doctors since at least 1994. It does not matter if baby is born in the car on the way, they will get HepB upon arrival. Home birth with certified Mid-wife? Yes; HepB. Written, notarized "birth plan" submitted to doctor at first visit? Yes; HepB (firstly, you don't give baby care instructs to the OB & secondly; nurses administer immunizations & nurses flip straight to doctors orders in chart for a newborn admission. "Legal" has it's own section & only DNR's go to front).

You would have to be very detailed in order to form a truly UN-vaccinated group.

The Lewin's group study(which did not show similar results) utilized EHR's but integration of EHR's & IIS's vary by state so you still have discrepancies.

After establishing a true unvaccinated cohort, I personally wouldn't consider a study that eliminated subjects based on any confounding variable other than those listed on the CDC's " “General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices", as a contraindication for immunization.

That would include PROM, prematurity, sibling history of anaphylaxis to vaccine, family history of SIDS, TB, etc ... If you administer to that population ... you include that population. But that's just me.

The invalidating factor of Mawson’s study is that by not cross-referencing with medical records, they were not able to establish an actual cohort of unvaccinated children.

Most parents who decline vaccinations are unaware that their child has had one out of the three Hep B’s; the “birth” dose.

That is in fact one of the least of the problems in Mawson's study. However, it does point to another absurdity in Mawson's hypothesis.

Among all the other problems with the hypothesis is the implicit assumption that all vaccines are identical. We know this is not the case, so the whole totally unvaccinated versus totally vaccinated study as a hypothesis is not supported by the existing information about vaccines.

But then as it ever was among the anti-vaccine groups, it is all about the vaccines. Not a specific vaccine, but vaccines in general.

After establishing a true unvaccinated cohort, I personally wouldn’t consider a study that eliminated subjects based on any confounding variable other than those listed on the CDC’s ” “General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices”, as a contraindication for immunization.

That is why you won't be asked to develop protocols for any epidemiological studies.

In my state, HepB is on all standing orders in all birth centers, for all doctors since at least 1994.

You don't say. Would you care to state how you ascertained this, or are you just going to leave everyone hanging?

P.S. Heh.

@#46 VP says I have not seen you address the experimental results, or new papers showing that Al is more toxic than previously believed (e.g. showing harm to animals at 3.4 mg/kg/day, a vaccine-relevant dosage).
Since the average daily dietary intake of Al is considerably higher than that received via vaccination, one has to wonder about that finding...

"Since the average daily dietary intake of Al is considerably higher than that received via vaccination, one has to wonder about that finding…"

Not true, and does not tell the whole story. Oral absorption of Al is 0.3%. So its not correct to directly compare ingested Al content. Have to multiple by 0.3% to obtain absorbed amount.

Also, Al adjuvant comprises PARTICLES, which have toxicity unrelated to dissolved Al3+ released by the particles.

Vaccines in the first 6 months of the CDC vaccine schedule contain about 3,675 mcg aluminum:
Birth (Hep B): 74 mcg/kg (250 mcg for 3.4 kg infant)
2 month: 245 mcg/kg (1225 mcg for 5 kg infant)
4 month: 150 mcg/kg (975 mcg for 6.5 kg infant)
6 month: 153 mcg/kg (1225 mcg for 8 kg infant)

Total for 0-6 months: 3675 mcg aluminum

Compare this to aluminum absorption (for infants) over the first 6 months from milk and formula. The total amount ingested must be multiplied by 0.3% to obtain the amount actually absorbed into the body.

breastmilk: 7mg x 0.3% = 21 mcg (0.021 mg)
formula: 38mg x 0.3% = 114 mcg (0.114 mg)
soy formula: 117mg x 0.3% = 351 mcg (0.351mg)

In the first 6 months of life, aluminum exposure from vaccines is 3,675/21 = 175 times higher than human milk. Infants receive far more aluminum from vaccines than from milk.

Giving a baby 175X more aluminum than normal exposure from milk is alarming to anyone with common sense.

Putting aside anything else, you're assuming that absorption from an IM injection is 100%. There's no basis for that. Here is a very detailed scientific discussion of this, and he points out that in the study that examined blood concentration of IM aluminum injection estimated bioavailability at 17% - and the basis for that.

https://scientistabe.wordpress.com/2017/04/15/sciencesjunk-sciencesbbb-…

@christine: re standing orders for Hep B

What state is that? Because standing order or no standing order, you are still required to obtain informed consent from the patient (or the parent) and give them a vaccine information sheet PRIOR to administering any vaccine.

Also, the parents should be given the immunization record card to take to their pediatrician's office so they can see what vaccines were given and when, so the child can be kept on schedule. Nurses are required to document the manufacturer, lot number, and expiration date of the vaccine on this card when they administer the vaccine.

Every parent should know what vaccines their kid got. If they don't, then there's a breakdown in the system in your area, or they're just really poor record keepers and threw away or lost the card.

@Panacea: yeah, christine is pulling facts out of her posterior again. There is no place (at least in the US) where a Hep B vaccine is given without a signed consent. And if you didn't give consent, you had to sign that, too. As a nurse and as a midwife, I can say without any qualms that she's full of inaccuracies.

If the amount of aluminum in certain vaccines was so alarming, we'd expect to see a jump in baseline blood levels after a shot was given. But we don't.

http://www.publichealth.org/public-awareness/understanding-vaccines/goe…

"...once aluminum is in the bloodstream, it is processed
similarly regardless of the source. Approximately 90 percent is processed by binding to a protein called transferrin, and about 10 percent is bound by citrate. Once bound, the majority of aluminum will be eliminated through the kidneys, a small amount through bile, and a small amount is retained in tissues of the body. About half of the aluminum in the bloodstream is eliminated in less
than 24 hours and more than three-quarters is eliminated within two weeks. The ability of the body to rapidly eliminate aluminum accounts for its excellent record of safety."

http://media.chop.edu/data/files/pdfs/vaccine-education-center-aluminum…

And of the 50-100 mg of tissue aluminum accumulated by adulthood, virtually all of it is from food.

VP needs to go back to Toxin School.

"If the amount of aluminum in certain vaccines was so alarming, we’d expect to see a jump in baseline blood levels after a shot was given."

Not true. Particles are toxic per se, due to surface chemistry effects and shape effects. Toxicity of dissolved Al3+ released by the particles is a separate, additional source of toxicity.

Al adjuvant comprises low-solubility particles, which explains why no rise in blood Al level is observed after injection.

This issue is considered here: http://vaccinepapers.org/debunking-aluminum-adjuvant-part-2/

The idiocy of #103 is truly breathtaking. Environmental Aluminum (the 3rd most common element on Earth, remember) has to be multiplied by .3%, but intramuscularly injected aluminum doesn't.

The oral route, which is "designed" to absorb material taken in, is only .3% efficient, whereas the muscles (which aren't) are 100% efficient. You can't make this stuff up!

Its injected. SO 100% enters the body. Simple concept.

But that simple analysis does not tell the whole picture. Also Depends on dissolution rate, transport kinetics and particle toxicity.

MI Dawn: I had thought we'd had this discussion with her before in some other comment thread as it has the ring of familiarity to it.

I forgot to mention that SO or no SO, the parents can still refuse the vaccine and many do. We get a lot of parents that come in with birth plans declining not only Hep B but VIt K.

@ VP #103. You don't multiply by 0.3% to compare oral vs injected. You look at bioavailability as much as absorption.

In any case aluminum is readily eliminated renally by patients with healthy renal function. So when you look at aluminum as part of vaccines, you don't stack the dose from one vaccination on top of all the ones before, because that aluminum has long been excreted by the time of the next dose. It's not like arsenic. Actual aluminum exposure is nothing like what you're trying to say.

Bioavailability = absorption. Its necessary to multiply by 0.3%

The fatally flawed Mitkus analysis is analyzed here:

http://vaccinepapers.org/debunking-aluminum-adjuvant-part-2/

The 3 problems with Mitkus are:
1) The MRL used by Mitkus is derived from feeding experiments, not injected Al adjuvant experiments.
2) Mitkus uses a proposed NOAEL of 26 mg/kg/day, but it is not a NOAEL. More recent science shows harm from ingestion of 3.4 mg/kg/day.
3) Mitkus assumes Al adjuvant particles have zero toxicity. There is no evidence for this, and much evidence it is wrong.

I agree with Vaccine Papers that Mitkus 2011 is flawed and addresses only a fraction of the safety problems associated with aluminum adjuvanted vaccines.

My review of Mitkus 2011:

Dr. Mitkus,

I was reviewing aluminum safety information for vaccines at the FDA website and found your study.1

You provide the following description of the effect of aluminum adjuvants on the immune system.

“Aluminum adjuvants are important components of vaccines, since they stimulate the immune system to respond more effectively to protein or polysaccharide antigens that have been adsorbed to the surface of insoluble aluminum particles. Specifically, these coated particles are phagocytized by cells of the innate immune system (e.g., macrophages) and activate intracytoplasmic sensors of pathogen-associated molecular patterns located within the cells, such as the nucleotide-binding domain leucine-rich repeat-containing family of sensors ([6]; Schroder and Tschopp [30]). The functional consequence of activation of this intracellular system is the activation of certain enzymatic caspases that cleave pro-interleukin (IL)-1β to interleukin (IL)-1β. The secretion of the mature cytokine, IL-1β, leads to an inflammatory reaction and a downstream Th2-dependent antibody response [7], which amplify the immune response to the antigen. Adjuvanted aluminum, therefore, plays a vital role in facilitating the response that underlies the immunoprotection afforded by vaccines.”

The rest of the paper focuses on body burden of aluminum AFTER it is absorbed from the muscle into the blood.

I was taken aback that you have COMPLETELY IGNORED any negative immunological effects that aluminum can have while it is still in the muscle.

The quoted paragraph above assumes that the only proteins in the vaccine are viral/bacterial proteins. In that case, as you state, the stimulation by aluminum plays a vital role in generating immunoprotection.

But obviously, vaccines contain numerous other proteins including food proteins (ovalbumin, milk, soy, yeast, etc.)2 , culture medium cell proteins (Vero monkey kidney cell proteins, calf serum proteins, WI38/MRC5 fibroblast cell proteins, etc.) that are also adsorbed to the surface of insoluble aluminum particles. As you state then, aluminum adjuvants stimulate the immune system to respond more effectively to ALL these proteins as well. The effect is an immune response that includes synthesis of antibodies against any and all of these proteins. The result of such a response of course includes food allergy3,4,5 and autoimmunity6.

How can you perform a safety assessment of aluminum in vaccines by COMPLETELY IGNORING this effect?

References

1. Mitkus RJ, King DB, Hess MA, Forshee RA, Walderhaug MO. Updated aluminum pharmacokinetics following infant exposures through diet and vaccination. Vaccine. 2011 Nov 28;29(51):9538–43.

2. Vaccine Excipient & Media Summary [Internet]. 2015 [cited 2016 Jan 16]. Available from: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipi…

3. Arumugham V. Evidence that Food Proteins in Vaccines Cause the Development of Food Allergies and Its Implications for Vaccine Policy. J Dev Drugs. 2015;4(137):2.

4. Platts-Mills TAE. The allergy epidemics: 1870-2010. Journal of Allergy and Clinical Immunology. 2015. p. 3–13.

5. Alice Hoyt, Peter Heymann, Alexander Schuyler, Scott Commins TAEP-M. Changes in IgE Levels Following One-Year Immunizations in Two Children with Food Allergy [Internet]. 2015. Available from: https://wao.confex.com/wao/2015symp/webprogram/Paper9336.html

6. Dahan S, Tomljenovic L, Shoenfeld Y. Postural Orthostatic Tachycardia Syndrome (POTS)--A novel member of the autoimmune family. Lupus. 2016 Apr 1;25(4):339–42.

Vinu

Great comment. Yes aluminum causes a wide range of health damage, not just brain inflammation and all the downstream consequences of that (autism, mental illnesses, depression anxiety etc). Aluminum alos causes allergic disorders and autoimmunity.

Yes I should have said "not all cases of autism bein in utero". Obviously some do (like autism cases resulting from gestational infection. But of course vaccines cause MOST causes of autism.

"In any case aluminum is readily eliminated renally by patients with healthy renal function. So when you look at aluminum as part of vaccines, you don’t stack the dose from one vaccination on top of all the ones before, because that aluminum has long been excreted by the time of the next dose. It’s not like arsenic. Actual aluminum exposure is nothing like what you’re trying to say."

But that all doesn't matter. In the anti-vaccine world, reason and science is to be misinterpreted and misused. Only their logic works, and they mock anyone who is actually educated and an expert. "Yeah, I don't have a science degree," they'll say. "But I've done my research." They're the same people who think they could fly and land a plane without any training if they are given the chance to look at some YouTube videos.

@VP troll:

Bioavailability.
You have heard of it I trust?
What is the bioavailability of aluminium compounds injected into muscle?
(Hint, it's not 100%)
Try Flarend's paper for enlightenment.

And I also notice you compared with human breastmilk, but not with formula milk or soyabased milk. (Now why would that possibly be, except to try and deceive readers into thinking only a comparison with breast milk's [lower] levels of aluminum is appropriate?)

www.merckmanuals.com

"Bioavailability refers to the extent and rate at which the active moiety (drug or metabolite) enters systemic circulation, thereby accessing the site of action."

That definition is not relevant when discussing immunotoxicity of intramuscularly injected aluminum.

https://www.ncbi.nlm.nih.gov/pubmed/11522584

Multiple studies like the one above have shown that aluminum injected into muscles persists for months at the site of injection. We are not interested in the amount of aluminum that enters circulation, as much as how much is left behind in the muscle, for how long and the immunotoxic effect of that persistence.

The fact that aluminum adjuvants make vaccines work, is the proof that aluminum adjuvants cause damage.

Today's vaccines contain relatively large quantities of a few poorly immunogenic target proteins and small quantities of thousands of contaminant proteins. So the immune system has to be fooled into treating the target proteins as pathogens. Aluminum injection does the necessary tissue damage thus boosting the immune response. However, the immune pathways activated by aluminum are not fully understood and are not the same pathways activated by a real infection. The result is the immune system's highly evolved intricately balanced response is replaced by a desirable disease-protecting vaccine target protein response + an undesirable contaminant protein response that causes allergy, asthma, autism and autoimmunity.

Details, with appropriate references:

https://www.researchgate.net/publication/313524429_Autism_Spectrum_Diso… https://www.researchgate.net/publication/316785758_Strong_protein_seque… https://www.researchgate.net/publication/313918596_Medical_muddles_that… https://www.researchgate.net/publication/312125211_Professional_Miscond… https://www.researchgate.net/publication/316785919_Significant_protein_…

Flarend is cited many times on the VP blog. Yes I am very familier with Flarend. Important results from Flarend:

1) biopersistence: AlOH adjuvant is biopersistent. only 6% eliminated after 28 days. For AlPO4, 22% is eliminated.

2) Aluminum travels to the brain and other organs.

Flarend results are not supportive of claims that Al adjuvant is safe. The persistence and transport to organs is concerning.

Anti-vaxxers I tell you...Wooo!!!

I bet they can't even bake cookies. I bet their aluminum-free cupcakes taste like shit. I am a cupcake connoisseur, and I know!

Autism Incidence in Vaccinated vs. Autism Incidence in Non-Vaccinated.

From Narad's link to Christine Kincaid's blog (who weirdly doesn't capitalise proper nouns like her name but does so with common nouns that aren't in German). Ms. Kincaid, perhaps you would like to tell me how this study will be conducted with sample power, effect measure, confounder control, etc. Vaccine Papers here seems to have a bit of difficulty with that hence the topic shift...again.

@108 I don't have "healthy renal function." In fact, I can't take Gaviscon which is the only thing that helps with Prednisone caused heartburn, but I will still get that flu shot every year because I'm old, and familiar with flu, and choose to try to avoid it, even with the tiny amount of aluminum that will stay with me until death. It makes sense to me - and to all my doctors, including my nephrologist.

Giving a baby 175X more aluminum than normal exposure from milk is alarming to anyone with common sense.

Once again you fail to understand and account for kinetics: https://www.ncbi.nlm.nih.gov/pubmed/22001122

The problems with Mitkus 2011 are explained here:

http://vaccinepapers.org/debunking-aluminum-adjuvant-part-2/

@Ellie: while Im glad you've been getting the 'flu vaccine, you haven't been getting any with aluminium-based adjuvants. (Not that there'd have been reason to worry if you had.)

If you're 65YO+ and in the US, FLUAD™ is the first adjuvanted seasonal 'flu vaccine, approved in late '15 (and as early as 1997, in 38 other countries). Its adjuvant is squalene- based. The other 'flu vaccine for seniors, FluZone High Dose, is not adjuvanted (like all other seasonal 'flu vaccines), but delivers significantly more vaccine antigens.

@Narad: I noticed that Ms Kincaid's post comprises her comment on JB Handley's post. Amusing that he refers VP as "a group of scientists", with ebullient praise. It seems the royal "we" was not such an ineffective strategy for a one-man-band after all, at least for some audiences.

Al adjuvant is not eliminated by kidneys. It comprises PARTICLES, which are biopersistent and remain in the body for years, causing inflammation wherever they go. And they travel into the brain, where they cause inflammation. This is how Al adjuvant causes autism and other brain injuries.

Vaccine Papers wrote:

Al adjuvant . . . PARTICLES . . . travel into the brain [to cause autism.]

Could you please explain how the adjuvant particles not only "travel into the brain" but also travel back in time to cause the developmental changes that begin in utero, months or years before the administration of the postnatal vaccines that anti-vaxxers have long blamed for autism?

Al adjuvant particles are carried to the brain by macrophages. macrophages travel to the brain in response to receiving a signal from MCP-1, macrophage chemotactic protein, which is produced by brain microglia in response to inflammation (even peripheral inflammation).

Process is explained in detail here: http://vaccinepapers.org/vaccine-aluminum-travels-to-the-brain/

Autism does not begin in utero. Thats never been proven. Correlation is not causation.

Vaccine Papers,

"Autism does not begin in utero."
It may be more accurate to state that not ALL autism begins in utero.
Please see:
Strong protein sequence alignment between autoantigens involved in maternal autoantibody related autism and vaccine antigens
https://www.researchgate.net/publication/316785758_Strong_protein_seque…

#121 "vaccine papers" best of luck communicating science to these folks. They are mostly in the medical profession and have been trained to think what they think just like soldiers in the army . TRAINED not educated. big difference, They wont give an inch. Their days are numbered their belief in pharmaceutical mysticism is quickly being eroded. God help them when it all comes crashing down. Its a blind spot.

Vaccine research is at best a primitive science, because it involves injecting into the bloodstream foreign substances, chemical and genetic, that would not otherwise naturally enter the body. When we bring into the equation the enormous amount of known and unknown genetic material and foreign proteins that vaccines introduce into the body, and then consider the rapid increase in epidemics raging through the American population – adult diabetes in children, large numbers of various inflammatory and immune deficiency diseases, asthma and new allergies, severe gastrointestinal disorders (e.g., leaky gut syndrome and Crohn's disease), chronic fatigue syndrome, and many different neurological disorders (e.g., autism, ADD and ADHD, Parkinson's, Alzheimer's) –

We must step back and reconsider their causes. We should avoid the kind of faith that the vaccine industrial complex has in its determinist, reductionist perspective of genetic materialism to find these answers without taking into account the bombardment of toxic chemicals such as vaccine adjuvants and preservatives, extraneous genetic material, pathogenic organisms, and foreign genetic fragments that assault our bodies from shortly after birth into old age.

"Autism does not begin in utero."

That's quite the dogmatic statement, but you're barking up the wrong tree. Just ask the folks at Autism Speaks:

https://www.autismspeaks.org/science/science-news/direct-evidence-autis…

There are some cases that begin in utero, but most do not.

Autism onset can occur as late as 10-11 years old. Autism is clearly brain injury from inflammation and cytokines.

This article explains why autism can occur postnatally: http://vaccinepapers.org/postnatal-immune-activation/

@VP 121: Source please. Because what you just said is utter bullshit.

Well, let's thank Theo for reminding us that the core of anti vaccine belief is the fear of making the body somehow impure.

Warning! Self referential statements for any finite path length risk infinite recursion, thermal runaway and other bad stuff.

Please hang up and try your call again.

VP's traffic must be down, given all the link whoring he's doing in the comments here.

orac

Traffic is doing just fine thank you. Its been on an upward trend of late.

You always fail to address the scientific issues. Why is that?

I stick to the science. Vaccine promoters prefer snark, insults and nonsense.

Vaccine Papers wrote:

Autism does not begin in utero. Thats never been proven.

That's quite a funny response, given that it comes from someone who just upthread stated that aluminum adjuvant particles travel to the brain and cause autism--which has "never been proven" and which, of course, cannot explain how the adjuvant particles might magically affect brain development months before vaccination.

It can be useful to understand something of gene expression and developmental biology. The free, full-text version of a recent Nature Neuroscience article linked below might serve as a reasonable startiing point, if you note that "transcriptome expression data implicates early fetal and midfetal stages of the developing human brain in ASD etiology."

http://biorxiv.org/content/early/2016/06/09/057828

Thi free full text of this article from last week's Nature Neuroscience might also be useful if you have even a nodding acquaintance with genetics:

http://biorxiv.org/content/early/2016/11/23/089342

I'm sure that you can find numerous similar articles on your own.

Aluminum adjuvant causes autism by inducing brain inflammation and the cytokine IL-6 specifically. Autism is becain damage caused by chronic or excessive inflammation during brain development. Can occur during gestation or postnatally. but most cases today occur postnatally, from vaccines.

^The second article that I cited was from the 15 May 2017 issue of Nature Genetics, not Nature Neuroscience.

Of course, the Couchesne article that DB mentioned was pretty good, too.

Particles are toxic per se

There's something you don't hear every day.

Whaddaya wanna bet if the particles are colloidal silver, they're just hunky-dory?

Colloidal silver does not seem to have the same inflammatory properties as Al adjuvant particles. But I definitely would not inject colloidal silver particles into anyone, especially a baby.

There’s something you don’t hear every day.

Yes but he capitalised it so it must be true. VP Dan, what is the order of tissue distribution for aluminium?

1) The MRL used by Mitkus is derived from feeding experiments, not injected Al adjuvant experiments.

Wrong Dan VP, Mitkus used Priest et al.'s human/IV and Flarend's rabbit/IM aluminium experiments.

2) Mitkus uses a proposed NOAEL of 26 mg/kg/day, but it is not a NOAEL. More recent science shows harm from ingestion of 3.4 mg/kg/day.

They do no such thing. Please cite your "more recent science".

3) Mitkus assumes Al adjuvant particles have zero toxicity. There is no evidence for this, and much evidence it is wrong.

They do no such thing. Please cite your evidence of harm from Al adjuvants and I'm not going to your site; you can explain it just fine here since you decided to show up. It's almost as if you expect that we haven't read these papers.

"Wrong Dan VP, Mitkus used Priest et al.’s human/IV and Flarend’s rabbit/IM aluminium experiments."

Mitkus used Priest and Flarend for KINETICS data only. For the toxicity data, Mitkus used a single feeding study (Golub 2001, as cited by the AYSDR 2008 report on Al). Golub reported that 26 mg/kg/day is a NOAEL, which us wrong. More recent science shows animals are harmed by 3.4, 4, 5.6, 6, 10 and 20 mg/kg/day aluminum ingestion.

So the Mitkus MRL curve is wrong by at least a factor of 7.6.

So you refuse to look at any information that challenges your beliefs? No wonder you get everything wrong!

"They do no such thing. Please cite your “more recent science”."

All these papers are summarized right here: http://vaccinepapers.org/the-foundation-for-al-adjuvant-safety-is-false/

Oh but you refuse to ever look at the VP blog. Cant be bothered with the facts, I see.

"They do no such thing."

Mitkus's modeling only considers the toxicity of DISSOLVED Al3+ released by the particles. The toxicity of the particles is not considered or discussed.

This issue is analyzed here: http://vaccinepapers.org/debunking-aluminum-adjuvant-part-2/

This paper demonstrates particle-associated toxicity of the Al adjuvant:

http://vaccinepapers.org/al-adjuvant-causes-brain-inflammation-behavior…

Al adjuvant particles are carried to the brain by macrophages.

If they're so toxic, why don't they kill the macrophages before they magically arrive at the brain to deliver their sinister payload?

Good question. Its likely because the Al adjuvant particles are present inside the macrophage lysosomes, which can be considered to be outside the macrophage.

The brain is probably very sensitive to Al adjuvant, for 2 reasons:
1) The brain is very sensitive to aluminum generally. Causes inflammation of neuro tissues at nanomolar concentrations.

2)The brain is very sensitive to inflammation, and Al adjuvant induces inflammation. Its an immunotoxic effect.

If they’re so toxic, why don’t they kill the macrophages before they magically arrive at the brain to deliver their sinister payload?

Because macrophages don't have brainz or immune systems and aluminium is only toxic to brainz or immune systems or both depending on the day of the week and what Mr. Vaccine Papers website thought he read in the literature last month.

VP: "Autism does not begin in utero. Thats never been proven. Correlation is not causation."

And yet actual science has discovered at least half of the genetic sequences that cause autism, and they are striving to find the rest. This is why there is a call out for fifty thousand families to participate in this study:
https://sparkforautism.org/

Here is a video presentation of genetics, the history of autism, and what they have learned... plus the fact there are now parent groups based the their child's genetic sequence:
https://www.youtube.com/watch?v=BOQ9s0GcG5s&index=41&list=PLjvfRtcMhn4P…

110:

Its injected. SO 100% enters the body. Simple concept.

If you swallow it, it's ingested. SO 100% enters the body. Simple concept. Apparently no concept is simple enough for you, though.

You claim that only .3% of ingested aluminum is absorbed by the body. I assume you're pulling this figure out of your butt, but aluminum that sits around in the muscle at the injection site is going to be absorbed even less efficiently.

The elephant in the room is that there is no way to avoid aluminum. It's 8% of the Earth's crust. Every lungful of air is loaded with aluminum-containing PARTICLES!!!!! that will be absorbed a lot more easily by capillaries in the lungs than in muscle tissue.

AND...THIS DOES NO HARM!

Vaccine Papers waved her hands and attempted to ignore the mounting evidence that autism begins long before the administration of vaccines that anti-vaxxers have long blamed for ASD by sputtering

Autism is becain (sic) damage caused by chronic or excessive inflammation during brain development. Can occur during gestation or postnatally. but most cases today occur postnatally, from vaccines.

So you got nothing?

"autism begins long before the administration of vaccines"

There are multiple mechanisms.

Mechanism 1: Vaccines (that Mom received) induce maternal antibodies that attack the fetal brain.
https://www.researchgate.net/publication/316785758_Strong_protein_seque…

Mechanism 2: Cow's milk protein contaminated vaccines that the child receives, induce folate receptor autoantibodies that block folate uptake and result in autism.
https://www.researchgate.net/publication/313524429_Autism_Spectrum_Diso…

The argument that the injury occurs in utero is based on unsupported assumptions, and is contradicted by better quality evidence showing the brain can be unjured by inflammation postnatally.

For example, Hotez and other have argued that cortical layer disruption must happen in utero because this is mostly when these layers form. Well, thats not totally true (layers continue to form postnatally), and its a bad assumption that layers cannot be disrupted by subsequent inflammation occurring during developing. Its an assumption without evidence.

This study shows that infants later diagnosed with autism have normal eye tracking as neonates, and this eye tracking deteriorates over 2-6 months, when vaccines are given: https://www.ncbi.nlm.nih.gov/pubmed/24196715

While some cases of autism are definitely the result of gestational injury , the evidence clearly indicates this is not the case for all (or most) cases.

The human brain develops intensely postnatally. The brain is vulnerable to immune activation/cytokine injury during development. In particular, synaptogenesis is MORE intense in the postnatal period, and disruption of synapse formation is definitely involved in autism.

An important study (Wei 2012) showed that IL-6 elevation in the brain, BEGINNING POSTNATALLY, caused synapse imbalance (excess excitation) and autistic behavioral abnormalities.

the overwhelming majority of the evidence shows that the developing brain is vulnerable to immune activation injury in the postnatal period.

More on that here: http://vaccinepapers.org/postnatal-immune-activation/

Note this paper states:

"in the first months of life, this basic mechanism of social adaptive action--eye looking--is not immediately diminished in infants later diagnosed with ASD; instead, eye looking appears to begin at normative levels prior to decline."

https://www.ncbi.nlm.nih.gov/pubmed/24196715

So, infants later-diagnosed with autism have normal eye tracking at birth. Their eye tracking deteriorates during months 2-12, when lots of neurotoxic vaccines are given.

“autism begins long before the administration of vaccines”

Cow's milk contaminated Tdap is administered to every pregnant woman to protect the newborn against pertussis. As described in the article below, Tdap can cause the synthesis of folate receptor autoantibodies (FRAA).

Autism Spectrum Disorders: A special case of vaccine-induced cow’s milk allergy?

https://www.researchgate.net/publication/313524429_Autism_Spectrum_Diso…

Such maternal FRAA bind to folate receptors in the fetal brain, block folate uptake and affect brain development. Similarly, they can also block folate uptake to the fetal thyroid gland and affect thyroid development.

Maternal FRAA in breast milk can continue the damage in the newborn. A vaccine schedule with numerous cow's milk contaminated vaccines can cause the child to begin synthesizing FRAA.

So Mom can synthesize FRAA. The child can synthesize FRAA. Or both. This can explain the spectrum in Autism Spectrum Disorders.

Maternal FRAA associated ASD may be mistaken as having a genetic origin when in fact vaccines are still to blame.

Would the following preventive measures help until the vaccines are cleaned up?

Pregnant women should be tested for FRAA and IgE to folate receptor protein.

If positive, they should avoid cow's milk to reduce FRAA levels.

Folinic acid treatment for pregnant/lactating women?

Delay administering cow's milk contaminated vaccines to the newborn until cow's milk is introduced in the diet? Thus reducing the risk of synthesizing IgE (and eventually FRAA) to cow's milk proteins.

Thyroid dysfunction in children with autism spectrum disorder is associated with
folate receptor alpha autoimmune disorder

http://onlinelibrary.wiley.com/doi/10.1111/jne.12461/epdf

Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial

http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2016168a.html

ORAC

"VP’s traffic must be down, given all the link whoring he’s doing in the comments here."

The questions and objections here are not new. I have answered them in detail many times. Several articles on the VP blog are written to address the common questions and objections.

So thats why I provide the links. I could also copy/paste the articles. Would you prefer that? the cited papers and images would not show up.

I invite you to write rebuttals to my answers to the common questions (e.g. about immune activation injury, Al adjuvant toxicity and kinetics, the Mitkus paper etc).

@154 (Vaccine Papers)

OK, you don't understand developmental biology and you didn't read the full-text papers that I cited. What else?

@VaccinePapers #154:

The argument that the injury occurs in utero...

Assumes that autism is as a result of injury, not genetics. Please try again.

The evidence that autism is primarily genetic is very weak. its a gene-environment interaction. Autism is rare without the environmental exposure (usually vaccines).

The "its genetic" argument is based on twin studies. but the twin studies are based on a bad assumption: that there are no gene-environment (GXE) interactions in autism. In order for the twin studies to calculate the genetic and environmental contributions to risk, it must be assumed that GXE interactions are not present. If GXE interactions are present, they falsely inflate the genetic/heritablity estimate.

“In basic twin models, gene–environment interactions are assumed not to exist, and if present, they are included as part of the additive genetic variance, inflating heritability estimates.”

“In some contexts, gene–environment interactions, i.e., that environments modify the effects of genes on the trait being studied, may account for a substantial part of the apparent heritability.”
quotes from:
https://www.ncbi.nlm.nih.gov/pubmed/22934540

There is a lot of evidence for GXE interactions in autism.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260177/

So, the high estimates (70-90%) of heritability in autism are wrong.

"Assumes that autism is as a result of injury"

Not only are some forms of autism a result of injury, it is partially reversible. Folate receptor autoantibodies block folate uptake and cause injury. It can be reversed by folinic acid treatment.

https://www.researchgate.net/publication/313524429_Autism_Spectrum_Diso…

Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial

http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2016168a.html

All this leaves me wondering whether Sin Hang Lee has any new scams going these days.

You always fail to address the scientific issues. Why is that?

I address scientific issues practically every day. It is you whom I choose not to address. There's a difference. I'm not a fan of going down the rabbit hole chasing a practitioner of the Gish gallop.

@ VP
Is there any randomized trial of delaying vaccines in high risk babies?

The key word from the publication in question is decline, not deteriorate, don't try to twist word please. An alternative explanation to aluminum can be explained by perceptual functioning, namely enhanced perceptual functioning (https://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Mottron+L) in which case, the neonate wouldn't just focus on the eyes but other features in the environment and I would be very curious about your answer, VP, to that and how the h*ll, aluminum is supposed to enhance perceptual functioning given that the bellcurve (you do know about statistics) properly emulate random events (i.e. by your tangent, aluminum is not neuron specific) yet, enhanced perceptual functioning is nowhere near a random effect; it is neuron and brain area specific.

Alain

more about the bellcurve:

https://mathbabe.org/2017/05/22/eugene-stern-how-value-added-models-are…

Given that VP made the hysterical claim that autism *can begin* as late at 10-11 years old (totally ignoring the diagnostic criteria required), I'll take anything posted by them with many, many grains of salt.

BTW...how did we end up with the unholy trinity of VP, MJD and VA all posting their own Idee fixe on one blog post?

It might not be that bad a thing. Keep them quarantined from the rest of the blog. :-)

BTW…how did we end up with the unholy trinity of VP, MJD and VA all posting their own Idee fixe on one blog post?

that post itch under their fingernails...

Alain

You claim that only .3% of ingested aluminum is absorbed by the body. I assume you’re pulling this figure out of your butt, but aluminum that sits around in the muscle at the injection site is going to be absorbed even less efficiently.

The literature quotes the 0.3% figure.

The figure for bioavailability from vaccine injection into muscle is 17%, so larger, but over 28 days. However, there is a lot more exposure by ingestion than by vaccination.

Added to this there has been 80 years of use of aluminium adjuvants in vaccines and somehow they have only been causing autism for the last 15 years once thiomersal was removed. It is truly magic.

BTW…how did we end up with the unholy trinity of VP, MJD and VA all posting their own Idee fixe on one blog post?

The bit I like is how they have all been congratulating each other on their insights, despite the three theses being completely at odds. It has been a nice little illustration of crank magnetism writ small.

Chris,

I have to admit I'm very curious to see how VP will drive out of the cognitive dissonance he/she drove into WRT my comment.

Very curious indeed.

Alain

I have to admit I’m very curious to see how VP will drive out of the cognitive dissonance he/she drove into WRT my comment.

Alain, their normal response has been to change the topic.

Alain, their normal response has been to change the topic.

Unfortunately, I know. It's a friggen game of whack-a-mole but see my comment on our host today's post. An "interesting" side effect of such a proposal would be never ending "fun" playing whack-a-mole with them.

(No I wouldn't look forward to 3000+ comments posts...)

Alain

"I would be very curious about your answer, VP, to that and how the h*ll, aluminum is supposed to enhance perceptual functioning "

It doesnt. Aluminum causes brain injury. The decline in eye tracking indicates pathology, not heathy/normal functioning.

"Given that VP made the hysterical claim that autism *can begin* as late at 10-11 years old (totally ignoring the diagnostic criteria required), "

https://www.ncbi.nlm.nih.gov/pubmed/12369775

“On the DSM-IV symptom checklist for autistic disorder, he met all the criteria for autism except the onset criterion because he did not have a history of any symptoms before three years of age.”

The authors state that this case “… provides further evidence that autistic symptoms can sometimes emerge after the age of three years following an external event such as an infection.”

The age 3 diagnostic requirement is arbitrary. Its not based on any mechanistic understanding of the injury.

Autism is brain injury caused by inflammation and cytokines. The brain becomes less vulnerable to injury with maturation. Children over age 3 can experience the same injury from inflammation as younger children.

Vaccine Papers, aluminum is one of the most common elements on the planet. Why are we not seeing the same results people getting dirt in wounds?

Gray Falcon,

"Vaccine Papers, aluminum is one of the most common elements on the planet. Why are we not seeing the same results people getting dirt in wounds?"

If dirt cheap dirt worked as well as aluminum adjuvant, why would vaccine makers not use dirt as an adjuvant instead for paying for Alhydrogel?

"The figure for bioavailability from vaccine injection into muscle is 17%, so larger, but over 28 days. However, there is a lot more exposure by ingestion than by vaccination."

For AlOH, its 6% over 28 days (Flarend 1997).

Not true for ages 0-6 months. Do the calculations. And you can even use the 6% and 22% numbers from Flarend (which ignore toxicity of the particles).

Birth (Hep B): 74 mcg/kg (250 mcg for 3.4 kg infant)
2 month: 245 mcg/kg (1225 mcg for 5 kg infant)
4 month: 150 mcg/kg (975 mcg for 6.5 kg infant)
6 month: 153 mcg/kg (1225 mcg for 8 kg infant)

Total for 0-6 months: 3675 mcg aluminum
6 months from ingestion:
breastmilk: 7mg x 0.3% = 21 mcg (0.021 mg)
formula: 38mg x 0.3% = 114 mcg (0.114 mg)
soy formula: 117mg x 0.3% = 351 mcg (0.351mg)

6% of 3675 mcg is 220 mcg, x 6 months (rough estimate) gives about 1300 mcg. And thats with the false assumption that all the Al is AlOH (which has lower solubility than AlPO4).

1300/21 mcg = 62X more than from human milk.

For AlPO4, the number is higher.

"Vaccine Papers, aluminum is one of the most common elements on the planet. Why are we not seeing the same results people getting dirt in wounds?"

1) dirt is generally not nanoparticulate unlike Al adjuvant, which is a gel, and 2) people clean their wounds, and 3) dirt in wounds is superficially deep, not injected into muscle.

"I address scientific issues practically every day. It is you whom I choose not to address. There’s a difference. I’m not a fan of going down the rabbit hole chasing a practitioner of the Gish gallop.

Orac-

You cannot describe my arguments as a gish gallop. I make 3 arguments: aluminum toxicity, immune activation and healthy user bias. THREE.

And I am specific about how they relate to autism (Al injection>Al transport to brain>IL-6 in brain> autism). I make detailed, falsifiable claims, and I show my reasoning. I dont hide the ball. I dont make vague assertions. I dont make dozens of superficial claims without reasing (thats a true gish gallop).

So I say you avoid my arguments because you do not know how to refute them.

It doesnt. Aluminum causes brain injury. The decline in eye tracking indicates pathology, not heathy/normal functioning

Oh, So that body of knowledge here: https://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Mottron+L does not exist? You need to take a stronger look because the subject described by that aforementioned body of knowledge are indeed autistic and it was found that they have increased perceptual functioning. Let me explain that again VP, autism == enhanced perceptual functioning

Do you get it?

Alain

"Added to this there has been 80 years of use of aluminium adjuvants in vaccines and somehow they have only been causing autism for the last 15 years once thiomersal was removed. It is truly magic."

Dosage of Al adjuvant from vaccines increased enormously during the 1990s, when the autism epidemic exploded.

other factors contribute, like vitamin D deficiency for example.

Al adjuvant has never been shown to be neurologically safe in EMPIRICAL studies. The safety studies (e.g. Mitkus) are garbage and not look at neurological outcomes. Further, the Mitkus analysis is not based on ANY empirical safety/toxicity data for Al adjuvant. Mitkus only uses toxicity data for INGESTED aluminum lactate (from a SINGLE study-Golub 2001).

The toxicity data used by Mitkus is from this study: https://www.ncbi.nlm.nih.gov/pubmed/11485839

All the empirical evidence shows that Al adjuvant causes brain injury at vaccine dosages. Here is the latest study:

http://vaccinepapers.org/wp-content/uploads/Non-linear-dose-response-of…

"it was found that they have increased perceptual functioning"

In what way? Can you be more specific about what was enhanced?

In autism, there is an excitatory/inhibitory synapse imbalance, in favor of excitation. It may be that in early development, the excess of excitation produces increased sensitivity to stimuli. Is this what you are referring to? Is your "increased functioning" the result of excess excitation?

The excitatory excess is certainly pathological at older ages (causes hypersensitivity to lights, sounds, stimming etc).

I suppose you are talking about this one:

https://www.ncbi.nlm.nih.gov/pubmed/27631982

Interesting results there. Impossible to know if the improved visual reasoning is caused by the cause of autism (inflammation) or is a result of the genes that confer autism risk (via GXE interaction with vaccines).

There was an article yesterday that intelligence-associated genes are also associated with autism. So the visual performance results may be because the genes that confer autism risk, also provide improved visual reasoning. Impossible to know the causal connections.

VP,

Not at all, look at my link again because this is the search result for 128 publications with over 4/5 of them on enhanced perceptual functioning by the same PI, Laurent Mottron. Obviously, this is not the only body of knowledge on enhanced perceptual functioning (other groups are investigating that hypothesis) but this one is the most familiar to me, I worked for the PI.

128 publication spanning close to 2 decades. Look at the link again.

OK i get it. Autism is associated with enhanced visual reasoning, according to these tests. Thats interesting, but does not mean much in the present discussion. Why are you citing this?

if your point is that there is no way aluminum could cause this, I disagree. The mechanism for autism causation is inflammation. And inflammation causes many changes in how the brain develops, connectivity etc. Most changes are pathological. But I certainly would never argue that absolutely 100% of the changes caused by high inflammation in the brain are pathological according to every measurement test.

its clear that autism is pathological.

"Is there any randomized trial of delaying vaccines in high risk babies?"

No. This is the type of study thats needed. The results would put an end to this ongoing tragic failure of orthodox medicine.

the medical establishment is terrified of facing he blame for the autism epidemic and epidemic of vaccine injury, so they oppose well-designed research into vaccine injury.. But science and truth cannot be stopped forever.

Orthodox medicine will be deeply ashamed and embarrassed when the truth is known.

Mitkus used Priest and Flarend for KINETICS data only. For the toxicity data, Mitkus used a single feeding study (Golub 2001, as cited by the AYSDR 2008 report on Al). Golub reported that 26 mg/kg/day is a NOAEL, which us wrong. More recent science shows animals are harmed by 3.4, 4, 5.6, 6, 10 and 20 mg/kg/day aluminum ingestion.

No, Mitkus et al. (sec. 2.4) used the ATSDR Tox Profile 2008 (which consists of several studies) to establish MRL and pharmacokinetics are intrinsically tied to availability, excretion and deposition. By all means cite your evidence of harms with the figures you posited.

So the Mitkus MRL curve is wrong by at least a factor of 7.6.

Prove it. Show your evidence here; I'm not going to your site.

So you refuse to look at any information that challenges your beliefs? No wonder you get everything wrong!

No, I refuse to bring this to your crank site. You came here making the claims, you show the evidence.

Mitkus’s modeling only considers the toxicity of DISSOLVED Al3+ released by the particles. The toxicity of the particles is not considered or discussed.

Ooooo the particles. Toxicity was already established so whatever you're on about is outside the scope of the Mitkus et al. paper. You have still yet to establish your claim as well as tell me the order of tissue distribution of aluminium.

Orthodox medicine will be deeply ashamed and embarrassed when the truth is known.

Of course and only bold, maverick, amateur "scientists" like yourself will show us the way. How long have you kooks been at this?

@VP: autism is a developmental delay not inflammation of the brain, TBI, or anything else. You posted a paper from 2002. While the first author has a respectable CV, I don't see any publications on THIS subject more recent that about 2005. I assume he's moved beyond that theory in those years.

Science Mom,

I guess I can color myself embarrassed and ashamed to divert part of the funding in the research for autism... ;)

Alain

I mean "this subject" as autism being an environmental insult.

"No, Mitkus et al. (sec. 2.4) used the ATSDR Tox Profile 2008"

The ATSDR gets its NOAEL number (26 mg/kg/day) from Golub 2001.

if the 26 mg/kg/day NOAEL is wrong, then Mitkus is wrong. And 26 mg/kg/day is wrong. Its definitely NOT a NOAEL.

"Prove it. Show your evidence here; I’m not going to your site."

Its based on a 2016 study from Alawdi et al showing neurotoxicity (behavioral changes and neuroinflammation) from a dosage of 3.4 mg/kg/day (17 mg/kg/day AlCl3).

26/3.4 = 7.6. So, the Mitkus MRL is wrong by a factor of AT LEAST 7.6. I say at least because 3.4 mg/kg/day is not a NOAEL. Adverse effects were observed at this dosage.

Here is the Alawdi study:: https://www.ncbi.nlm.nih.gov/labs/articles/26897372/

This article explains this stuff in detail (for people not scared by information they disagree with): http://vaccinepapers.org/the-foundation-for-al-adjuvant-safety-is-false/

Alawdi is NOT the only study showing toxic effects at dosages less than 26 mg/kg/day. There are many others (I count 7-8 or so).

"Ooooo the particles."

Yes the particles. They matter. Particles have different transport/kinetics properties and totally different mechanisms of toxicity.

Here is a review paper on the subject:

"Toxicity of Nanomaterials"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703119/

I don't know if you're thivk or just stubborn, Vaccine Papers.

Autism is associated with enhanced visual reasoning, according to these tests. Thats interesting, but does not mean much in the present discussion. Why are you citing this?

The key phrase there is "enhanced reasoning", which would appear to refute your conjecture that autism is a brain injury.

"autism is a developmental delay not inflammation of the brain,"

There is widespread, intense and chronic inflammation in the brains of autistic people. Lots of studies on this.

Here is the seminal paper on this topic: https://www.ncbi.nlm.nih.gov/pubmed/15546155

Thanks Julian,

You said it better than I could. I need to work on my phrasing & writing ability.

Alain

VP: the doses DO NOT STACK. Aluminum is excreted by the kidneys. Any aluminum given in one dose is eliminated well before a subsequent one is given.

If your insane theory were correct, EVERYONE would have neurological impairments.

If that's what he considered to be the "seminal" work, no wonder he's delusional.

"The key phrase there is “enhanced reasoning”, which would appear to refute your conjecture that autism is a brain injury."

enhanced VISUAL reasoning, according to the specific test.

Autism is very clearly a brain injury and pathological, even if by some measures they perform better.

As I pointed out, we dont know if the enhancement is due to the autism, or merely associated with it (e.g. the enhancement may be because the genes that confer autism risk also improve visual reasoning).

Schizophrenia is also associated with some enhancements in visual performance tasks.

Does this mean that schizophrenia is not pathological?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756604/

@Vaccine Papers #196, I had a look at the paper you referenced.
1) It dates back to 2005. Please use something more up to date.
2) Sample size.

Brain tissues from cerebellum, midfrontal, and cingulate gyrus obtained at autopsy from 11 patients with autism were used for morphological studies. Fresh-frozen tissues available from seven patients and CSF from six living autistic patients were used for cytokine protein profiling.

That's just 24 subjects. 11 corpses, seven non-autistic patients and six autistic patients.
Somehow, that doesn't strike me as very convincing.

"If that’s what he considered to be the “seminal” work, no wonder he’s delusional."

The vargas paper has been cited by 339 other papers. its one of the most highly cited papers in the autism literature. It stimulated huge interest in brain inflammation in autism. Its definitely seminal and very important.

The Vargas results have been replicated many times. Example: https://www.ncbi.nlm.nih.gov/pubmed/23404112

Its proven beyond any doubt that the brain is inflamed in autism. There is no debate about this. Its as settled as science ever gets.

So important that you can't cite anything better?

Sorry, but color me entirely unconvinced.

So how exactly do unvaccinated children suffer from exactly the same symptoms of autism as children who are vaccinated?

"the doses DO NOT STACK. Aluminum is excreted by the kidneys. Any aluminum given in one dose is eliminated well before a subsequent one is given."

Not true. See Flarend 1997, which provides the best data on Al adjuvant kinetics. It showed that excretion of Al adjuvant after 28 days is:

6% for AlOH
22% for AlPO4.

Other studies show it hangs around for months and years. Khan 2013 demonstrated Al adjuvant particles in mouse brain ONE YEAR after injection.

the kidney cannot excrete Al adjuvant particles. They dont even travel via the blood. They are carried around the body by macrophages.

And diseases such as measles, which used to infect just about everyone back in the day, caused much more robust "inflammatory" responses than any vaccine could.

VP,

Instead of relying on a single paper about enhanced visual reasoning for which you provided the situation, how about you look at the 128 papers I mentioned and which also, refute your hypothesis of brain damage?

Alain

Someone has aluminum on the brain, and it isn't people with autism.

"So how exactly do unvaccinated children suffer from exactly the same symptoms of autism as children who are vaccinated?"

CITATION NEEDED. There is no study supporting your claim.

Note that the MMR vaccine does not contain aluminum, and its the only vaccine studied in relation to autism. There have been no epidemiological studies of Al adjuvant exposure and autism.

typo: situation == citation.

Alain

"And diseases such as measles, which used to infect just about everyone back in the day, caused much more robust “inflammatory” responses than any vaccine could."

What matters is inflammation in the brain. Al adjuvant causes inflammation in the brain specifically.

Also, chronic inflammation is what matters. Inflammation from an infectious illness is transient. Al adjuvant causes long term, chronic brain inflammation.

"how about you look at the 128 papers I mentioned and which also, refute your hypothesis of brain damage?"

Im not going to dig through 128 papers to find support for your argument. Thats your job. You are making a GISH GALLOP. I looked at a number of them and did not immediately see that all of them reported enhancements.

What enhancements occur other than visual reasoning in the specific test mentioned in that paper I identified?

Wow, just wow.

And I wonder why VP is wasting all of our time here & not submitting for a Nobel Prize?

"Sorry, but color me entirely unconvinced."

You are skeptical that inflammation is present in the autistic brain?

This is autism 101. Please learn the basic scientific facts about the disorder before commenting.

https://www.autismspeaks.org/science/science-news/study-suggests-brain-…

"And I wonder why VP is wasting all of our time here & not submitting for a Nobel Prize?"

Ah the Nobel prize gambit. So funny! Like I havent heard that bullshit before. Vaccine promoters are so predictable.

Thats not an argument.

@Vaccine Papers #203:

The Vargas results have been replicated many times...Its proven beyond any doubt that the brain is inflamed in autism.

No it isn't. As to the study you mentioned, it had 20 subjects. In addition, "excessive microglial activation" is not indicative of brain injury.

"The investigators conclude that the brain inflammation likely resulted from, rather than caused, autism"

There are lots of other studies establishing inflammation> autism causation. Like this study in monkeys.

https://www.ncbi.nlm.nih.gov/pubmed/24011823

Epidemiological studies in humans also show that autism is caused by immune activation (inflammation).

You are making a GISH GALLOP

False accusation. I provide the evidence against your hypothesis of autism being brain damage. There is also auditory enhancements and better results on the Raven Standard progressive matrix including in neuroimaging beside faster response time.

Now if you won't go read that evidence, you have no business or any grounding to say that autism is a result vaccine injuries.

Alain

Link to the specific citations and I will look at them. Not going to look at a list of 128 unsorted papers produced by a search query!

Enhancements in a few types of test results does not establish its not a brain injury/pathological. Overwhelming science shows autism is a brain injury.

A study mentioned by "Autism Speaks" in 2014? Seriously?
"Autism Speaks" pushed the "vaccines cause autism" line long after it was no longer tenable. And the number of subjects?

The investigators compared gene expression in 72 brains, 47 of which came from children and adults affected by autism.

Another study with a ridiculously small sample size. That's the third one you've posted. And did you see the word "suggests"? That doesn't mean the study is definitive, just preliminary.

And that rhesus monkey study you mention had 13 subjects and 11 controls. "Underpowered" doesn't even begin to cover it.

There is widespread, intense and chronic inflammation in the brains of autistic people. Lots of studies on this.

Here is the seminal paper on this topic: https://www.ncbi.nlm.nih.gov/pubmed/15546155

The authors of that small study are mortified by how it has been co-opted and completely abused by cranks like you leading to parents shovelling Rx anti-inflammatories and anti-virals into their autistic children. No, there is not "widespread, intense and chronic inflammation in the brains of autistic people." And no there are not "lots of studies on this." Not surprised ignorant attention-whores like you just make things up though.

Just making sure you see this response re: Mitkus.

“No, Mitkus et al. (sec. 2.4) used the ATSDR Tox Profile 2008”

The ATSDR gets its NOAEL number (26 mg/kg/day) from Golub 2001.

if the 26 mg/kg/day NOAEL is wrong, then Mitkus is wrong. And 26 mg/kg/day is wrong. Its definitely NOT a NOAEL.

“Prove it. Show your evidence here; I’m not going to your site.”

Its based on a 2016 study from Alawdi et al showing neurotoxicity (behavioral changes and neuroinflammation) from a dosage of 3.4 mg/kg/day (17 mg/kg/day AlCl3).

26/3.4 = 7.6. So, the Mitkus MRL is wrong by a factor of AT LEAST 7.6. I say at least because 3.4 mg/kg/day is not a NOAEL. Adverse effects were observed at this dosage.

Here is the Alawdi study:: https://www.ncbi.nlm.nih.gov/labs/articles/26897372/

This article explains this stuff in detail (for people not scared by information they disagree with): http://vaccinepapers.org/the-foundation-for-al-adjuvant-safety-is-false/

Alawdi is NOT the only study showing toxic effects at dosages less than 26 mg/kg/day. There are many others (I count 7-8 or so).

“Ooooo the particles.”

Yes the particles. They matter. Particles have different transport/kinetics properties and totally different mechanisms of toxicity.

Here is a review paper on the subject:

“Toxicity of Nanomaterials”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703119/

"“excessive microglial activation” is not indicative of brain injury."

Oh yes it is. Microglial activation indicates ongoing neuroinflammation. Activated microglia cause all sorts of damage to the brain.

There is PLENTY of science richly demonstrating the brain injury present in autism. its preposterous to say autism is not a brain injury. Just shows a complete ignorance of the literature. Not interested in debating this point.

VP,

How many papers do you have on your website?

Alain

"And no there are not “lots of studies on this.” Not surprised ignorant attention-whores like you just make things up though."

So you are suggesting that there is not inflammation in the autistic brain? Really?

Arguing this is utterly ridiculous. Im amazed.

There are lots of other studies establishing inflammation> autism causation. Like this study in monkeys.

https://www.ncbi.nlm.nih.gov/pubmed/24011823

Epidemiological studies in humans also show that autism is caused by immune activation (inflammation).

And another example of the VP crank abusing studies about maternal infection to make the chasmic leap to vaccinesdidit.

ANother paper on the chronic inflammation in the autistic brain:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770268/

Really, you guys need to stop arguing this point.

So you are suggesting that there is not inflammation in the autistic brain? Really?

Immune markers found in the brain tissue of a handful of autistics is not "inflammation in autistics' brains. Really.

Arguing this is utterly ridiculous. Im amazed.

It certainly is given your woeful ignorance of biology and study interpretation. Glad we agree on something.

""And another example of the VP crank abusing studies about maternal infection to make the chasmic leap to vaccinesdidit.

Autism is brain injury caused by early life inflammation in the brain. And thats exactly what Al adjuvant does.

Al adjuvant in fact stimulates the exact same type of immune activation (interleukin-6) proven to cause the disorder.

So you are suggesting that there is not inflammation in the autistic brain? Really?

I haven't said that, neither that the normal brain doesn't have any inflammation either. My point of contention is autism being brain damage. I provide the evidence to the contrary.

So, how many papers do you have on your website^ and second question, is that an exhaustive search for paper?

Alain

There are so many pathologies in autism: inflammation, impaired methylation, oxidative stress, cogntiive impairments, immune dysfunction. And there are many associations with other disorders: autoimmunity and allergy are examples.

Autistics also have higher mortality. We can agree this is pathological, right?
https://www.ncbi.nlm.nih.gov/pubmed/23008058

The scientific literature does not often specifically describe it as pathological, because it does not need to. Everyone knows that chronic inflammation is pathological.

Orthodox medicine faces the blame for the epidemic of vaccine brain injury known as autism. Thats why they want to shift the blame to things like genes, and pretend like its not really a problem. Politics, not science, is driving opinions about autism in the medical community.

"No, there is not “widespread, intense and chronic inflammation in the brains of autistic people.”"

CITATION NEEDED.

Every study ever done on this question has reported the same thing: widespread, intense and chronic inflammation in the autistic brain.

And, a study of several dozen autistic brains is a good size study. Very difficult to obtain human autistic brain samples and analyze them. You are expecting/demanding a study of THOUSANDS of brains? Really?

The Vargas 2005 study looked at dozens of cytokines and inflammatory markers in numerous brain regions separately, in controls and autistics. That study was a huge amount of work.

Its not reasonable to demand such an impossibly high level of evidence.

Again, I'm confused why VP is wasting time on us "ignorant" folk & not applying to the Nobel committee....

VP,

Again, how many papers do you have on your website? And also, is that an exhaustive search for papers?

Alain

"And also, is that an exhaustive search for papers?"

I dont understand this question.

Vaccine Papers,

You responded to DB's citation of a study that suggested that lesions in the brains of people with autism arose early in gestation by stating that "cortical layers continue to form postnatally." Uh huh.

In response to a citation of work that involved the comparison of whole exome sequencing data from over 80,000 individuals, you indicated that you don't like twin studies. Got it.

You're just embarrassing yourself.

Thats an insult, not an argument.

"And that rhesus monkey study you mention had 13 subjects and 11 controls. “Underpowered” doesn’t even begin to cover it."

Thats a decent size for a monkey study, which are very expensive to do.

The results were highly statistically significant, which is what counts.

"In response to a citation of work that involved the comparison of whole exome sequencing data from over 80,000 individuals, you indicated that you don’t like twin studies. "

The claims of high heritability are based on the twin studies, not the genome sequencing studies, because genome sequencing has failed to provide evidence that its highly heritable. There are hundreds of genes associated with autism, most with weak association. That indicates its NOT a genetic disorder. Its a gene-environment interaction.

Not to tooth my horn but I also wonder why VP isn't inclined to read only 128 papers of my own choosing while, in my case, from our publication, there is this text:

Of over 7000 articles retrieved, 58 (19 PET and 39 fMRI) satisfied all inclusion criteria and were included in the analysis

Source: https://www.ncbi.nlm.nih.gov/pubmed/21833294 and http://journal.frontiersin.org/article/10.3389/fpsyg.2010.00241/full

Of which, I personally read over 2000 of them at a rate of 50 per day ;) While attending my undergrad study...and doing my usual daily chores.

That said, I'm perusing the list of 128 article I provided to VP to trim that down to a readable list...if only VP would give me the number of publication for his / her evidence that autism is brain damage...Will I be waiting? :)

Alain

Papers on the VP website are contextualized and explained. They are not merely listed without explanation, as you have done.

VP,

To answer your question, for our paper, we did an exhaustive search for papers (which in our case, was over 7000 papers needing screening and assessment). I want to know if the list of papers on your website is as complete as possible and how many there is? Your website doesn't specify the number of papers you have there. I want a number.

Alain

You are free to go count them. I havent done that.

# 167 Dr. Corcos,
"Is there any randomized trial of delaying vaccines in high risk babies?"

What is considered "high risk" in this case?

You are free to go count them. I havent done that.

oooohhhh....Now that doesn't support your argument that there is massive evidence of brain damage if you are not even able to count the number of papers on your website which is the bare minimum task to do if one want to be considered a scientist. Did you even read them?

Alain

Again, how many papers do you have on your website?

I'm sure that curl or wget would be more than happy to provide you with the answer to that. More interesting to me is how many of them are pirated.

Narad,

Sure I can and will do that but I wanted to verify his / her assertion that there are massive evidence of brain damage.

Alain

Here is a suggestion: you should engage with my evidence and arguments. Explain why my arguments are wrong.

Explain why this causal chain is wrong:

Al adjuvant injection > transport to brain > inflammation in brain > autism.

Again, why are you wasting time trying to convince us of your hypothesis?

Why aren't you accepting a Nobel Prize as we speak, since you've got it all figured out?

Ok,

I will mention it again, the enhanced perceptual functioning and associated hypothesis (Markram et al. at least but there are other) goes against your hypothesis that autism is a result of brain damage. Furthermore, IQ range of autistic peoples goes from mental disability range (not testable) to over 150 IQ point score (98th percentile on the RSPM) which argue against brain damages.

Of course, there can be inflammation in autistic brain but that can be present in the normal brain too (fever among others), that is not, automatically brain damages. Furthermore, there is evidence from, at a minimum, the lab I was working in of excellent memory (we also studied autistic savants for which, the epidemiology is 1/5 autistic subjects having savants abilities compared to the general population rate of 1%).

Which again, goes against brain damage. Yes, autism is a pathology (a social one and sometime, a language one) but that doesn't mean brain damage.

You get it?

Alain

While VP insists that "every" study on the question reveals that there's widespread chronic inflammation in the brains of those with autism, VP ignores that such inflammation to some extent may be the _consequence_ and not the cause of autism.

https://www.autismspeaks.org/science/science-news/study-suggests-brain-…

If we accept the idea that inflammation causes autism, then VP will have to continue doing a dance around evidence that autism begins during gestation and inflammatory changes in utero could have a causative role.

"Autism likely begins in the womb, during brain formation, and animal studies indicate that layer formation in the fetal brain may be damaged by inflammation in the mother. A study published in February 2014 followed 1.2 million pregnancies in Finland. Researchers measured the women's levels of C-reactive protein (CRP), a well-established measure of inflammation. They found that the risk of autism in the children of women with the highest levels of CRP was 43 percent higher than in those of the women with the lowest levels."

"Other studies have begun to show that mothers who have certain pro-inflammatory conditions are at greater risk of having children with autism—these conditions include rheumatoid arthritis, asthma, celiac disease, diabetes, and obesity. Women with autoimmune diseases are more likely to produce "antibrain antibodies," which can attack the brain tissue of a fetus. Women who have an infection during pregnancy may also be at increased risk of having children with autism.
These studies suggest that measuring inflammation in pregnant women may help identify those children most at risk for developing an ASD and help get them early intervention."

http://www.healthline.com/health-news/connection-between-inflammation-a…

Note that last part about infection-associated risks. VP would have you believe that minute quantities of aluminum-based adjuvant or other Vaccine Toxins are grievously harmful to developing brains, but somehow serious infections with their raft of actual toxins causing release of large amounts of cytokines are inconsequential.

In a way, it's amusing to see so many fallacies dressed up in pseudoscientific jargon in defense of antivax ideology.

But it's also depressing.

I want to reemphasize your later point - that if inflammation was the issue, the diseases would be the concern, not the tiny amounts of aluminum salts in vaccines. VP suggested earlier that measles does not cause inflammation in the brain - which is strange in a disease for which one of the complications is encephalitis, in about 1:1000. Mumps can also cause encephalitis, and other diseases also have such effects. So if the issue was inflammation, why are the vaccines the culprit and not the solution?

" Researchers measured the women’s levels of C-reactive protein (CRP), a well-established measure of inflammation. They found that the risk of autism in the children of women with the highest levels of CRP was 43 percent higher than in those of the women with the lowest levels.”"

Elevated inflammation during gestation creates higher risk of injury from inflammation from vaccines. Its the "two-hit" model. First hit does not cause great damage, but creates vulnerability to a second hit. The second hit (vaccines) causes the injury.

"VP would have you believe that minute quantities of aluminum-based adjuvant or other Vaccine Toxins are grievously harmful to developing brains, but somehow serious infections with their raft of actual toxins causing release of large amounts of cytokines are inconsequential."

The quantities are not minute. They are proven to cause life-long debilitating brain injury and inflammation in the brain, at vaccine dosages. Al adjuvant causes long term chronic inflammation in the brain, because it puts aluminum in the brain. Normal infectious illnesses do not do this. They cause transient inflammation, not necessarily in the brain.

Of course he doesn't.

Because he's talking about a "brain damage" which is so specific that this "inflammation" cannot be replicated by anything other than aluminum salts adjuvants.

Which leads me back to the question of why we find autistic children (and adults) who are entirely unvaccinated.

Al adjuvant injection > transport to brain > inflammation in brain > autism.

The part in bold: inflammation in brain, does not always lead to autism. This is a non-specific finding which can present in every brain on this planet leading to different results or pathology, if any (pathology that is) is present.

Alain

"Of course, there can be inflammation in autistic brain but that can be present in the normal brain too (fever among others), that is not, automatically brain damages. Furthermore, there is evidence from, at a minimum, the lab I was working in of excellent memory (we also studied autistic savants for which, the epidemiology is 1/5 autistic subjects having savants abilities compared to the general population rate of 1%).

Which again, goes against brain damage. Yes, autism is a pathology (a social one and sometime, a language one) but that doesn’t mean brain damage.

You get it?"

yes I get it. Thank you for explaining.

Yes inflammation must be intense and/or long enough to cause injury.

Autism is associated with intelligence genes. So, association with some types of improved cognitive function does not establish its not injury. We dont know what the cognitive function would be like in these individuals if they were not autistic.

As I mentioned, there are MANY reasons why autism is an injury-the inflammation, missing purkinje cells and associations with diseases. We know some of the causes, like early life infections and toxin exposures, and they are definitely not beneficial or benign.

See the literature on immune activation and autism. Experiments in animals prove causation, i.e. the link:

inflammation 9IL-6) >> autism.

example:

https://www.ncbi.nlm.nih.gov/pubmed/22310922

Lawrence,

Agreed. Time for me to go to work.

Later ;)

It's a gene-environment interaction.

Remarkably, recent evidence suggests that gene-environmental interaction at very early periods of fetal brain development produce ASD-related phenotypes. This has nothing to do with postnatal administration of adjuvanted vaccines.

Atladottir HO, Thorsen P, Ostergaard L, Schendel DE, Lemcke S, Abdallah M et al. Maternal infection requiring hospitalization during pregnancy and autism spectrum disorders. J Autism Dev Disord 2010; 40(12): 1423-1430.

Baron-Cohen S, Auyeung B, Norgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L et al. Elevated fetal steroidogenic activity in autism. Molecular psychiatry 2015; 20(3): 369-376.

Birnbaum R, Jaffe AE, Hyde TM, Kleinman JE, Weinberger DR. Prenatal expression patterns of genes associated with neuropsychiatric disorders. The American journal of psychiatry 2014; 171(7): 758-767.

Brimberg L, Sadiq A, Gregersen PK, Diamond B. Brain-reactive IgG correlates with autoimmunity in mothers of a child with an autism spectrum disorder. Molecular psychiatry 2013; 18(11): 1171-1177.

Courchesne E, Mouton PR, Calhoun ME, Semendeferi K, Ahrens-Barbeau C, Hallet MJ et al. Neuron number and size in prefrontal cortex of children with autism. JAMA : the journal of the American Medical Association 2011; 306(18): 2001-2010.

Jiang HY, Xu LL, Shao L, Xia RM, Yu ZH, Ling ZX et al. Maternal Infection during Pregnancy and Risk of Autism Spectrum Disorders: A Systematic Review and Meta analysis. Brain Behav Immun 2016.

Lee BK, Magnusson C, Gardner RM, Blomstrom A, Newschaffer CJ, Burstyn I et al. Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders. Brain Behav Immun 2015; 44: 100-105.

Lombardo, MV, Moon, HM, Su, J, Palmer, TD, Courchesne, E, Pramparo T. Maternal immune activation dysregulation of the fetal brain transcriptome and relevance to the pathophysiology of autism spectrum disorder. Molecular Psychiatry advance online publication 21 March 2017; doi: 10.1038/mp.2017.15

Parikshak NN, Luo R, Zhang A, Won H, Lowe JK, Chandran V et al. Integrative functional genomic analyses implicate specific molecular pathways and circuits in autism. Cell 2013; 155(5): 1008-1021.

Stoner R, Chow ML, Boyle MP, Sunkin SM, Mouton PR, Roy S et al. Patches of disorganization in the neocortex of children with autism. N Engl J Med 2014; 370(13): 1209-1219.

Willsey AJ, Sanders SJ, Li M, Dong S, Tebbenkamp AT, Muhle RA et al. Coexpression networks implicate human midfetal deep cortical projection neurons in the pathogenesis of autism. Cell 2013; 155(5): 997-1007.

If they’re so toxic, why don’t they kill the macrophages before they magically arrive at the brain to deliver their sinister payload?

Good question. Its likely because the Al adjuvant particles are present inside the macrophage lysosomes, which can be considered to be outside the macrophage.

Do you even know what a lysosome is?

""Because he’s talking about a “brain damage” which is so specific that this “inflammation” cannot be replicated by anything other than aluminum salts adjuvants.

Which leads me back to the question of why we find autistic children (and adults) who are entirely unvaccinated.

Anything that causes the right type of inflammation in the brain, of sufficient duration and/or intensity, can cause autism. Infections can cause autism, because infections can cause inflammation in the brain.

"Remarkably, recent evidence suggests that gene-environmental interaction at very early periods of fetal brain development produce ASD-related phenotypes. This has nothing to do with postnatal administration of adjuvanted vaccines."

The injury can occur prenatally or postnatally.

There is nothing in your cited papers that indicates the injury can occur only in the prenatal period.

The human brain has intense development after birth, including the formation of most synapses. Synapse formation is known to be disrupted in autism.

"There is nothing in your cited papers that indicates the injury can occur only in the prenatal period."

Remarkably, prenatal development can explain postnatal phenotypes, but postnatal exposure to adjuvants cannot explain observed ASD-related changes during fetal development.

"but postnatal exposure to adjuvants cannot explain observed ASD-related changes during fetal development."

Actually they can, because your evidence is mere correlation.

Differences observed in the prenatal period are simply indicators of vulnerability to vaccine injury.

Specifically, this vulnerability can be caused by things like nutrient deficiency (e.g. vitamin D deficiency) or genetic tendency to high inflammation or autoimmunity (which would create vulnerability to vaccination).

Autism is brain injury caused by early life inflammation in the brain. And thats exactly what Al adjuvant does.

Al adjuvant in fact stimulates the exact same type of immune activation (interleukin-6) proven to cause the disorder.

No it doesn't and your hand-waving isn't a substitute for evidence. As usual the VP crank starts off with his aluminium fixation, can't answer rebuttal nor provide evidence to support his claims then moves on to his other obsession, IL-6. Tell me VP crank, what is the order of tissue deposition for aluminium?

You should read my arguments, including articles on the VP blog, before commenting.

Lots of scientific evidence supports the IL-6 > autism connection.

https://www.ncbi.nlm.nih.gov/pubmed/23994594

Thats a decent size for a monkey study, which are very expensive to do.
The results were highly statistically significant, which is what counts.

That study had 11 controls and 13 subjects. There is no way on Earth it was statistically significant.

Summary of the results. Several results had P<0.01.

(A) Maternal immune activation (MIA) off- spring exhibit increased frequency of motor stereotypies and self-directed behaviors. Left panel: When observed alone in a large cage at 10 months of age, second trimester MIA (MIA2) animals produce significantly more repetitive behaviors than control animals (CON) (**p # .01). The first trimester MIA (MIA1) offspring also produce more repetitive behaviors than control animals, but this difference does not reach statistical significance at 10 months (p 1⁄4 .06). Middle panel: When observed alone at 22 months of age, MIA1 offspring produce significantly more repetitive behaviors (*p # .05). Second trimester MIA animals also produce significantly more repetitive behaviors than control animals at 22 months (**p # .01). Right panel: When tested at 17 months of age in the Y- maze social preference assay, MIA2 treatment animals produce significantly more repetitive behaviors than control animals (**p # .01). (B) Maternal immune activation offspring display decreased affiliative vocaliza- tions. Left panel: At 22 months, MIA2 offspring produce significantly fewer coo calls than control animals (**p .01). Right panel: When observed with a novel conspe- cific at 24 months of age, MIA1 offspring produce significantly fewer coo calls than control animals (*p # .05). (C) Maternal immune activation offspring exhibit inappropriate interactions with unfamiliar conspecifics. Left panel: First trimester MIA offspring demonstrate inappropriate social interactions with an unfamiliar animal, as indexed by high frequency of approaching (*p 0.05) and more frequently moving within arm’s reach of the unfamiliar animal (**p .01). Right panel: First trimester MIA offspring remained near the unfami- liar animal, as indexed by the duration of time spent in physical contact or within arm’s reach of the unfamiliar animal (*p .05).

“And that rhesus monkey study you mention had 13 subjects and 11 controls. “Underpowered” doesn’t even begin to cover it.”

Thats a decent size for a monkey study, which are very expensive to do.

The results were highly statistically significant, which is what counts.

You're really not clear on this concept, are you?

By the way, most of the Papers you list use the words "suggest" "may" and "might".

Such language is common in scientific literature, which is typically written with an (over) abundance of caution. What matters most is the data presented, not the opinions of the authors. The Wei IL-6 paper reviews strong evidence proving that IL-6 causes autism in animal models. Its proven beyond any reasonable doubt, at least in the animal models.

Also see this (IL-6 induces IL-17, so this paper is another replication of the IL-6 results):

https://www.ncbi.nlm.nih.gov/pubmed/26822608

If I resume that correctly:

Autism is brain damage caused by 9IL6 which is a causative agent even in autistic people having an IQ off the chart for which if there where no vaccines given and no injuries to the brain, autistic people would have even greater IQ. Everything else is correlational.

I think there's lots of assumptions in there but I'll leave it to the regulars because of work and commenting on a phone is awful.

"autism in animals" model?

So, via the current DSM, what should autism in a Rat look like?

abnormal social and communicative behavior, and repetitive behavior. Also, damage to purkinje cells and cerebellum. Successful animal model replications have been done in monkeys, which are obviously more human-like. The animal models are excellent models of human disease, since immune activation (infection) also causes autism in humans, and they produce the same physiological damage and behaviors. Also, the same drugs and brain inflammation is observed. The animal models match human autism in every way thats been tested. The validity of the immune activation animal models is accepted, by consensus.

A recent quote from a well known autism researcher:

“These MIA (maternal immune activation) animal models meet all of the criteria required for validity for a disease model: They mimic a known disease-related risk factor (construct validity), they exhibit a wide range of disease-related symptoms (face validity), and they can be used to predict the efficacy of treatments (predictive validity).”
–Dr Kimberley McAllister, UC Davis MIND Institute, Science, August 2016 (i.e. this paper: http://science.sciencemag.org/content/353/6301/772 )

Differences observed in the prenatal period are simply indicators of vulnerability to vaccine injury.

Uh huh. So here are some fetal neurodevelopmental "indicators of vulnerability to vaccine injury":

Blurring of the gray/white matter junction as the result of a migratory defect where cells that should move to the cerebral cortex get stuck in the subplate region.

Corpus callosum abnormalities that indicate axonal guidance defects related to abnormalities of neuronal migration, e.g., heterotopias, an increase in subpial neurons, and cortical malformations.

Disorganization of minicolumns, the units of the basic architecture of the brain.

Reduction of the number of interneurons along with abnormal migration of radially migrating neuroblasts as a result of mistiming of migration.

You dont have evidence that those defects are present prenatally. Thats ASSUMED.

Differences observed in the prenatal period are simply indicators of vulnerability to vaccine injury.

Uh huh.

"Begging the question" appears to be something else that has failed to sink into Dan's cranium.

Autism is a "spectrum" which ranges from very severe to high functioning.....so pray tell, how can you use these "animal models" that you put so much faith in, to relate back to a single vaccine ingredient?

I ask the question, knowing that you really can't answer it.

Again, if you're so sure, why aren't you receiving your Nobel Prize?

"how can you use these “animal models” that you put so much faith in, to relate back to a single vaccine ingredient?"

The connection is IL-6.

IL-6 causes the injury in the animal models, and aluminum adjuvant induces IL-6 in the brain.

Al adjuvant > IL-6 in brain > autism

You should read my arguments, including articles on the VP blog, before commenting.

I've read some of your block. You're a hack and obviously out of your depth.

Lots of scientific evidence supports the IL-6 > autism connection.

https://www.ncbi.nlm.nih.gov/pubmed/23994594

Something something opinion piece and nothing to do with vaccines as usual.

You guys are supposed to have mountains of evidence that vaccines do not cause autism, right? How come I have not seen any such evidence with regard to aluminum adjuvant?

What matters most is the data presented, not the opinions of the authors.

This was a howler. Data pl. numpty and the interpretation of the data by the authors who know a helluva lot more on the subject than you do matters, not your free-wheeling associations and lack of intellectual integrity.

They argue that IL-6 causes autism.
quotes:

"All these evidences suggest that brain IL-6 may play an important role in the development of autism."

"IL-6 elevation in the brain, caused by the activated glia and/or MIA could mediate autism- like behaviors, through impairments of neuroanatomical structures and neuronal plasticity"

"Wei et al. developed a mouse model of over-expressing IL-6 in the brain with an adenoviral gene delivery approach and confirmed that IL-6 is an important mediator of autism-like behaviors. This study found that mice with an elevated IL-6 level in the brain developed autism-like behaviors (Wei et al., 2012a). These findings suggest that IL-6 elevation in the brain could modulate certain pathological alterations and contribute to the development of autism."

IL-6 causes the injury in the animal models, and aluminum adjuvant induces IL-6 in the brain.

Al adjuvant > IL-6 in brain > autism

If there is no animal model for autism, you haven't established vaccines induce IL-6 in the brain to produce pathology and that pathology is autism, then how can you possibly expect not to be laughed at.

There is an excellent animal model of autism: immune activation exposure during early development.

Several studies show al adjuvant induces long term inflammation in the brain and pathology, and there is some evidence now that it induces IL-6 in the brain. Several studies show Al induces IL-6.

http://vaccinepapers.org/aluminum-inflammation-interleukin-6/

Oh and still waiting for VP crank to list the order of tissue deposition for aluminium since he's such an expert on the subject.

Well Dan, when you going to get around to that?

There is an excellent animal model of autism: immune activation exposure during early development.

Well what is it? There is no animal model of autism and I'm not going to your blog, you can cough your evidence up here. I'm not doing your job for you.

Because he can't....guess he's too busy writing up his Nobel submission, right?

Several results had P<0.01.

So?

The connection is IL-6.

And G-d = $latex G_{uv}$.

^ "[sic]" for the subs.

There is an excellent animal model of autism: immune activation exposure during early development.

"Model." You keep using that word, etc.

VP: "Autism does not begin in utero."
VP: "The injury can occur prenatally or postnatally."

I detect a subtle lack of consistency here. :)

Of course, we're dealing with someone who's convinced of "strengths" in the Mawson article, while being incapable of understanding how its conclusions are disqualified by its multiple fatal flaws. When it comes to critical thinking skills, lack of consistency is the least of VP's problems.

Of course, this post will be dismissed as "snark" that doesn't address The Science - which I and others have discussed at length, only to be met with denial, Gish galloping to other misunderstood and/or irrelevant publications, and admonitions to read VP's blog, where all will be revealed..

Correction: Autism usually is not caused in utero, but the conditions that create vaccine vulnerability may begin in utero, though these conditions will not cause autism on their own.

Going back to VP's thing about aluminum. First VP says that Al (injected intramuscularly) can't be excreted, that it is stuck in the muscle.
Then VP says that Al moves to the brain.
Well, which is it? AL is stuck in the muscle forever, or Al can move through the body?

You can't have it both ways.

Never said it was stuck in the muscle. I said it was stuck in the BODY. The particles dont dissolve and they cannot be excreted by the kidneys.

Some of it travels into the brain. In the mouse experiments with 200mcg/kg, about 1.3% traveled to the brain, which was enough to cause long term brain inflammation and brain injury.

Its carried into the brain by macrophages. Thats explained here: http://vaccinepapers.org/vaccine-aluminum-travels-to-the-brain/

There is an excellent animal model of autism: immune activation exposure during early development.

How does altered gene expression during fetal development suggest that macrophages carrying postnatally-delivered, vaccine-derived particles of aluminum across the blood-brain barrier cause ASD?

Vaccine Papers:

There is an excellent animal model of autism: immune activation exposure during early development.

Um, are you unclear what "model of autism" means? Because you just said that the animal model of autism is the thing you claim causes autism.

We're not asking what you claim causes autism. We're asking how you know these animals have autism at all (or something similar enough to count). Merely possessing the thing you claim causes autism isn't enough, because you're trying* to test whether or not this thing causes autism.

*Well, theoretically. I'm making the possibly unwarranted assumption that you possess some degree of intellectual honesty.

Same behaviors. Same physiological damage. Same treatments are effective as humans. Same causes as in humans.

Thats a good animal model.

You dont have evidence that those defects are present prenatally. Thats ASSUMED.

Those statements are based on decades of research in developmental biology. If you hope to contradict not only that evidence but the evidence from an entire field of biology, you need to do something more than wave your hands.

Let's see if I can not-b0rk the markup here:

[']Women with autoimmune diseases are more likely to produce “antibrain antibodies,” which can attack the brain tissue of a fetus.[']

<stagmom>And are due to maternal vaccinations.</stagmom>

[']Women who have an infection during pregnancy may also be at increased risk of having children with autism.[']

<Dachelbot>"Besides bad genes, experts like to associate the habits of mothers with the developmental of autism: old moms, young moms, fat moms, moms who have C-sections, drinking moms, smoking moms, moms who have babies too close together, moms who marry old dads, moms who live too close to freeways."</Dachelbot>

All those things cause inflammation prenatally, which greatly increases vulnerability to vaccine injury. When there is already inflammation present, additional inflammation (from vaccine) is made more harmful.

“IL-6 elevation in the brain, caused by the activated glia and/or MIA could mediate autism- like behaviors, through impairments of neuroanatomical structures and neuronal plasticity”

Oh, dear. The odd thing is that this really only appears in the abstract* and pretty much identtically in the conclusion. Well, that, and the fact that the subject warranted a six-page review paper.

How the VG thinks this glues anything together for his idée fixe beyond selective word associations is beyond me.

* Apparently the only part of a Neuroscience paper that receives the otherwise conventional benefit of "hyphenation."

^ Dan's copy of Wei et al. (2013) (PDF) came from LibGen,* just in case anybody was wondering whether he actually got off his ass and went to the library or anything before posting it.

* XMP, honeybunch.

So you prefer to attack me instead of attacking my evidence and arguments.

I say thats because you dont now how to refute my arguments.

Autism usually is not caused in utero, but the conditions that create vaccine vulnerability may begin in utero, though these conditions will not cause autism on their own.

Ah, of course--and which vaccinated-unvaccinated studies--the studies that your fellow travelers claim have never been conducted--show this? Because vaccines.

All those things cause inflammation prenatally, which greatly increases vulnerability to vaccine injury. When there is already inflammation present, additional inflammation (from vaccine) is made more harmful.

Was I talking to you, Dan? Mind your place.

Slightly OT: looks like the VAXXED folks have pi$$ed off a Maori doctor.

https://www.tvnz.co.nz/one-news/new-zealand/watch-your-presence-here-ca…

@ VP
I don't think that your hypothesis is impossible. But before it is seriously considered, you should provide some evidence of the correlation between aluminium in vaccines or changes in the schedule of vaccines and the rise in autism incidence.

There are no epidemiological studies of Al adjuvant exposure and autism. There is zero human data. The MMR-autism studies dont count because MMR does not contain aluminum. No studies of autism look at Al adjuvant exposure.

There is the Shaw ecological study, but being ecological, it doesnt mean much. Its useful for hypothesis generation only.

The animal studies on autism and Al adjuvant are convergent and strongly indicate that Al adjuvant is a serious safety hazard. Animals suffer brain injury and inflammation from the same dosages given to human infants.

@ Dorit reiss"VP suggested earlier that measles does not cause inflammation in the brain – which is strange in a disease for which one of the complications is encephalitis, in about 1:1000. Mumps can also cause encephalitis, and other diseases also have such effects. So if the issue was inflammation, why are the vaccines the culprit and not the solution?"

I never stated that measles does not ever cause inflammation in the brain. it definitely can. But your risk of 1:1000 is overstated. That may be the risk for REPORTED cases, not total number of actual cases of measles.

Vaccines are the culprit because of the aluminum adjuvant. it travels to the brain, which is extremely sensitive to low levels of aluminum. Vaccines contain far more than enough aluminum to cause brain injury. In the recent experiment with 200mcg/kg, about 1.3% traveled to the brain over 6 months, which was enough to cause brain injury and long term inflammation.

Slightly OT: looks like the VAXXED folks have pi$$ed off a Maori doctor.

And Lo, there was a mighty butt-hurt across the land, and great was the clutching of pearls.

Orthodox medicine faces the blame for the epidemic of vaccine brain injury known as autism.

You are trying to convince Alain that he is brain-damaged. Alain does not believe you. Your main rhetorical technique seems to consist of begging as many questions as possible within each single sentence, so you're probably not convincing anyone else either.

Sorry. I dont know Alain. Its nothing personal. Im not here to insult anyone.

OK. I get an e-mail notification every time there is a comment. I'm getting tired of seeing half the comments here by VP. This is basically the sort of flooding of a comment thread designed to drown out the rest of my commenters. I've put up with it for around three days now, but it has be, and VP's responses are very repetitive and incredibly tiresome. If the pace of posting doesn't slow, I will take measures to slow it. I won't ba outright, but I have my ways. Moderation delay is generally the first step.

I am merely responding to objections and questions. Im not trolling or flooding. I am the only one here representing contrary opinion, so of course that creates a higher level of responses. Not my intention to take over. Sorry that impression occurred. Was planning to abandon this thread today, since it is getting repetitive.

Orac-

Are you going to address the new science showing brain injury from Al adjuvant? Like the new Crepeaux paper: https://www.ncbi.nlm.nih.gov/pubmed/27908630

The new science showing the Mitkus analysis (the foundation for Al adjuvant safety) is wrong?

The links between Al adjuvant and immune activation/cytokine brain injury?

This is where the vaccine controversy is headed.

Oh, you'll be back. You always come back eventually. This episode had just started to get on my nerves because of your repetition. And, yes, you were trolling and flooding. As for the "science," you do seem way too enamored of mouse studies.

I will be back!

A big advantage of animal studies is that they can be properly controlled. Poorly-matched controls is the big problem with human epi studies of vaccines (i.e. healthy user bias).

We have some good studies now on immune activation brain injury in monkeys.

I do enjoy reading your blog. Its helpful to understand opposing opinion.

[Dorit's] risk of 1:1000 is overstated. That may be the risk for REPORTED cases, not total number of actual cases of measles.

It is next to impossible to miss Measles. And if anything, Dorit understated the risk of Measles encephalitis.

You are trying to convince Alain that he is brain-damaged. Alain does not believe you.

And neither do I

@ Vinu
I mean babies with autist siblings.
@ VP
What has to be explained is the rise in autism incidence after adjustment for diagnostic criteria change. If there is no evidence for concomitant changes in aluminium injections, why would people be interested in your hypothesis, knowing that testing it will be tricky?

"I mean babies with autist siblings."

In that case we have to account for the fact that autism may have been caused by maternal autoantibodies against the fetal brain.

Same behaviors. Same physiological damage. Same treatments are effective as humans. Same causes as in humans.

Thats a good animal model.

“These MIA (maternal immune activation) animal models meet all of the criteria required for validity for a disease model: They mimic a known disease-related risk factor (construct validity), they exhibit a wide range of disease-related symptoms (face validity), and they can be used to predict the efficacy of treatments (predictive validity).”
–Dr Kimberley McAllister, UC Davis MIND Institute, Science, August 2016 (i.e. this paper: http://science.sciencemag.org/content/353/6301/772 )

Another case of Dan the VP crank hearing what he wants to hear and not understanding or critically-evaluating.

Are you going to address the new science showing brain injury from Al adjuvant? Like the new Crepeaux paper: https://www.ncbi.nlm.nih.gov/pubmed/27908630

Oh look it's the Who's Who of aluminium cranks. Another case of overdosing, non-randomisation, non-blinding, irrelevant animal tests, a couple of statistically-significant results and no clinical relevance. But this tells the VP crank what he wants to hear so it's "good science".

The new science showing the Mitkus analysis (the foundation for Al adjuvant safety) is wrong?

What is this "new science" you speak of?

The links between Al adjuvant and immune activation/cytokine brain injury?

Evidence?

This is where the vaccine controversy is headed.

Only in your fevered imagination. But I guess every crank needs a hobby.

Darn, I was hoping to hear further revelations about f VP's Dreadful Particles, which "dont dissolve and they cannot be excreted by the kidneys" but somehow magically cross the blood-brain barrier and cause The Autism.

I'm sure that can be explained as readily as the concept of brain inflammation in utero and in early infant life which is perfectly harmless if it comes from infection and maternal autoimmune disorders - but not if it is due to DEM EVIL VACCINES, in which case it causes The Autism.

I see VP is still fixated on the idea that IL-6 from "vaccine induced inflammation" is the cause of autism, but somehow overlooks the inconvenient fact that the main triggers for IL-6 production are infections, particularly the childhood vaccine-preventable ones.

If IL-6 caused autism, then the rates would have been higher prevaccine than they are now.

I was hoping to hear further revelations about f VP’s Dreadful Particles, which “dont dissolve and they cannot be excreted by the kidneys” but somehow magically cross the blood-brain barrier

Yah, he failed to get back to me on that hiding-in-lysosomes proposal, apparently preferring to wait for something he could whine was a personal attack instead.

Oh look, Vinu is blaming the mother's vaccines now.

Thanks HDB,

Given that in the last two day, I only slept 3 hours but did enjoy an overfull night of sleep last night, I had the time to think about the whole mess and will write about it targeting VP in a few hours but I had to dig deep in the past WRT some of my experiences posting on AoA (among other) but definitely Orac is very right on a recent post (not referring to this one although this one is very right & fine too).

Sorry.|
I dont know Alain. Its nothing personal. Im not here to insult anyone.

Me. I go by my first name. You could even deduct my last name from the post where I list the publication I worked on as part of the team of scientist coworker working on an auditory neuroimaging meta-analysis close to 10 years ago.

https://www.ncbi.nlm.nih.gov/pubmed/21833294

http://journal.frontiersin.org/article/10.3389/fpsyg.2010.00241/full

I have no qualm about putting up my real name here.

Alain

I do enjoy reading your blog. Its helpful to understand opposing opinion.

For certain values of "understand." Face it, Dan: your whoe trip is priggish in the extreme. Is there some reason you host the pirated material rather than just commenting on it and telling you audience how to steal it themselves?

I'm somehow reminded of the Little Rascals/Our Gang episode in which a chicken plucks off the cowlick from a hiding Alfalfa, who has to suppress a loud cry of "My personality!"

Given the behaviors unvaccinated mice exhibit (eating their babies for one) I'm not sure that they're a great behavioral model for humans.

VP (Dan): "I do enjoy reading your blog. Its helpful to understand opposing opinion"

So did you check out the genetics of autism that was discussed on this video:
https://youtu.be/ub3WlwRM1F0?list=PLjvfRtcMhn4PB0NTW0RlvsMJGu1Csnn5s

Yes.

Its not genetic. Its a gene-environment interaction, which explains:
1) why all the twin studies show high heritability (a wrong result).
2) why there are hundreds of associated genes,.

Aargh, failed "Copy video URL" in moderated comment!

Okay, VP (Dan), since you said " Its helpful to understand opposing opinion” it would seem you would understand actual opposing data. Did you watch the video I posted earlier on autism genetics? Did you understand that this is what is going forward with discoveries that will actually help children?

In case you missed it, here it is again (I hope):
https://www.youtube.com/watch?v=BOQ9s0GcG5s&list=PLjvfRtcMhn4PB0NTW0Rlv…

Danny Boy who thinks his Vaccine Papers are relevant: "Its not genetic. Its a gene-environment interaction"

So you did not even watch the video. You really do not want to even watch opposing fact. Pity.

I watched the stupid video. its wrong.

Heritability estimates are derived from twin studies, which must assume there is no GXE interaction. That assumption is wrong, so the high heritability estimates are wrong.

The associations of hundreds of genes with autism is meaningless. No way to calculate or estimate heritability from those results.

VP (Dan the Vape Man): "I watched the stupid video. its wrong."

So that is your answer? Do tell us how being a vape supplier gives you moew expertise than the actual autism researchers who gave the presentation. Then post the PubMed indexed studies that show the following is wrong:

(for those following along, the relevant pie charts start at about a half hour into the video)

5% are Genetic Syndromes like Fragile X, Tuberous Sclerosis (TSC1 and TSC2), …. etc

10% are Copy Number Variants like 15q11-1, 1q21…. etc.

2% are 16p11.2

30% are De novo gene variants like DYRK1A, ADNP, … etc

1% CHD8

8% are rare inherited gene mutations (letters too small to make out).

And 45% are still unknown, hence the massive recruitment for families for SPARK for Autism by the Simons Foundation (https://sparkforautism.org/).

At around the 57th minute there is a slide of various groups parents have formed around the specific genetic sequence their child has. It includes FamiliesSCN2A and ADNPkids.

At 59 minutes there is a slide showing how knowing the specific gene sequence is important. For instance those with SCN1A need to avoid sodium channel blockers, and those with SCN8A need to use sodium channel blockers.

Just post your "Vaccine Papers" showing those sequences are wrong right here. Because we are not going to your silly cherry picked web site.

And Lo, there was a mighty butt-hurt across the land, and great was the clutching of pearls.

He frightened her, the big bully.

(Say, do Kiwis always go off into a haka like that when they're angry? It's pretty impressive)

It's amusing to see yet again that while anti-vaxxers think that "gene X environment" interactions must somehow, sorta-kinda implicate vaccines, they ignore that the environment includes the expression of other genes. I suppose that the fact that the parents and siblings of children with ASD are more likely than the general population to be similarly affected or to evidence the broader autism phenotype must mean, in AoA-speak, well, nothing. Or vaccines. Because vaccines.

Oh, lo! Here I am stuck in automatic moderation because of a stupid sock puppet from Wisconsin! And yet Dan the Vape Man can tell us exactly why he is smarter than actual PhD persons who research autism genetics.

Woot!

I don't think you are. I looked at the list and didn't see your e-mail address anywhere on the automod list. I can't figure out why you got stuck. Ditto for a couple of the other regulars, whom I also checked. Strange are the ways of WordPress.

I watched the stupid video. its wrong.

Heritability estimates are derived from twin studies, which must assume there is no GXE [sic] interaction. That assumption is wrong, so the high heritability estimates are wrong.

At the end of the day, I think it's Dan's carefully reasoned nuance that really makes the performance so persuasive. It's not as though there are dozens of spot-on reviews he could be "deconstructing" on his site, after all.

The associations of hundreds of genes with autism is meaningless. No way to calculate or estimate heritability from those results.

Muttley, Mumbly . .&nbsp. Mumbly, Muttley. So many choices.

^ So close, yet so far.

Gene environment interaction may mean, for instance, that, in order to get a disease, you MUST have some genetic factors AND an environmental factor. If the environmental factor is widespread, then you may conclude that there is very strong heritability. Is it so hard to understand, or should people refer to authority? Like these two:
https://www.ncbi.nlm.nih.gov/pubmed/25554788
https://www.ncbi.nlm.nih.gov/pubmed/28336671

Please allow me one offtopic comment but really great news.

For many years, I've been an important person in the life of the daughter of my best female friend (I've been living with them for many years despite having my own apartment) and I learned very recently that she got accepted to veterinary medicine school and will begin her studies next august.

Alain (best friend also said that I make a really good father).

I learned very recently that she got accepted to veterinary medicine school

Kudos to your friend's daughter. Med school is for people who aren't good enough to get into vet school.

(Say, do Kiwis always go off into a haka like that when they’re angry? It’s pretty impressive)

I have never performed a haka, nor have any of my immediate family, and it is not for lack of getting angry. Of course we may not be representative Kiwis. Family traditions are more along the lines of "Gnaw at the edge of shield, howl like a bear, froth at the mouth, charge into battle wielding sword in a frenzy".

This turns out to be an unconstructive way to approach an academic disagreement.

"I watched the stupid video. its wrong. "

And that's VP, intrepid Person of Science, who derides others for allegedly favoring snark over substance.

Meantime, while we hear of celebrities who go to the dark side, here are a couple of them supporting children's health. And they had to navigate dense underbrush and brave an onslaught of hippos, crocodiles and antivaxers:

http://www.dailymail.co.uk/tvshowbiz/article-4516300/Julia-Roberts-Bear…

Orac: "I don’t think you are."

Thank you. Though it has been frustrating this past week.

Ohh, oh... there's 'a study to show':

In a randomized, double-blind, placebo-controlled clinical trial—the gold-standard design—a component of marijuana called cannabidiol (CBD) reduced seizures in children with a rare and devastating form of epilepsy...

The trial was sponsored by GW Pharmaceuticals, which has branded its CBD oil Epidiolex. The company has already received a “Fast Track” designation from the Food and Drug Administration to hasten its approval process, which will begin later this year. Currently there are no FDA-approved drugs specifically for Dravet syndrome.

https://arstechnica.com/science/2017/05/marijuana-component-reduces-sei…

Of course, there is no 'high' associated with CBD although the whole herb witch includes THC remediates some CBD side effects.

I'm ambivalent; Something that is deemed 'medicine' is still taken away from the people and put behind a sometimes-insurmountable prescription wall.

Similarly, he voted against a measure to allow Veterans Affairs doctors to recommend medical marijuana to their patients, as well as against a separate measure to loosen federal restrictions on hemp, a non-psychoactive variant of the cannabis plant with potential industrial applications.

“the only way I would agree to consider legalizing marijuana is if we had a really in depth-medical scientific study. If it does help people one way or another, then produce it in pill form.”
https://www.washingtonpost.com/news/wonk/wp/2017/04/12/the-new-white-ho…

Fekkin' pharma shill.

Ohh, oh… there’s ‘a study to show’:

In a randomized, double-blind, placebo-controlled clinical trial—the gold-standard design—a component of marijuana called cannabidiol (CBD) reduced seizures in children with a rare and devastating form of epilepsy…

Yeah, but did you read the entire article? Didja see this part?

But these benefits had costs. Ninety-three percent of those taking CBD reported side effects, while only 75 percent of placebo participants made similar reports. The most common side effects reported in the CBD group (and at much higher rates than the placebo group) were sleepiness, diarrhea, and loss of appetite. Other side effects included fatigue, vomiting, raised body temperature, lethargy, upper respiratory tract infections, and elevated liver enzymes. Eight participants taking CBD withdrew from the trial due to the side effects, as did one in the placebo group.

Effective? Maybe. Safe? Gee, I dunno.

Of course, there is no ‘high’ associated with CBD although the whole herb witch includes THC remediates some CBD side effects.

Citation needed. I don't see that in either the report you linked to, nor at http://www.nejm.org/doi/full/10.1056/NEJMoa1611618 I freely admit I haven't seen the entire paper. Have you?

Something that is deemed ‘medicine’ is still taken away from the people and put behind a sometimes-insurmountable prescription wall.

There's a lot of medicines that are prescription only. Mostly those that are effective and have high incidence of side effects. You know, like possible liver failure.

“the only way I would agree to consider legalizing marijuana is if we had a really in depth-medical scientific study. If it does help people one way or another, then produce it in pill form.”

Isn't that the smart thing to do? Controlled, measured dosage to achieve the desired therapeutic effect. That's hard to get in a biological sample - too much variation. That is, if your goal is good medicine. If you just wanna get high, well, YMMV.

Fekkin’ pharma shill.

I know, right? Who paid for this study? From your link -

The trial was sponsored by GW Pharmaceuticals, which has branded its CBD oil Epidiolex.

Did you read the disclosures? (bolding mine)

Dr. Devinsky reports receiving grant support from Novartis, PTC Therapeutics, and Zogenix and holding equity interest in Rettco, Pairnomix, Tilray, and Egg Rock Holdings. Dr. Cross reports receiving grant support, paid to her institution, from GW Pharmaceuticals, Zogenix, Sanofi, and Vitaflo; fees for serving on an advisory board, paid to her institution, from Eisai; lecture fees, paid to her institution, from Shire and Nutricia; and consulting fees, paid to her institution, from Takeda. Dr. Marsh reports serving as a site primary investigator for a trial supported by Neuren Pharmaceuticals and receiving consulting fees from Stanley Brothers Social Enterprises. Dr. Miller reports receiving honoraria and travel support from INSYS Therapeutics. Dr. Scheffer reports receiving travel support and fees for serving on a scientific advisory board from GlaxoSmithKline; receiving travel support and lecture fees from UCB and Sanofi; receiving lecture fees from Eisai and Transgenomic; holding a patent on diagnostic and therapeutic methods for epilepsy and mental retardation limited to female patients, for which a single royalty payment has been made to University of Melbourne Commercial (WO2009086591); and holding a patent on methods of treatment and diagnosis of epilepsy by detecting mutations in the SCN1A gene, which has been licensed by Bionomics (WO2006133508). Dr. Thiele reports receiving consulting fees from Eisai, grant support and consulting fees from Zogenix Pharmaceuticals, and grant support from Courtagen. Dr. Wright reports being an employee of GW Pharmaceuticals, holding a pending patent on the use of cannabinoids in the treatment of epilepsy (WO2015193667), and holding a patent on the use of phytocannabinoids in the treatment of epilepsy (EP2448637). No other potential conflict of interest relevant to this article was reported.

And may the Gods of HTML protect me from the lack of preview.

elevated liver enzymes

Hmm. That was addressed in the article. Valproic acid (depakote), which is also given for seizures/epilepsy, will elevate detected liver enzymes all by itself:

But some of the side effects may have been due to drug combinations, not CBD alone. For instance, kids in the CBD group who were also taking the epilepsy drug valproate were the only ones to experience liver problems as a side effect.

Controlled, measured dosage to achieve the desired therapeutic effect. That’s hard to get in a biological sample – too much variation.

What is the major damage of this society that disgards *use until desired effect* for an otherwise non toxic substance? There is immediate feedback with smoking/vaping vs ingested/pills. People are different; The homogenized 'standard dose' is retarded with most drugs -- Universal joint; fits everything but your car.

**THC remediates some CBD side effects.**

Citation needed.

It is universally known amongst users that the THC component stimulates appetite and alleviates nausea. That is why it is popular amongst those undergoing chemotherapy or HIV individuals.

Citation? I guess, there are no studies to show. Is there a study to show that multiple stab wounds can mean shorter lives?

https://www.youtube.com/watch?v=cQ7J7UjsRqg

Chris @112: At least you're only stuck in moderation here. I'm stuck in moderation over at Aardvarcheology too.

Gilly*, just say that you want easy access to legal pot so you can get high, and stop with the medicine stuff, m'kay? We know it, you know it, and it would save all of us a lot of time. It might even happen someday. I want drive-thru 5 cent beer stands, and, while beer is currently legal, I think you'll get your wish sooner than I get mine.

I'll admit that there might be a therapeutic use for weed. There are enough chemical compounds in it that I believe it's more than possible. But claiming it's a cure all prior to finding the evidence is just dishonest.

Yes, the current drug laws are pretty messed up. Pot is mostly legal to have and use almost everywhere, but it's illegal to import, grow and sell across the entire country. It was a screwed up situation during Prohibition, and it's just as screwed up now. Working to change the law is a noble endeavor, but trying to back-door legalization under the guise of "it's medicine" is despicable.

*Heh - autocorrect changed it to Silly. Sometimes it knows better.

I have Timmeh in the killfile, but . . .

Of course, there is no ‘high’ associated with CBD although the whole herb witch [sic?] includes THC remediates [sic] some CBD side effects.

I vaguely wonder whether these include cannabinoid hyperemesis syndrome. Whatever.

@ Chris #102:

I have zero interest in pursuing a future in Epidemiology. I just question why many studies list "excluded due to confounding variables" that match the criteria in the "Conditions commonly misperceived as contraindications" column in the CDC guidelines.

If a demographic group has already been declared as part of the representative group by the CDC, don't you lose the discretion to exclude?

@ Narad #103:

It occured to me that something may have changed as I have not worked Mom/Baby for about 10 years so I did check & Colorado is still vigilant in their "Colorado Universal Hep B" campaign that provides incentives & annual "scoring" of facilities & MD's utilizing standing orders.

My statement was not meant to imply that vaccination is done without signed consent; it was made in the context of a study that could have been invalidated due to recall bias of the mothers, as it did not utilize medical records to cross-reference their recall.

This is my position based on personal assessment vs "just" professional & I don't claim any scientific precedent for my reasoning.

Simply put; I gave birth to 11 children here in Colorado & 9 out of the 11 were born after 1991 when the Hep B was added to the CDC schedule.

I can "recall" giving consent for exactly 5 of those 9 although their immunization records reflect that I consented for all my children to receive not just the Hep B but all their recommended immunizations.

I'm sure the consents are legit; I would not have refused. I just don't "recall" it.

Seven of the eleven were born during the years when the "Discharge home 24hrs post-delivery for low-risk prenatal/birth/infant apgar" was a trend with MCO's. Do you know how many times various department representatives run in & out of the room with stacks of papers to be signed, all while you are sleep-deprived & half delerious when discharge is planned for 24 hrs post-delivery?

I just don't think there is much potential for "accurate recall" & the study relies soley on accurate recall; thats all.

And; you & your links. I vascilate. I'm concerned & I want to be wrong. Am I not in the right place (this blog/venue) if I'm looking for the right people to make me wrong?

I'm pretty sure I've written less than 10 comments here & I believe I've asked questions as many times as I've made statements. Carry on ...

I just question why many studies list “excluded due to confounding variables” that match the criteria in the “Conditions commonly misperceived as contraindications” column in the CDC guidelines.

Because they are confounding variables and will confound.

So, we know for example that fragile X syndrome results in symptoms similar to autism. If you include these children in a study of whether vaccines are related to autism, you will have a whole group of children showing autism-like symptoms regardless of whether they were vaccinated or not. That muddies the water unnecessarily.

The fact that you lack the understanding that this is a problem renders your comments about which children should be included in a study useless.

While all you pro-vax losers are spending Saturday night home alone in your basements "blogging", the Fun people are whooping it up at the AutismOne gala in Colorado Springs, featuring:

"A meaty carving station, hor d'oeuvres, a mouth-watering fountain of chocolate dessert options, and more included!

TWO-HOUR OPEN BAR! (Followed by cash bar.)

Check out the ever-exciting raffle, and dance, dance, dance to the DJ's tunes!"

Sort of disappointing they aren't dancing to the hip tunes of The Refusers. And seeing the emphasis that crowd places on avoiding unhealthy diet to improve symptoms of autistic children, they're not setting a great example with a menu heavy on meat and calorific chocolate desserts.

While all you pro-vax losers are spending Saturday night home alone in your basements “blogging”

Hey, I was in the basement alone because I was trying to figure out what was going on with an iMac A1174 from the campus recycling so I could hand it off to a friend who really needs an upgrade.

Actually, we had some strawberries with thick dark chocolate sauce with a nice Merlot wine, and just now finished watching "The Accountant" with Ben Affleck playing the autist who is a sharpshooter with math and bullets.

Dear Wordpress: :-p

I hate automatic moderation, and so does Orac if he is not in control of it!

@DB: I spent MY Saturday night (and all day Saturday) riding roller coasters at the local amusement park.

I have no doubt I had a much better time than attending a crank fest. And that includes the sun burn.

#131 --> travis???

@Alain no. Just Dangerous Bacon being really sarcastic.

A horrendously bad "vaxed/unvaxed" study rises from the dead yet again

oracknows — Mon, 08 May 2017 01:37:40 +0000

A horrendously bad "vaxed/unvaxed" study rises from the dead yet again

Some posts I really enjoy doing. I'm so fired up by the topic that the words flow, and I finish a post in record time. Other posts are more of a chore, written not so much because I'm excited by the topic, but because I feel duty bound to address it. I feel the need to write such posts when, for example, a bit of pseudoscience has gained traction in mainstream groups and readers keep writing me about it, to the point where I finally give in. This is one of the latter posts. None of this is to say that I don't still do my best with these posts to explain and argue my points. Fear not, I'll get some good Orac snark in. It's just that duty tends to be less fun than passion.

One of the most frequent topics for posts like this is a pseudoscientific or just plain bad study that, despite being retracted, keeps rising from the grave, like the proverbial zombie. I call them, appropriately enough, zombie studies. Depending on my mood when I write posts like this, I often add imagery featuring zombies (or, if you're into The Walking Dead, walkers). Other times, I'll include imagery featuring Jason Vorhees or Michael Myers, two supernatural slashers who would routinely through misbehaving teens for a whole movie, die (or appear to die) at the end of the movie, only to come back in the next installment in the series to kill again. Antivaccine pseudoscience (for example) is a lot like these monsters. In actuality, they're probably more like Jason or Michael Myers than walkers because you can actually kill walkers dead for good. Be that as it may, whenever a truly awful study that should never have been accepted in the first place for publication in a peer-reviewed journal is retracted, you can be sure that it won’t be too long before it is magically resurrected and rears its ugly head again in some form or another, to be wielded not just as a weapon to frighten parents with but as a bogus example of how the peer-reviewed medical literature “suppresses” science that doesn’t support vaccines, to be used to feed the conspiracy theories behind the antivaccine movement. Same as it ever was.

This time around, the zombie study is one that I've been checking in with and covering periodically ever since its inception in 2012, when antivaxers were fundraising for it. The principal investigator was Anthony R. Mawson, M.A., DrPH. Indeed, J.B. Handley himself spearheaded the fundraising effort. It is, unsurprisingly, the Holy Grail of antivaccine studies, the mythical "vaccinated/unvaccinated" study. Antivaxers, at least the ones who retain a bit of reason with respect to medical ethics, have come to realize that a randomized, double-blind, placebo-controlled trial of vaccinated versus unvaccinated children is considered utterly unethical because it would leave half the children unprotected against vaccine-preventable diseases. They might not accept how unethical such a study would be, but they do realize that scientists do consider such a study unethical.

So they fall back on comparing health outcomes in children who are vaccinated to those who are unvaccinated (or undervaccinated). They're pretty much all crap, because those carrying the studies out are biased and/or incompetent. Examples include a telephone survey disguised as a "study" done ten years ago and a survey disguised as a "study" performed by a German homeopath. This study is different in that it isn't an antivaccine activist parent with no background in science or a homeopath but an actual academic. He is, however, clearly biased towards antivaccine views, as he has defended Andrew Wakefield's 1998 Lancet case series and is a vocal supporter of his.

I've written about this study before. Hilariously, when it was published in its first form, the full study wasn't published, only the abstract. Then the abstract was, in essence, retracted. Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals. If a Frontiers journal retracts your paper, it's plenty bad indeed. It turns out that the manuscript had been reviewed by a chiropractor and a peer reviewer without expertise,

Then, back in February, the Mawson zombie study rose from the dead again, as antivaxers spread around copies of the retracted article and crowed that it had been accepted for publication elsewhere, and indeed it has. It's fallen even farther down the food chain than a Frontiers journal, having been published by Mawson et al in the Journal of Translational Science, a journal published by Open Access Text, as Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12- year old U.S. children.

There's nothing new in this study that makes it any better than it was in its previous incarnations. Indeed, its introduction alone contains a boatload of fail that gives away the antivaccine leanings of Mawson et al. For example, there's the implication of "too many too soon":

Under the currently recommended pediatric vaccination schedule [7], U.S. children receive up to 48 doses of vaccines for 14 diseases from birth to age six years, a figure that has steadily increased since the 1950s, most notably since the Vaccines for Children program was created in 1994. The Vaccines for Children program began with vaccines targeting nine diseases: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b disease, hepatitis B, measles, mumps, and rubella. Between 1995 and 2013, new vaccines against five other diseases were added for children age 6 and under: varicella, hepatitis A, pneumococcal disease, influenza, and rotavirus vaccine.

The implication is, of course, the common antivaccine trope that as a result of the gradual expansion of the recommended vaccine schedule children are getting, yes, "too many too soon," with adverse health effects. Then there's this:

A complicating factor in evaluating the vaccination program is that vaccines against infectious diseases have complex nonspecific effects on morbidity and mortality that extend beyond prevention of the targeted disease. The existence of such effects poses a challenge to the assumption that individual vaccines affect the immune system independently of each other and have no physiological effect other than protection against the targeted pathogen [21]. The nonspecific effects of some vaccines appear to be beneficial, while in others they appear to increase morbidity and mortality [22,23]. For instance, both the measles and Bacillus Calmette–Guérin vaccine reportedly reduce overall morbidity and mortality [24], whereas the diphtheria-tetanus-pertussis [25] and hepatitis B vaccines [26] have the opposite effect. The mechanisms responsible for these nonspecific effects are unknown but may involve inter alia: interactions between vaccines and their ingredients, e.g., whether the vaccines are live or inactivated; the most recently administered vaccine; micronutrient supplements such as vitamin A; the sequence in which vaccines are given; and their possible combined and cumulative effects [21].

The wag in me can't help but provide Mawson with an example of a "complex nonspecific effect on morbidity and mortality" due to a vaccine. He's not going to like it, though, because it shows that the benefits of the measles vaccine go beyond just preventing measles. Basically, there is a prolonged period of immunosuppression after the measles that lasts up to three years. Vaccinating against the measles prevents that immunosuppression and therefore lowers the death rate due to other infectious diseases to which children are more vulnerable after having had the measles.

The bias is also apparent in the statement of purpose for the study:

The aims of this study were 1) to compare vaccinated and unvaccinated children on a broad range of health outcomes, including acute and chronic conditions, medication and health service utilization, and 2) to determine whether an association found between vaccination and NDDs, if any, remained significant after adjustment for other measured factors.

This is serious bias, as the authors assume that vaccines cause harm. It's not quite explicitly stated, but certainly implied. They clearly expected to find an association between vaccination and neurodevelopmental conditions, despite all the copious evidence that there is no such association.

I also can't help but turn a frequent antivaccine trope back on itself. Antivaxers and promoters of alternative medicine often criticize studies of drugs and vaccines because the drug and vaccine manufacturers are frequently the funding source. That is not an entirely unreasonable objection—to a point. I myself look more skeptically at studies funded by drug companies, but with this caveat. If the study is well-designed, executed, and analyzed, I take its results seriously, regardless of funding. However, since antivaxers seem to think that even a whiff of pharma funding of a study invalidates it, I can't help pointing out the funding of Mawson's study:

This study was supported by grants from Generation Rescue, Inc., and the Children’s Medical Safety Research Institute, charitable organizations that support research on children’s health and safety. The funders had no role or influence on the design and conduct of the research or the preparation of reports.

Generation Rescue is Jenny McCarthy's antivaccine organization, although it was originally founded by J.B. Handley, and the CMSRI is one of the looniest of the loony antivaccine groups. Sure, it's probably true that Generation Rescue and the CMSRI didn't directly influence design or execution of the study, but ask yourself this: Would these groups have funded an investigator if they weren't pretty sure how his study would turn out? I think you know the answer to that question.

Of course a study this flawed is close to guaranteed to find a positive result. The flaws begin with the selection of study population:

The study was designed as a cross-sectional survey of homeschooling mothers on their vaccinated and unvaccinated biological children ages 6 to 12. As contact information on homeschool families was unavailable, there was no defined population or sampling frame from which a randomized study could be carried out, and from which response rates could be determined. However, the object of our pilot study was not to obtain a representative sample of homeschool children but a convenience sample of unvaccinated children of sufficient size to test for significant differences in outcomes between the groups.

We proceeded by selecting 4 states (Florida, Louisiana, Mississippi, and Oregon) for the survey (Stage 1). NHERI compiled a list of statewide and local homeschool organizations, totaling 84 in Florida, 18 in Louisiana, 12 in Mississippi and 17 in Oregon. Initial contacts were made in June 2012. NHERI contacted the leaders of each statewide organization by email to request their support. A second email was then sent, explaining the study purpose and background, which the leaders were asked to forward to their members (Stage 2). A link was provided to an online questionnaire in which no personally identifying information was requested. With funding limited to 12 months, we sought to obtain as many responses as possible, contacting families only indirectly through homeschool organizations. Biological mothers of children ages 6-12 years were asked to serve as respondents in order to standardize data collection and to include data on pregnancy-related factors and birth history that might relate to the children's current health. The age-range of 6 to 12 years was selected because most recommended vaccinations would have been received by then.

Notice how Mawson claims that this is a cross-sectional study, when in reality it's a survey targeting parents who homeschool. Of course, parents who choose to home school are not like your average parents. There are a lot of confounding factors that go along with home schooling, including the association between home schooling and antivaccine views. This association is very clear in the data, which show that 261 of the 666 subjects were unvaccinated. Of these 405 who were vaccinated, only 197 were "fully vaccinated." Thus, less than 1/3 of the children in the study were fully vaccinated according to the CDC's recommended schedule, and well over 1/3 were completely unvaccinated. This is not in any way representative of the population at large. Add to that the likelihood of selective memory and reporting, and the likelihood of this survey providing useful information is vanishingly small. Also, surveys are not the best means of gathering health data, and in this case it was a particularly bad situation. Mothers were asked whether their children were vaccinated, unvaccinated, or "partially vaccinated," and what conditions or diseases their children had had. There was no effort to make any independent assessments of the children's health, nor was there any attempt to account for bias, and there almost certainly was a lot of bias here:

A number of homeschool mothers volunteered to assist NHERI promote the study to their wide circles of homeschool contacts. A number of nationwide organizations also agreed to promote the study in the designated states. The online survey remained open for three months in the summer of 2012. Financial incentives to complete the survey were neither available nor offered.

Even more telling, consider how the subjects were recruited. The authors admit that the "object of our pilot study was not to obtain a representative sample of homeschool children but a convenience sample of unvaccinated children of sufficient size to test for significant differences in outcomes between the groups." In other words, no effort was made to construct a representative sample.

So what are we to make of the results of this study, which show:

The vaccinated were less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but more likely to have been diagnosed with pneumonia, otitis media, allergies and NDD. After adjustment, vaccination, male gender, and preterm birth remained significantly associated with NDD. However, in a final adjusted model with interaction, vaccination but not preterm birth remained associated with NDD, while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5). In conclusion, vaccinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children. While vaccination remained significantly associated with NDD after controlling for other factors, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD.

Nothing. The bias and flaws in this study guaranteed no other result, particularly when you consider another confounding factor, namely that the parents of children who are fully vaccinated are very different in their health-seeking behavior than those whose children are unvaccinated. They tend to take their children to visit the doctor more regularly, which means that health disorders their children have are more likely to be diagnosed and treated. They're also less likely to be seeing naturopaths and other alternative practitioners.

I'll conclude by pointing out yet again that it is a myth that there are no studies comparing the health of vaccinated children compared to unvaccinated children. In fact, there have been several. It turns out that they don't show what antivaxers think a vaxed/unvaxed study will show. Basically, all of the vaxed/unvaxed studies not done by antivaccine-friendly scientists or quacks have shown either no differences in the prevalence of neurodevelopmental or chronic diseases between vaccinated children and unvaccinated children or have actually found better health outcomes in the vaccinated population. Mawson concludes by arguing that further "research involving larger, independent samples and stronger research designs is needed to verify and understand these unexpected findings in order to optimize the impact of vaccines on children’s health." Mawson's study is so biased, flawed, and incompetently carried out and analyzed that its results can be discounted as almost certainly worthless. It doesn't provide the rationale for "more studies." Quite the contrary.

Yet, that's how antivaxers are spinning it, as they always do.

Same as it ever was.

oracknows Sun, 05/07/2017 - 21:37

Tags

Quackery

http://oatext.com/Preterm-birth,-vaccination-and-neurodevelopmental-dis…

There are a lot of confounding factors that go along with home schooling, including the association between home schooling and antivaccine views.

This is particularly true of Mississippi, which at the time was one of only two states that did not allow nonmedical exemptions to vaccine requirements. So parents in that state who do not want to vaccinate their special snowflakes have no choice but to homeschool.

Oh, and one of the other confounding factors with homeschooling is one that would lead me, at least, to regard the parents as less trustworthy than others. I'll leave it at that, before this turns into an off-topic rant.

Another confounder (IIRC pointed out on FB), is that fully vaccinated children would have been more likely to regularly see a physician, therefore receiving diagnoses for illnesses and issues as opposed to unvaccinated children who might only see a doctor rarely.

Also...no attempt was made to validate what parents said. No medical records were requested. In fact, the DATES vaccines were given weren't requested - "to decrease the burden of the respondents". Which tells me the whole survey was a load of cr@p.

The fact that the same people who reject large, well controlled studies have no criticism of this is also very, very telling.

#3 MI Dawn -
That would be an apt description of this POS.
It isn't a "study", it is a survey of anonymous respondents from a biased pool of a very rare and unique group of persons: All home schooled. 39% completely unvaccinated when the anti-vaccinationists repeatedly assure us that completely unvaccinated children only make up about 1/2% of school children? Pending participants recruiting additional participants from their social circle.
No wonder it took over a year to find a scum sucking journal to accept it.

I suggest confounding the anti-vaxers by presenting an analogous and equally flawed survey:
- Select congressional districts in Cali, Oregon, Washington, NY, NJ, etc. that are heavily Democratic.
- Survey the voters about the intelligence of their children allowing anonymous responses and making clear that no evidence for the responses will be asked.
- Be amazed when the results come back that the children of Democratic Party parents are all reported to be very much above average with IQs of 140+ and the children of Republican Party parents are all reported to be very troubled and of average to below average intellect with IQs of <100 - Because no Democrat would ever lie or pretend they were Republican with a below average child just to make the Repubs look bad.
[Reverse the parties if the anti-vaccine believer is an All Gnatchrule Left-wing neo-Hippie instead of a Sovrun Libertarian Right-wing Anarchist Trumpet.]

How this "study" is even a thing is explainable only in context of the intellects and dishonesty of the fanatics that are embracing it.

More than intentionally pretending their children are vaccinated, I suspect what Orac described previously is going on - these parents seeing their vaccinated children through very, very negative lenses and looking to validate their prejudices about their unvaccinated one.

In a particularly ugly form of in-family favoritism, the problematic Vaxxed crew do "vaccinated v. unvaccinated" videos in which families talk about how wonderful their unvaccinated children and how less good their vaccinated children are. In front of said kids.

The same bias is probably at work here.

#6 Dorit -

Yeah, the Vaxxed team are a bunch of real sweethearts...
That's if you spell "sweethearts" thusly: "psychopaths".

As are the parents who play along with this disgusting differential in children appreciation within the family.

This study sounds terrible. However, wouldn't a properly done study also compare vaccinated vs unvaccinated homeschoolers? Otherwise, wouldn't the differences between the populations be more pronounced?

In a particularly ugly form of in-family favoritism, the problematic Vaxxed crew do “vaccinated v. unvaccinated” videos in which families talk about how wonderful their unvaccinated children and how less good their vaccinated children are. In front of said kids.

That is despicable. I haven't seen those videos, fortunately.

"However, wouldn’t a properly done study also compare vaccinated vs unvaccinated homeschoolers? Otherwise, wouldn’t the differences between the populations be more pronounced?"

A properly done study of vaccinated versus unvaccinated would only be ethical in the days of Edward Jenner, the late 1700s. Back then, the benefits of vaccination were not known. Today, you couldn't possibly randomize one group into getting no vaccines and another into getting a vaccine. Can you imagine deliberately exposing children to polio, measles, influenza?

Here's a modest proposal for a vax v. unvax study. I hope you see the satire in it: ht_tp://www.chadhayesmd.com/vaccinestudy/

Heidi: yes. That's why this study cannot be considered representative of the population at large. Because it only compared vaccinated vs unvaccinated homeschoolers, and thus the results are greatly distorted . . . and that's assuming the data collected is even reliable, which it is not.

If Dr. Mawson had submitted this study as his dissertation, his doctorate would not have been granted.

While I agree with your dissection of the study, I disagree with "Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals." This is exactly what antivaccinationists sometimes resort to, that is, calling open-source journals who receive a fee to publish articles, vanity press and other journals for receiving pharmaceutical advertisements. There are good open-source journals, e.g. PLOS group, and bad journals; but what counts is not where something is published, even a blog, but the actual content of the article. Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack and detracts from your otherwise excellent dissection of Mawson's study.

I strongly disagree. The reason is simple. The primary reason antivaxers publish in these bottom-feeding predatory journals is because they can't get published anywhere else. Believe me, if Mawson could have gotten his study accepted for publication in a halfway decent journal, he most certainly would have. Indeed, he started at the more "respectable" level of predatory open access journals, Frontiers, and then when even Frontiers figured out his study was too bad even for its journals he went to an even lower tier of dodgy journal.

There is nothing wrong at all with pointing out when a study is published in a crappy journal known for publishing basically anything, as long as you pay it enough. That's the dark side of open access; While there are quite a few reputable open access journals, there are a lot of predatory ones too. In fact, I would go further. I would argue that, whenever you see an article in one of these journals, your skepticism should be turned up to 11. Similarly, I consider funding sources fair game, too. This study was funded by antivax groups (Generation Rescue and CMSRI). It's all a package.

What is NDD? The only thing relevant I found when I searched was "Nutrient Deficit Disorder" which is a quack diagnosis--"He isn't autistic! He has NDD!" It doesn't seem relevant here as you can cure NDD by buying supplements.

NDD = Neurodevelopmental disorders.

The authors should be congratulated for the only study in about 50 years that did not find prematurity associated with neurodevelopmental disability.

NDD = Neurodevelopmental disorders.

Which is a huge catch-all and presents another confounder for this survey. I didn't see that this was clarified but CMSRI is Claire Dwoskin's charity.

what counts is not where something is published, even a blog, but the actual content of the article

As somebody with your claimed credentials should know, this is not the world we actually inhabit. People who follow such things can and do take into consideration where the article was published. I have heard of departments where your publication only counts if it was in Nature, Science, or Physical Review Letters (these are physics departments; replace PRL with Cell if you are in a biomedical field).

As Orac implies, the business model of these journals is to provide the appearance of peer review while actually not imposing any quality control beyond whether the check for the publication fees clears. Inevitably, we point to articles such as this one to make the point that these journals are not worth the pixels they are printed on.

Orac's point is not limited to OA journals, either. Medical Hypotheses is an Elsevier title. I have also encountered a journal called Physics Essays--I don't recall exactly who the publisher is, but it is otherwise the physics equivalent of Medical Hypotheses.

Thank you--yes, that alone is depressing enough. Many of these people diagnose their own progeny with all sorts of nonsense, then cure them the same way.

Joel A. Harrison, PhD, MPH (#14) writes,

Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack...

MJD says,

Orac has journal fever (i.e., bias) which often brings entertainment value to the subject.

Q. If Orac's prodigy published in a "lesser" journal would he use the same respectful-insolence zeal?

Oh, crap. I missed one. Mawson took what I like to call the "minimal publishable unit" (MPU) approach, divvying up his data to publish a second paper in the same crappy journal using the same survey data to look at vaccines and preterm birth as risk factors for neurodevelopment disorders:

Argh. Do I have to subject myself to this one too?

"Have" is such a strong word.

In an ideal world, there would be an Orac post on that bad study. But I know Orac has many calls on his time.

I figured the facebook post I saw was this study resurrecting itself. Graphic about how vaccinated children are eleventy billion times more likely (OK, OK 30x or so in one category) more likely to be terribly ill,disabled and damaged.

I didn't realize he found a journal to re-publish it (why am I surprised some journal will take his money?)

And I'll just put my soapbox away before going on my "least publishable unit" rant, I've been yelling at more things than is good for my blood pressure lately.

And I strongly disagree with you. Once again, it doesn't matter if it was on a blog. I think your articles are excellent; but where is the peer-review? Just as antivaccinationist blogs, this is just a blog. Does that mean your articles have NO validity?

I wrote an article several years ago reviewing Andrew Wakefield's book, "Callous Disregard." I went point by point through his claims against vaccine safety. The article was 15,000 words. I submitted it to several journals. Each said they would be interested if I cut it to 2,500 words. I was considering finding a blog to post it when one open-source vaccine journal editor accepted it and arranged, since I am retired and not affiliated with anyone, to publish it waiving any fees. The journal, Open Vaccine Journal, was one of many published by a for-profit company, some of their journals quite reasonable due to editor and others less so. And since it wasn't one of their profitable journals, the company has discontinued it, maintaining the published articles in an archive.

Antivaccinationists, Age of Autism, included in their attacks on me that it was for-profit vanity press journal that I paid to get published. I challenge you or anyone else to find fault with my article. And I remind you that almost every major journal has had retractions and articles that were less than good. How about NEJM's article years ago on coffee and pancreatic cancer?

It is OK to mention funding source; but, again, if I had not found a journal to publish my article and posted it on a blog, would that change its content? Or that your articles are on a blog, does that make them less valid?

Don't stoop to the level of antivaccinationists. The fact that Paul Offit was one of the developers of an excellent rotavirus vaccine and the Children's Hospital of Philadelphia shared royalties with him and other developers doesn't change the validity of his journal articles.

You did an excellent job of dissecting Mawson's article. Attacking the journal was unnecessary and affirms that what antivaccinationists do is legitimate. Mentioning the funding source is OK; but should NOT be emphasized. Focus on the science and logic!

For those interested, you can find my article: "Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous
Disregard”" at: https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

@ Eric Lund:

All science is tentative. One study, whether in the best journal or not, is just one study. This is a point that should be emphasized again and again. The absolute best study, even a double blinded randomized trial, is subject to random variables that can influence the results. Also, there is a bias in publishing against publishing negative results, so even the best journals often get it wrong. Peer-review helps; but is no guarantee. I know of several instances personally where a journal sent a manuscript to someone for peer-review and he gave it to a grad student. Once again, I repeat, what is important is the science and logic AND to explain over and over that one study should NOT be relied upon. Replication, which doesn't have to be a perfect replica of a previous design, is one of the sine qua nons of science.

This blog should serve as a model for science and logic, not stoop to the same level as antivaccinationists. Of course, some of them are so outrageous that they deserve this being pointed out. They love to resort to ad hominem attacks which, in my opinion, are clear evidence of their inability to actually deal with the science and logic.

Besides my article on Wakefield, I have written another 10 articles debunking antivaccinationists, one 45,000 words, so even this blog would probably not be interested. For those interested, you can find the summaries of my articles which link to the full pdfs at: http://www.ecbt.org/index.php/facts_and_issues/article/expert_commentary

The mechanisms responsible for these nonspecific effects are unknown but may involve inter alia:

SRSLY? Who uses legalese in medical "journals"?

^ G-ddamn blockquotes.

Don’t stoop to the level of antivaccinationists. The fact that Paul Offit was one of the developers of an excellent rotavirus vaccine and the Children’s Hospital of Philadelphia shared royalties with him and other developers doesn’t change the validity of his journal articles.

You did an excellent job of dissecting Mawson’s article. Attacking the journal was unnecessary and affirms that what antivaccinationists do is legitimate. Mentioning the funding source is OK; but should NOT be emphasized. Focus on the science and logic!

Journals are not blogs and are evaluated by different standards—higher standards. Also, pointing out that a dodgy predatory journal is a dodgy predatory journal is legitimate criticism, as is pointing out that a study is published in a dodgy predatory open access journal, as long as it's not the central reason for dismissing the study (which it wasn't in this case). Basically, to me characterizing the journal is no different than characterizing the funding source—and just as much fair game, as long as it isn't central to the criticism.

I tried to be very calm in my initial response, but now I'm starting to get irritated, because you appear to me to be acting as though my citing how this is a dodgy predatory open access journal is somehow central to my criticism of Mawson's study when it's obvious that it isn't. We should probably just let this argument drop, because nothing good will come of pursuing it, particularly if you continue to characterize me of "stooping to the level of antivaccinationists." Them's fightin' words, so much so that I wrote and almost posted a response that we would've both regretted. Fortunately, I put it aside for a while before coming back to it and was thus able to delete the more...colorful...passages before hitting "Submit comment."

Can you imagine deliberately exposing children to polio, measles, influenza?

Something something Salk vaccine field trials something.

"This is not in any way representative of the population at large."

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

At least you didn't call the results statistically insignificant this time, illiterate shill.

The problem of poor science/pseudoscience and predatory "pay to view" journals is becoming a really serious one.

These journals are multiplying in number; their content is inferior and of poor quality, and the public (and many in the scientific arena too) cannot distinguish the useless from the useful.

What can be done about them? Science publishing as we know it needs to address the issue somehow.

Argh. Do I have to subject myself to this one too?

Mawson's motto seems to be "Trust me, thistime I've got it right." I guess someone will have to endure his "publications" until he actually does get one right. Just another form of job security or punishment for some past sins.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

Jake, I understand you pretend to know epidemiology?
If so, then you will know that you might need more of one group (unvaccinated) in your sample, but to achieve this you address it through your sampling process, for instance recruiting two unvaxed kids for every vaxed kid, but still maintaining the unbiased randomisation so that the samples you picked were representative of the background population.

You cannot find a subgroup who have generated your "more unvaxed" through the selection bias of differential parental choice about vaccines.

I don't pretend to be an epidemiologist, but the principle of what I am saying here should be obvious to even you.

Given that the ranking of journals (and, yes, I know about the pitfalls of impact factors) is a critical metric of academic performance, one would have to wonder why anyone would publish in such an outlet.

It simply isn't true that the merit of studies can be assessed just by reading them. If Wakefield's seminal deception isn't evidence of that, then what is it? Peer review at least gives a sense that a person or persons who are very familiar with the specialist field have said it doesn't suck.

The idea that all words on a page are of equal merit if you know how to read is just crazy.

Broad and Wade said there were too many biomedical journals 30 and more years ago. Nowadays most of the entire output is crap, as the general journal editors are fond of suggesting.

Oh, goody. The Gnat is buzzing again. The Gnat, for someone training to be an epidemiologist (allegedly), sure seems pretty ignorant of epidemiology. He also seems to be oblivious to the use and abuse of p-values. You know, I forgot to check if Mawson controlled properly for multiple comparisons. Any bets on whether he did so correctly or not? :-)

I bet if I discussed p-hacking and the arguments between Bayesian and frequentist interpretations of p-values and statistical significance his little Gnat head would explode.

It simply isn’t true that the merit of studies can be assessed just by reading them.

I disagree with this assertion as a blanket statement. Certainly, for many studies, just reading the paper, looking carefully at the figures and tables, and determining if the data support the conclusions can allow one to make a good assessment of the merit of the study. However, that is not to say that such assessments are easy or straightforward or that there aren't pitfalls that trip up even experienced reviewers. Also, such assessments assume that the scientists who wrote the paper describing the study are basically honest.

That's where Wakefield's 1998 case series comes in. In the case of scientific fraud, you are correct that reading a paper isn't enough to be able to assess its merit. However, on the optimistic side, I like to point out that, if there's anything that PubPeer has shown, it's that careful examination of papers by many people interested in detecting fraud often leads to fraud being detected.

I still don't understand what the hypothesis is that justifies comparing completely unvaccinated children as a category to anyone unless you buy into the completely unfounded idea that any vaccine does something irreversible to you, which doesn't quite go with claims that there has been a change in recent generations - after all, almost all adults have got at least one vaccine.

What's the alleged biological mechanism that makes comparing completely unvaccinated children valid, but something like Smith and Wood or DeStefano et al that looks at children getting more or less vaccines not valid?

What am I missing?

@dingbat:

"Jake, I understand you pretend to know epidemiology?"

Pretend epidemiology: "You cannot find a subgroup who have generated your “more unvaxed” through the selection bias of differential parental choice about vaccines."

You have no f*cking idea what selection bias is or how it works.

"Something something Salk vaccine field trials something."

Something something Barrack Obama, something, something, Baby Face.

Seriously, though, did Salk have IRB approval? Because I just got approval for my dissertation project, and, well, it was hard to get.

You have no f*cking idea what selection bias is or how it works.

Jake,
I take it from your answer that neither do you.

Put another way, do you think there was any selection bias present in this sample conducted by Mawson?
Yes or No?

I wonder if he thinks there was any in Wakefield's twelve.

I guess Salk was guided by similar principles as those here:
http://www.who.int/bulletin/volumes/91/4/12-113480/en/

"You have no f*cking idea what selection bias is or how it works."

Are you sure that it's because you're autistic that women won't date you, Jake? It seems to me that it might have something to do with your demeanor, your inability to be cordial, or your propensity to get triggered.

See, when someone gets something wrong, you're better off pointing that they're wrong and then offering the correct solution. For example, you could have quoted what Boston University School of Public Health has on their site regarding selection bias:

"Selection bias can result when the selection of subjects into a study or their likelihood of being retained in the study leads to a result that is different from what you would have gotten if you had enrolled the entire target population."

In this case, this vax v. unvax study clearly had subjects in their study survey who were more likely to be surveyed than others. Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias.

Watch how Jake ignores the above comments and goes straight at my assertion of his propensity to be triggered.

The declaration of Helsinki gives more details on trials outwith the "Humanitarian crisis" scenario.

@Ren #41

In the 1950's IRB, not so much, IIRC those really became a thing in the 1970's

I will say research done before an after wide-spread implementation of an effective protocol may have different ethical concerns. Why some trials compare with "usual care" rather than a true placebo.

And IRBs are constantly evolving. Seems every time I renew one of ours there is some new question or nuance that has to be addressed. Sometimes procedural (do you remove consent forms once you are done enrolling patients), but sometimes because of evolving ethical standards.

There are statistical methods to handle small numbers of the subjects of interest. Propensity score matching is one. Small numbers can be dealt with through appropriate analysis.
Also, many home schooled children are home schooled because of their NDD. I saw no effort to account for this in the study.

@ Brian Deer:

While it is true that your excellent investigative journalism uncovered flaws/fraud in Wakefield's 1998 article, there were obvious problems that could be seen in the article itself. First and foremost, it was supposed to be an article looking at GI tract and regressive disorders. So, the mention of what the parents thought as the cause was totally irrelevant. It was a dead giveaway that the article had an agenda. And it was, at a case series. So, even if Wakefield had been on the up and up, the article, as a case series, claiming to find an association, at best, would have been the basis for subsequent research. Case studies and series are NOT for hypothesis testing but hypothesis generating. And after your investigative series, one of the most prestigious peer-reviewed medical journals, The Lancet, took more than a half dozen years to finally retract it. More and more articles are being retracted, most from less reputable journals; but even from the "best" journals. See website, Retraction Watch, http://retractionwatch.com

There have been occasions where an article was rejected by journal after journal and eventually found some obscure journal to publish it, only to later become a classic.

There have been a number of recent reports critical of peer-review. Until one develops another format for reporting research, journals are the usual venue, and each journal can only publish so many studies and, especially the print journals, are limited in space , so I disagree with Broad and Wade. A colleague once told me how he had included a "caveats section" in an article which was published in a good journal; but they cut it due to space.

As I mentioned in a previous comment, my review of Wakefield's paper was 15,000 words. I know you have read it and thought it quite good. As I wrote above, I tried numerous journals. No way could I have cut it to 2,500 words, so I was fortunate to find a journal editor willing to publish it. Once published, at least, it was available for people to read and decide for themselves its merits. My final choice would have been a blog.

And I repeat, that one article should NEVER be relied on. Even the best of research, published in the best of peer-reviewed journals, is tentative. And, on the whole, journals do NOT publish negative results which means even peer-reviewed publications often give a biased picture. Eventually, negative findings do get published; but sometimes long after the impact of the original publication has been felt.

One approach is to go back to how academia was 60 - 70 years ago when teaching and community service were more valued instead of publish or perish; but given that, in US, universities make a lot of money from grants, indirect costs, the pressure to get grants and publish is enormous.

But there are more researchers and, though a lot of garbage, more and more good stuff as well. With the limited space of the more prestigious journals, how would you get the information out?

I would love to see a system where abstracts of ALL research was available on an easily accessed website, e.g. PubMed, with links to pdf of articles articles and data, etc (the articles wouldn't have to be limited in size, appendices, etc.) Keep in mind that one of the criticisms of the "prestigious" journals is that they get much of their funding from the pharmaceutical industry. In several of my articles for Every Child By Two I refute this with numerous examples of their publishing articles critical of the industry.

And the "prestigious" journals limit the number of articles posted as open source, so when I want one of their articles, I have to drive to university to photocopy. Otherwise, many charge up to $40 for a 10 page pdf. If the goal of publishing, of science, is to disseminate information, certainly not well served by these journals.

And I remind you that your original investigative series on Wakefield wasn't in a peer-reviewed journal. It was excellent, well-researched and has subsequently been confirmed by other sources as well; but, at the same time, I can give examples of articles in major newspapers that didn't come remotely close to the quality of yours.

Orac misses the point I was trying to make which is, if he had not mentioned anything about the journal, his dissection of Mawson's study was EXCELLENT and was all that was necessary. This blog and the other Science-Based Medicine blog represent SCIENCE and LOGIC. Both blogs have articles that are excellent representations of science. In my opinion, by using science and logic to refute antivaccinationists and other anti-science claims, one reinforces scientific thinking, a role model for scientific thinking.

You have been the target for numerous ad hominem attacks, none valid or justified. In fact, in my opinion any ad hominem attack not only shows the authors inability to make a valid argument; but their being unethical as well. I mean by ad hominem, attacking someone for being a shill, for being bought and paid for. However, though unnecessary and probably counterproductive, some antivaccinationists are so outrageous, so infuriating, that attacking them as some sort of moron on steroids is something I plead guilty to.

As for the pharmaceutical industry, yep, many of the studies they sponsor are flawed. Ben Goldacre's excellent book, "Bad Pharma", documents this; but even more he documents with extensive footnotes flaws in even all peer-reviewed journals.

My first comment was NOT meant to attack Orac. Maybe I could have worded it better; but just to make clear that he usually does such an excellent job of dissecting antiscientific thinking as he again did in this article that it is an unnecessary distraction to mention the quality of the journal.. And that even the most egregiously greedy journal can publish something of merit that for some reason did not make it into one of the more "prestigious" journals.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

For someone who is an alleged epidemiology student, that is one dumb statement.

At least you didn’t call the results statistically insignificant this time, illiterate shill.

Says the kid knows nothing about statistical power, confounding or selection bias among other things.

“Something something Salk vaccine field trials something.”

Something something Barrack Obama, something, something, Baby Face.

Oh, relax. It was in reference to both "only be ethical in the days of Edward Jenner" and it's support of "exposing children to polio, measles, influenza." I was hurrying to get out the door.

Seriously, though, did Salk have IRB approval?

The trials were led by Thomas Francis, but anyway, they postdated the Nuremberg Code. There's a brief history here; Lambert & Markel conclude that "in organizing the trials, researchers at both the NFIP and the University of Michigan Vaccine Evaluation Center proceeded according to the ethical standards of their day."

I'd have to go back to the original publication series to see whether there was something that would approximate an IRB, which I can't do at the moment.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

For someone who is an alleged epidemiology student, that is one dumb statement.

Yah, I was going to ask him for a mathematical proof of Crosby's Sampling Assertion.

# 50: Science Mom:

"Alleged epidemiology student?" Surely, he studied under Mark "I must have missed a zero" Geier.

http://briandeer.com/wakefield/dtp-garth.htm

“Alleged epidemiology student?” Surely, he studied under Mark “I must have missed a zero” Geier.

http://briandeer.com/wakefield/dtp-garth.htm

Oh yea, thanks for refreshing my memory. Incompetent birds of a feather or something like that.

"a mathematical proof of Crosby’s Sampling Assertion"

I expect the number 'i' would appear at least once in said proof.

Aw, I can't get the study to load - did it already get retracted again? :)

Disappointed because I wanted to see a few more of their comparisons - and laugh at the yyyyyyyuge confidence intervals.

"In this case, this vax v. unvax study clearly had subjects in their study survey who were more likely to be surveyed than others."

Who are the "others" and how does that equate to below?

"Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias."

These journals are multiplying in number; their content is inferior and of poor quality, and the public (and many in the scientific arena too) cannot distinguish the useless from the useful.

When a publisher is known to be fraudulent (claiming to be UK-based when in fact it operates out of Hyderabad; claiming to have peer-review when none exists; etc). it creates an obligation to point and laugh at the authors who use it to pretend that their press-releases are actually papers.
It is also fair to wonder why the authors could not publish through one of the alternative journals known to have actual standards, and resorted to a pukefunnel instead.

OT(ish) but Wakefield just appeared at the end of Channel 4 news in the UK. Go Cathy.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

To search for lost keys with meaningful results, you have to look under the streetlight rather than in the dark alley where your dropped it. This is a strength of the search, not a weakness.

@ Jake Crosby:

You write: "“Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias.”

You apparently don't understand different types of sampling. One is done to try to equate as much as possible the two groups being compared. The other, representative sampling, deals with whether either group is representative, finding can be generalized to some larger group. In the Mowrer study, the choice of home schooled who received vaccinations certainly wasn't a random sample of home schooled in general, not even close.

@ Herr Doctor Bimler:

I suggest you read carefully what I wrote in several previous comments. There are too many studies trying to get published in too few journals. What is your solution if one believes they have done a good study and can't get it into one of the "respected" journals, either because doesn't fit their present areas of interest, too long, or just too many submissions.

Read also Ben Goldacre's book, "Bad Pharma", which has a well-documented extensive footnotes that make a strong case that many journal articles, etc. can't be trusted, despite peer-review.

I remind you that Wakefield's 1998 article passed peer-review in one of the most prestigious medical journals, the Lancet, and it took an intrepid investigative journalist, Brian Deer, to uncover all the problems with it, the fraud. And what about NEJM's peer-reviewers and the article of coffee and pancreatic cancer? Once published, it was subject to the same kind of scientific refutations as demonstrated by Orac and others. .

Sampling is fine - but there was not even an attempt to confirm the results of the survey....nobody looked at medical records.

How can the Gnat defend any conclusions made, if there was never any confirmation of even the answers being correct?

Good grief, my epi professors would have a field day with this study.
No defined population, no sampling frame, no randomization, no response rate, no power calculation, no addressing of any of the obvious sampling biases.
No verification of vaccination status.
No verification of NDD diagnosis.
No verification of any other diagnosis.

Also, convenience samples are generally for hypothesis *generating* studies, not hypothesis verifying studies.

It's too bad we don't get to see the survey tool also, so I can imagine what my survey professor would say about that.

@Joel:

Ren wrote that, not me.

It’s too bad we don’t get to see the survey tool also, so I can imagine what my survey professor would say about that.

Chris Hickie linked to the survey form in a previous thread:
http://www.nheri.org/pdfs/Survey%20PDF%202012-08-21.pdf

Aw, I can’t get the study to load – did it already get retracted again?

OAText have unpublished both Mawson papers.
http://retractionwatch.com/2017/05/08/retracted-vaccine-autism-study-re…

Cache is here, if anyone cares:
http://webcache.googleusercontent.com/search?q=cache:U4jtg9e4f2wJ:oatex…

Yeah, of course you would need to look at a larger group of unvaccinated kids than you would normally have by just randomly picking a group of 666 kids . . . because randomly picking a group of 666 kids you would end up with less than 10 who were completely unvaccinated. Really, you'd need a group of *thousands* of unvaccinated kids to confidently pick out health differences between a vaccinated and an unvaccinated group.

But sampling by using a survey of homeschooled kids is not going to be representative of the population. I don't know what kind of bias that is (I'm just an engineer, not even pretending to be an epidemiologist), but it is surely a problem.

While not a study, in large parts of the world children that get vaccinated live and children who aren't tend to die early.

In the US we have 1 to 3 people year die from rabies (usually they didn't know they had been infected and it was to late for the vaccine). In the rest of the world about 49,000 people die each year because they can't afford the rabies vaccine.

For anyone with a brain larger than a gnat, this shows being vaccinated is orders safer VS being unvaccinated.

Aw, I can’t get the study to load – did it already get retracted again? ?

Disappointed because I wanted to see a few more of their comparisons...

The link does seem to be dead. If you want to read the paper, you can see it at
http://www.rescuepost.com/files/mawson-et-al-2017-vax-unvax-jnl-transla…

I went searching for the paper at http://oatext.com, and the results were interesting.

They have a search box, and when I plug Journal of Translational Research into it, this "study" pops up as number 2 on the list. The URL is the same as our host links to in his post. But I didn't see any other hits for Journal of Translational Research, just a bunch or partial matches (I admit that I didn't look at all 995 results). When I add quotes around it, the result is zero hits.

I want to say that the paper is so bad that they not only retracted it, but retracted the entire journal. But I'm sure there is a different explanation.

@ herr doktor

Thanks for the update and link!

Golly, herr Doctor, I have to learn to type faster. I've a post in moderation that is going to mostly come out as a 'me too'.

(I thought that 2 links were safe, and 3 triggered moderation)

@Joel:

Ren wrote that, not me.

How do you get into a graduate program without being able to type (and there are apps that do it for you) <blockquote> and </blockquote>?

@Reverend - lots of your parent's money, apparently.

(I thought that 2 links were safe, and 3 triggered moderation)

It wasn't the links - I messed up my e-mail.

HDB @66: Thanks!
Yeah, my survey prof would have a field day with this too. Let's start with the income question: that's almost always one of the last questions because people don't like answering it.
Why on earth does the child'd hair color matter?
Those are some super leading questions about why they homeschool and why the kids aren't vaccinated.

Here's something else I want to know: why on earth does this paper even mention the BCG vaccine (for systemic TB in children) when it is *not* a vaccine that is given in the US?
I mean, it's just not relevant at all.

I want to say that the paper is so bad that they not only retracted it, but retracted the entire journal. But I’m sure there is a different explanation.

Try searching for Mawson, or for "Journal of Translational Science". The dudes at OAText are low-life grifters and a decent Search function is not high on their priorities. Nor is a formal retraction procedure, which is why there is no notification or explanation, only a couple of 404s where the PDFs used to be. They have Mawson's money, is what they care about.

I don’t know what kind of bias that is (I’m just an engineer, not even pretending to be an epidemiologist), but it is surely a problem.

I am not an epidemiologist either--I am a physicist by training and trade--but there are multiple problems with drawing a study group exclusively from homeschooled children. There are what are called confounding factors: for instance, homeschool parents are disproportionately likely to be anti-vaccine. And there is a selection bias as well. Not to mention response bias, because this study depended on parents filling out the survey truthfully and returning the forms to the investigators.

Doing such a study right is actually quite hard. One cannot rely on public school children alone for such a survey either, especially when collecting data in Mississippi, which only allows medical exemptions to vaccine requirements. There, if you choose only public school students for your study group, you are guaranteed to find that vaccinated children are healthier than unvaccinated children, because the unvaccinated children will invariably have some medical condition which means that they cannot or should not be vaccinated.

Selection bias is an issue in my field, because I work with geophysical data sets, and big events tend to be rare. We have to be careful that a major event doesn't bias our results.

Just found the following on the WA DOH Website. Thought it might be of some interest.

Latest School Report, Most Kindergartners Are Immunized

OLYMPIA – The Department of Health recently released school immunization results for 2016-2017, and for the second year in a row, 85 percent of kindergartners had received the required vaccinations to start school.

Nearly 5 percent of kindergartners have an exemption or waiver from immunizations on file for a medical, personal, or religious reason. This means more than 4,000 children in Washington aren’t protected from diseases that vaccines prevent. While the exemption rate hasn’t increased since 2011, it’s more than double the national average of 2 percent.

About 8 percent of kindergartners are out of compliance with school immunization requirements. These students don’t have all of their immunizations up to date, haven’t submitted an exemption, or are missing paperwork. The remaining students are “conditional,” or getting caught up on their vaccinations or paperwork.

More than 95 percent of schools submitted data this year. Explanations of school immunization rates, as well as trends and data, can be found at the department’s website.

Parents and guardians can access their child’s immunization records at MyIR and locate school immunization rates on SchoolDigger.com.

Washington provides vaccines at no cost for all kids up to age 19 through the Childhood Vaccine Program.

Here’s something else I want to know: why on earth does this paper even mention the BCG vaccine (for systemic TB in children) when it is *not* a vaccine that is given in the US?
I mean, it’s just not relevant at all.

Offhand, I'd guess they were citing Aaby's Guinea-Bisssau work for that part of "put reference here."

"Who are the others?"

Jesus H. Christ.

@ Joel #62: I get it. I really do. In today's academic world of publish or perish for tenure, the pressure to have publications to get tenure or post doc grants or whatever can be pretty intense.

My college does emphasize teaching and service over publication. Officially. And yet the RPT folders of my colleagues have tended to have a lot of presentations, posters, and publications in them.

I have a teaching idea I've been working on for four years now. I've tried to get published in Nurse Educator or the Journal of Nursing Education but the idea wasn't ready for prime time, and it was rejected. It happens every day to perfectly good articles, as well as to horrid ones, for the very reasons you cite: not enough press space.

There is a place for open access journals to improve the landscape, especially for novice writers and researchers looking to get their foot into the door. I'm doing that, with the article rejected by the aforementioned journals.

However, there are key differences between what I'm doing and what Mawson has done. My article did undergo peer review; it took the editors awhile to find someone qualified to peer review it. I do not have to pay for publication; while open access, the journal is supported by my university. I had to heavily revise the article to get it ready for prime time.

That's how the process should work. If you're having to pay to get something published because you've been rejected by every one else, including small onine OA presses, then the problem is your work and not the system.

There's still a chance the work could be good, but a rational reader will subject it to extra scrutiny. It does matter.

@Joel

If your work is so very good, you can cut it and maintain the essence. Going to a crappy journal just to get published just isn’t a good enough argument. Personally, I am damned happy that Orac has taught me about these journals so I don’t fall prey to them. That means I will miss your brilliant writing--well, better that than get sucked into the void.

From Jake's latest temper tantrum about this study:

"Please also be sure to troll the bitch who has led the charge for the study’s removal."

By "bitch," he means Dr. Tara C. Smith of Aetiology fame. I'm sure women just swoon at the level of respect and admiration Jake shows for the opposite sex.

Jake also seems to think that he wields some immeasurable amount of power:

"Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on the National Library of Medicine would be taken away."

Is that the royal "we"? Unless some of those Iraqi oil dollars can wield that much power, I'd say that this is another one of those temper tantrum empty threats.

"Please tweet the link to the republished study to Frontiers on Twitter, repeating the threat of National Library de-listing."

Yes, please do, loons.

Is that the royal “we”?

As I remember from his earlier post, he thinks he can convince Orange Thinskin, thru his appointed toadies, to order the National Library of Medicine to 'delist' Frontiers.

Like Trump, I doubt Jake has read the Constitution, or if he did, he never made it down to those pesky amendments.

@ Panacea and darwinslapdog

I really wish people would take the time to carefully read what I wrote; but I guess that is expecting too much. I covered a number of points.

Panacea wrote: "There’s still a chance the work could be good, but a rational reader will subject it to extra scrutiny. It does matter." Actually, as I explained, even the so-called best journals have had numerous retractions and those decent studies they published have often not been replicated, so one should be careful about how much one believes from any article. Read Ben Goldacre's book, "Bad Pharma," and do what I do, put a post-it on page of footnotes and check them out.

darwinslapdog writes: "If your work is so very good, you can cut it and maintain the essence. Going to a crappy journal just to get published just isn’t a good enough argument. Personally, I am damned happy that Orac has taught me about these journals so I don’t fall prey to them. That means I will miss your brilliant writing–well, better that than get sucked into the void."

First, as I explained, I could have posted it on a blog. My article refuted each claim in Wakefield's book, point by point, and I did it with direct quotes from numerous sources so as not to rely on one article as antivaccinationists often do. My article had 150 references. It would have been absolutely impossible to cut down from 15,000 to 2,500 words. And, as I wrote, once it was available online, it didn't matter who put it up, people could read it, check out the references (I gave hyperlinks to most of them) and decide for themselves. I repeat, once it was available online, anyone could judge for themselves. Who put it up was irrelevant.

Try read my article yourself and if you have even a modicum of a brain, please tell me how it could have been shortened from 15,000 to 2,500 words? And I also explained that there is much more research going on than could possibly be published in the major journals, including replications that don't back up key articles. Please explain how we would find out about them?

Everyone should in today's society understand some of the basics of science and take the time to read carefully articles and understand that every piece of research is tentative.

One last thing, most of the even egregious for-profit companies do arrange some type of peer- review. May not be great; but what type of peer-review does one find on blogs such as this; yet, readers such as I think many of the articles are good to excellent. Being an obsessive-compulsive, I actually click on links, go to mentioned articles, and download them, often reading them.

@Joel: That the reputable journals have had retractions is not the issue. It is not an excuse to pay to have your work published in what is in essence a scam journal. Smaller, less well known journals, sure. But when you pay to get published its a vanity press and it simply isn't worth it to you.

I don't know how you could have cut down 15,000 words to 2500. Perhaps you could have serialized it. Or maybe you had redundancies you haven't acknowledged. But a publisher can't take up that kind of space, especially in a print journal.

JK Rowling's books got longer and longer as the Harry Potter series went on. To their detriment. Her editors lost control over her, and it didn't do her work any favors. A good editor helps a writer tighten up and clarify the core message. It's your work; you don't have to change it. But the editor is under no obligation to publish it, either. And sadly, neither of us is JK Rowling.

@ Panacea:

I guess you are unaware of the PLOS and BMC open source collection of journals, many top rated with excellent editorial staff and peer-reviewers. They charge fees to publish and, at the same time, they have NO advertisers. More and more researchers are turning to such journals because they get a much wider readership. As I wrote in a previous comment, when I have found abstracts of articles that aren't available online, I have to drive to university library and photocopy or if the local university library doesn't have the journal, have to ask friends/colleagues to photocopy at their respective universities. Otherwise, most of the "prestigious" journals charge up to $40 for a pdf of an article that may be less than 10 pages long. Not exactly conducive to sharing of science. So, open source journals are more and more playing a roll.

If it is vanity to get ones article published in an open source journal that charges, what type of vanity to create ones own webpage and post away?

You write: "I don’t know how you could have cut down 15,000 words to 2500. Perhaps you could have serialized it. Or maybe you had redundancies you haven’t acknowledged. But a publisher can’t take up that kind of space, especially in a print journal."

It is really STUPID to make such statements when you haven't even bothered to read my article. I guess you pull your thoughts out of your, you know what.

And, none of the print journals are going to serialize an article like mine. And, as I wrote earlier, the journal that posted my article, as many of the open source journals sometimes do, waived any fees on my part. And the editor is a well-respected virologist and assured me that it was reviewed by FIVE qualified reviewers.

As I explained and you are apparently too dense to understand, I wanted to get my article online so that people could see it. Anyone who seriously reads it and is open-minded will see that Andrew Wakefield's clams about vaccine safety are just bogus. I guess you think that anyone who takes the time and effort to refute others who are hurting public health, if they can't get their refutations published in a peer-reviewed journal, regardless of how good they are, should just forget it?

Read my article you frigging idiot!

https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

Joel, I don't have to read your article to identify potential problems with an analysis that long. If you'll note I didn't suggest it was badly written in anyway.

I really don't have time to read something that long about an issue I'm already familiar with.

You have a tendency here, though, to rely on argumentum ad nauseum. I understand; I can be verbose myself.

I don't understand why you have to drive to your university to get articles behind paywalls, though. I can get pretty much anything online from my university library, including NEJM, JAMA, Lancet and more.

And I still haven't said paying for publication means bad. It simply means, I take a much harder look at it.

Quit being so defensive.

While I agree with your dissection of the study, I disagree with “Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals.” This is exactly what antivaccinationists sometimes resort to, that is, calling open-source journals who receive a fee to publish articles, vanity press and other journals for receiving pharmaceutical advertisements. There are good open-source journals, e.g. PLOS group, and bad journals; but what counts is not where something is published, even a blog, but the actual content of the article. Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack and detracts from your otherwise excellent dissection of Mawson’s study.

I am going to disagree with what you have written here. An ad hominem attack is one where the character or personal traits are attacked in order to undermine an argument. However, ad hominem does not occur when the character or personal traits are part of the argument.

In this case, it is well known that there are stables of predatory open access publishers who lie about their editorial boards, lie about peer-review and happily publish any old junk so long as the author pays. Practicing scientists generally steer clear of these journals, meaning they only publish work that cannot pass peer review elsewhere.

If someone tells me that a paper was published in a Frontier's journal, I immediately know it didn't pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

That doesn't mean that there is not junk science published in other journals (look at Scientific Reports for examples), but if you have to stoop to a predatory open-access journal to get published, then there is something seriously wrong with the work.

As I remember from his earlier post, he thinks he can convince Orange Thinskin, thru his appointed toadies, to order the National Library of Medicine to ‘delist’ Frontiers.

Nonono, it's better (boldface added):

"Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on [sic] the National Library of Medicine would be taken away."

I have a Kraken to be unleashed, you dykes!

“Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on [sic] the National Library of Medicine would be taken away.”

Jake is going to be beside himself when he discovers that OAText has done the same to Mawson's papers.

I suspect a letter writing campaign will work less well on an outfit run out of Hyderabad, but with a fake mail address in London.

^ Oh, rats, Ren already got that. So much for reading comments from the bottom up.

Quit being so defensive.

This. We've (tinw) been through it all before, anyway.

@ Ren he is truly off the rails. I found this stupid turd of a tweet on his sh!teshow of a twitter feed:
Deplorable Autist @JakeLCrosby Apr 16

"Science Mom" of @JusttheVax is actually Camille Clark, once known as "Autism Diva" (and still just as big a bitch).

The Gnat can be hysterically stupid sometimes in his speculations.

@Science Mom: wait, what? I thought you were Bonnie Offitt. ;) :p

Julian, I thought you were Bonnie Offit. ;^Þ

I am Bonnie Offitt!!

I am Bonnie Offitt!!

I have never been accused of being Bonnie Offitt. But I have been accused of being Paul Offitt.

Why Paul Offitt would be commenting on the internet using the name Chris Preston was never properly explained. But that is anti-vaccine logic for you.

Didn't you guys know that I'm Brian Deer?

(not that I mind being compared to an award winning journalist & all)

If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

I know Jeff Beall channelled his inner Savonarola and was wont to denounce Frontiers as an instrument of the Devil profit motive, but they could still get their act together and stop publishing bafflegab (or at least bring down the ratio of bafflegab to that of longer-established profiteers like Elsevier). It's not going to be easy, of course, because of the way they incorporated the Multilevel Marketing business model into their structure, and decentralised the incentive to accept bad papers in exchange for $$$.

Full disclosure: I have reviewed manuscripts for Frontiers journals. In fact I have published with Frontiers journals, so I have a vested interest in them rebuilding their reputation.

Well, Joel, you wasted a good paragraph up there at #87 quoting me in full rather that simply referencing the comment #. You call it “meticulous”, I’m not surprised, as you say you are OCD (-ish at least) This is further demonstrated by your going on and on with your argument even though perfectly good arguments and alternatives have been suggested. Did you ever submit your draft to an editor? I have found that when forced to to so, I can cut my writing drastically and still make my point.

@ Panacea:

You write: "Joel, I don’t have to read your article to identify potential problems with an analysis that long. If you’ll note I didn’t suggest it was badly written in anyway. I really don’t have time to read something that long about an issue I’m already familiar with."

Really, you don't have to read something? You are already familiar? What an arrogant idiot!

You write: “I don’t understand why you have to drive to your university to get articles behind paywalls, though. I can get pretty much anything online from my university library, including NEJM, JAMA, Lancet and more.”

First, to get it online from a university library one has to either be an employee or student to have an account. I am neither. Second, I’ve asked friend’s to get me articles and our university libraries online electronic databases do not include many journals. In fact, fewer and fewer each year as the library funds are reduced and the journals charge more and more.

You write: “And I still haven’t said paying for publication means bad. It simply means, I take a much harder look at it.”

I agree and have said so in several of my previous comments, except if I think an article important, I become more critical, regardless the source and I keep in mind at all times that even a well-done piece of research’s findings are tentative.

Once again, use a little of your “precious time” and read my paper and then comment on it. You might learn something, if that is possible:
https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

@ Chris Preston:

You write:

“If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science. That doesn’t mean that there is not junk science published in other journals (look at Scientific Reports for examples), but if you have to stoop to a predatory open-access journal to get published, then there is something seriously wrong with the work.”

Really, “you immediately know it is junk science.” And, I guess one should know that any research published in a journal that gets much of its funding from the pharmaceutical industry is suspect? And anything written on blogs like this are . . . well, you know. I’ve dealt with your idiotic statement in several of my previous comments. What amazes me is the arrogance of certainty that exactly mirrors that found on many antivaccinationist websites. They too automatically know which studies are good and which biased. Must be nice. Can you walk on water as well?

@ darwinslapdog:

You write: “Did you ever submit your draft to an editor? I have found that when forced to to so, I can cut my writing drastically and still make my point.”

Yes, I did. In fact, prior to trying to get it published anywhere, I had friends/colleagues (over 10), several who are excellent editors, critique and edit it. And the editor who finally accepted my article actually did edit it and more changes were made following evaluations from FIVE peer-reviewers. I am “meticulous”. I have edited books, theses, articles; but never rely on my own editing of my own writings. I mentioned some of the people who reviewed/critiqued my articles in an Acknowledgments section; but some preferred to remain anonymous, given that antivaccinationists have been known to harass people.

In fact, even the 10 articles I wrote for Every Child By Two were looked at by up to 10 friends/colleagues. As I wrote in several previous comments, I could have just posted it on a blog and it was the article on Wakefield that led to Every Child By Two allowing me, as a volunteer, to post additional articles on their website. I don’t work for them; but they seem to like my articles and post them. And each article is long with quite a few references.

Antivaccinationists rely on one or two articles, or, sometimes, just take something from an article out-of-context. I write my articles intentionally to demonstrate how one writes a scholarly review, that is, not relying on one or two; but building my case with numerous credible articles. In a way, one could consider my articles a form of legal brief.

Well, since I'm such an idiot, I see no point in reading your analysis. Probably over my head anyway.

And if you think that's what I actually mean, you should rethink it.

Didn’t you guys know that I’m Brian Deer?

I can outdo that: I've been accused of being "Brain Deer."

@Joel Harrison #109

“I mentioned some of the people who reviewed/critiqued my articles in an Acknowledgments section;”

I note that you listed Steven A. Rubin PhD in your acknowledgements. That would be the same Steven A. Rubin who along with Stanley A. Plotkin in their excellent paper recorded the rate of meningitis in Canada following administration of a urabe containing vaccine to be 1 case in 62,000 doses?.

"In Canada, the observed rate of meningitis after vaccination with Urabe strain was calculated to be 1 in 62,000 doses of the vaccine manufactured by GlaxoSmithKline"
Stanley A. Plotkin and Steven A. Rubin (" Mumps Vaccine chapter 20")

Maybe you’d like to explain why you erroneously wrote it up in your article, as 1 case per 100,000 doses………..

"Based on reports of aseptic meningitis, the Canadians estimated its occurrence in association with the vaccine as 1 case per 100,000 compared with 1 in 400 following
natural mumps"

If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

I would have phrased this differently. I would have said that if a paper is published in a Frontiers journal I know that the probability of its being junk science is much, much higher than if it had passed peer review in an established journal.

@ Wendy Stephen:

You write: “Maybe you’d like to explain why you erroneously wrote it up in your article, as 1 case per 100,000 doses………..”

If you actually carefully read my paper, you would see that I referred to the UK decision in 1988 to continue use of the Urabe containing vaccine while trying to obtain an adequate supply of a Jeryl Lynn containing vaccine. This decision was made based on a 1987 Canada Diseases Weekly Report and a visit to Canada, which, as you know, clearly indicated that the Urabe vaccine associated aseptic meningitis was a benign condition. Benign doesn’t mean totally nice, just no need for heroic medical interventions and no disabilities on follow-up. The stats you give were contained in a December 1990 Canada Diseases Weekly Report, two years after the UK decision. If you had bothered to check out reference [57] in my paper it would have been obvious., I know you would love to find fault with anything related to me; but sorry to disappoint you as I used the stats available to the UK at the time, so what I wrote wasn’t “erroneous. “

Below are the actual quotes from the two Canadian Reports.

You claimed in comments quite some time ago that you are NOT an antivaccinationist; yet, are obsessed with the Urabe strain of mumps containing vaccines which has not been used in UK or Canada in over 20 years. Not once have you written something like: “There were problems with MMR vaccines containing the Urabe strain of mumps; but the vaccine currently being used in UK, US, and Canada contains the Jeryl Lynn strain of mumps which has a good safety record and I would recommend it for anyone’s children.”

In addition, you indicated that you would e-mail me the official document regarding your daughter’s case. So far, I haven’t received it. You can e-mail it to Every Child By Two and they will forward it to me. I am currently working on an article on Mumps and intend to do my best to cover everything, including as many case reports and studies on the Urabe strain vaccine. Currently I have over 200 documents, articles, chapters, reports, etc. So, send me any relevant papers related to your daughter’s case. If not, I will evenutally obtain them, just more work getting colleagues in UK involved.

CANADA WEEKLY DISEASES REPORTS

“Based on the assumption that approximately 250 000 to 300 000 doses of this vaccine may have been given in the past 12 months, the expected rate of reported CNS reactions would be 1 per 100 000. This is consistent with the reported rate of the CNS reactions for this vaccine worldwide which ranges from 1 in 70 000 to 1 in 200 000. This is also comparable to the incidence of about 1 in 100 000 reported in the literature for CNS involvement after use of a trivalent vaccine containing other measles and mumps strains or another monovalent mumps vaccine.
The “background” incidence of aseptic meningitis (of unknown etiology, or due to mumps) requiring hospitalization can be estimated historically from hospital discharge diagnoses. The average incidence in any given 4-week period for the years 1978 through 1983 in Canada was about 1 case per 100 000 children age 1 to 14. This is remarkably similar to the estimates of vaccine-associated CNS illness. All of these estimates are insignificant when compared to the rates of meningitis/encephalitis following natural measles (1in 2000) or mumps (1 in 400) infections.

Canada Diseases Weekly Report, September 5, 1987 Available at: http://publications.gc.ca/collections/collection_2016/aspc-phac/H12-21-…

In Table 22-10 of Rubin’s chapter on Mumps in the 6th Edition of the book, Vaccines, it does give 1/62,000 based on an article by Furesz which states; “Since the laboratory findings confirmed conclusively that the meningitis observed in recipients of TRIVIRIX vaccine was caused by the Urabe mumps vaccine, the latter vaccine was not considered safe for immunization of Canadian children. Effective May 1990, TRIVIRIX measles, mumps and rubella vaccine is not longer licensed for sale in Canada.”

Canada Diseases Weekly Report, December 15, 1990. Available at: http://publications.gc.ca/collections/collection_2016/aspc-phac/H12-21-…

Joel, the definition of an antivaccinationist is………………….

“One who opposes vaccination”

I have asked you previously to provide evidence of any conduct on my part which might support your continued accusations that I am an antivaccinationist. You have failed to do so, probably because it doesn’t exist. I do however have an interest in the urabe mumps vaccine which I have never sought to hide. What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.

In your article you questioned what the UK decision to license the URABE MMR vaccine was based upon.

In response to your own question, you note that in 1987 the UK conducted MMR vaccine trials in approximately 5,000 children.

A clinical trial with 5,000 of a cohort is a respectable sized trial to establish the safety, efficacy and efficiency of a product, however what you failed to mention in relation to your own question was that just over a mere 600 children received the URABE containing Pluserix vaccine (the vaccine you are referring to), the remaining 4,400 did not. Only feedback from the 600 could have been relied upon to influence the UK decision to license and implement a URABE containing MMR as to its safety and efficacy. By comparison a trial with a cohort of 600 children on board, isn’t nearly so impressive as your quoted 5,000. Why would you seek to convey to the reader that the clinical trial relied upon to establish the safety of the Urabe containing Pluserix MMR which influenced the decision to introduce the urabe MMR into the UK, was far greater than it actually was?

Additionally, you reference three “reported studies using the Urabe strain that found no serious problems” where none of the brands involved remotely resembled, let alone matched, the urabe containing Pluserix MMR vaccine which the UK authorities were seeking to introduce in 1988. Just as negative safety issues and adverse reactions etc following the use of one brand of vaccine cannot be visited on to another entirely different brand, neither can the positive results from studies involving entirely different brands with entirely different component parts, excipients and dosages be used to assert the safety of the Pluserix MMR vaccine. Anyone who sought to do so would be entirely remiss not to mention unscientific and I have seen no evidence anywhere that the UK decision to introduce the Urabe MMR was based on the studies you propose.

@ Wendy Stephen:

You write: “I have asked you previously to provide evidence of any conduct on my part which might support your continued accusations that I am an antivaccinationist. You have failed to do so, probably because it doesn’t exist. I do however have an interest in the urabe mumps vaccine which I have never sought to hide. What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.”

You continue to ignore my asking why you haven’t once in any comment I have seen by you in any way encouraged people to get their kids vaccinated. All you do is harp on the Urabe vaccine, not later developments. As I suggested, if you were NOT antivaccine, you could have said that an earlier MMR that contained a strain of mumps called Urabe was found to be associated with unacceptable adverse events; however, a new strain of mumps called Jeryl Lynn, that has been used in UK and Canada for about 20 years has a good safety profile and I recommend it to all parents for their children. The fact that you go on and on about something that occurred over two decades ago and don’t make it clear to the reader that, even if it was a problem, that it isn’t today, easily can be read by anyone as valid today. Antivaccinationists, for example, continue to harp on the Cutter Incident, something neither I nor anyone I know downplays; but it happened in 1955 and led to far more stringent requirements for vaccines and oversight. However, if all one were to hear was the Cutter Incident they would think that the polio vaccine of today is unsafe. So, yes, whether you like it or not, you come across as antivaccine.

And anyone who reads my paper would see that I did NOT “play down” the adverse event findings associated with the Urabe; but made clear that it was still far safer than the wild-type disease and that, at the time, the data available did NOT indicate it differed in its adverse event profile from the Jeryl Lynn. You continue to twist things to give the impression that the UK continued using the Urabe without taking into consideration possible adverse events when they decided to use it as it was better than the natural disease and immediately began trying to get an adequate supply of the Jeryl Lynn containing vaccine. In another post you found that the UK had approved a Jeryl Lynn mumps vaccine in 1972; but you assume that the pharmaceutical company kept their production facility ready for a program that the UK began in late 1988. Without any evidence that the company was producing or capable of immediately producing quantitities of the vaccine, you assume so. In law courts that is termed “facts not in evidence.” Actually, I am trying to find out; but it isn’t easy.

I noticed that you failed to admit that you misread my paper regarding the 1 in 100,000 vs 1 in 62,000. And even if I had gotten it wrong, whether 1 in 100,000 or 1 in 62,000, the Canadian report gave the risk for aseptic meningitis from the wild-type mumps as 1 in 400. So, the Urabe was still the safer bet. And if you actually carefully read Steven Rubin’s chapter, safer in regard to a number of other adverse events associated with the natural disease. And your choice of word “erroneous” was obviously not just to point out a possible error. I edit books and articles written by quality people and always find a few errors. I remember once in a graduate statistics course arguing with the prof about an error in a formula. Turns out his copy was a later printing, so the authors had corrected it. It was an excellent book with a couple of errors. Happens all the time; but that wasn’t your intention. Antivaccinationists and other unscientific types believe if they find one or two errors that it discredits an entire work. Not true anymore than if a defense lawyer discredits one witness, the jury should then ignore the entire prosecution’s case.

And you continue to try to find fault with my paper and again are wrong. From my paper:

“Before the beginning of the program, vaccine trials were conducted in the UK, starting in early 1987 [69]. By the beginning of October 1987, data had been collected for five months from three districts: Somerset, Fife and North Hertfordshire. The data included health diaries kept by the parents covering the three weeks before vaccination and three weeks after [58]. Approximately 5,000 children were included in these studies [70]. However, the diaries were not the only means used for reporting adverse events (see below)” (Wrong About Vaccine Safety, p. 13. Available at: https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

If you checked out reference [70]. I was citing a UK committee:

“Dr Cameron Bowie spoke on the MMR trials which had been carried out using Health diaries on approximately 5,000 children . . .”

Joint Sub-Committee on Adverse Reactions to Vaccination and Immunisation, March 8, 1988. Available at:
http://webarchive.nationalarchives.gov.uk/20120907090205/http://www.dh…

And do notice that I wrote: “However, the diaries were not the only means used for reporting adverse events (see below).”

And the UK looked at the Canadian data and other studies. Yes, not every vaccine was exactly the same; but they looked at everything available at the time. And, once more, despite the Urabe assocation with adverse events, it was till much safer than the natural disease. Can you accept that? ? ?

You continue to misread what I write because you need to given your obsession with the Urabe vaccine.I consider any child injured whether from the natural disease or a vaccine a tragedy; but since life isn’t black and white, I choose to weigh benefits vs risk. If the risks from the natural disease outweigh those from a vaccine, I choose to vaccinate. However, I also choose to not only compensate children hurt by vaccines; but a society where all children are given whatever help, medical/educational etc. is necessary to allow them to reach their full potential. Given what I so far know about the Urabe, if it was the only available vaccine available I wouldn’t hesitate to give it to children.

It really is a waste of my time responding to you as you refuse to admit when wrong, e.g. 1 to 100 000 and you continue to focus on only part of my paper. As I said, I am working on a paper just on the Mumps. As opposed to you, if I find more evidence against earlier versions of Mumps vaccine or even the current, I will include it. You said a while back that you would e-mail me the decision on your daughter’s case and any relevant papers; but I haven’t received them, so I guess I will have to request colleagues in UK to help. Do you have something to hide? So, are you going to send the info via Every Child By Two or not? ? ?

Joel @117

“In another post you found that the UK had approved a Jeryl Lynn mumps vaccine in 1972; but you assume that the pharmaceutical company kept their production facility ready for a program that the UK began in late 1988. Without any evidence that the company was producing or capable of immediately producing quantitities of the vaccine, you assume so”.

No Joel, I make no assumptions. I learned from the 17th May 1988 MMR Working Party Minutes that even as far back as May 1988, (four months before the launch of the UK MMR campaign) an approach had been made to the Department of Health in the UK advising that MMR II vaccine “wished to join the MMR market”.

Even before the launch of the campaign in the UK there is a clear indication that the MMR II production facilities were ready for the UK program otherwise they would not have indicated that they wished to join the market. MMR II was implemented in November of 1988 and continued without interruption even after the withdrawal of the urabe containing brands.

Additionally, the Minutes of the JCVI meeting on 6th November 1992 record how

“Department of Health officials visited the MSD factory in Philadelphia and obtained agreement for the supply of the additional amounts required by the UK”.

I’d say that was ample evidence that the company was (a) capable of supplying the UK market with MMR II even before the campaign was launched and (b) was immediately capable of increasing their supplies to the UK to meet our entire demand when asked to do so, after the withdrawal of the two urabe containing brands.

@ Wendy Stephen:

You write: “No Joel, I make no assumptions. I learned from the 17th May 1988 MMR Working Party Minutes that even as far back as May 1988, (four months before the launch of the UK MMR campaign) an approach had been made to the Department of Health in the UK advising that MMR II vaccine “wished to join the MMR market. Even before the launch of the campaign in the UK there is a clear indication that the MMR II production facilities were ready for the UK program otherwise they would not have indicated that they wished to join the market.

According to the document you refer to: “Dr Salisbury reported that he hoped the SKF MMR vaccine would be license shortly since its constituent parts were already licensed. Wellcome contacted him to say they wished to join the MMR market. Their vaccine contains the Jeryl-Lynn strain of mumps. The MSD vaccine already has a product licence. Dr Thorne asked whether there would be central purchasing . . .”

JCVI Working Party on the Introduction of Measles, Mumps and Rubella Vaccine, May 17, 1988. Available at: http://webarchive.nationalarchives.gov.uk/20120405095146/http:/www.dh.g…

“Wished to join” doesn’t mean that they were ready on a moment’s notice to begin production!

And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn.

In the UK, “despite the benign nature of vaccine-induced meningitis, a decision was made to replace the brands containing Urabe (Immravax by Merieux, and Pluserix MMR by SmithKline Beecham) with that containing Jeryl Lynn” [91].
[91] Peltola H (1993). Mumps vaccination and meningitis. Lancet; 341(8851): 994-995.

However, as another document makes clear: “The Health Departments had had a difficult time with regard to MMR supply, problems caused in the main by the manufacturers. Other vaccine manufacturers producing MMR which contained the Jeryl Lynn strain of the mumps virus included RIVM (under a very prescriptive license from MSD making sale in the UK impossible) and Rubini in Switzerland (a vaccine which lacked sufficient study in the field to be certain that there would not be a Urabe-like problem). Merck and Merieux were collaborating to produce a Jeryl Lynn strain vaccine [90].

[90] UK Department of Health. Joint Committee on Vaccinationa and Immunisation. Minutes of Meeting, May 7, 1993. Available at: http://webarchive.nationalarchives.gov.uk/20120907090205/http://www.dh…

So, yes, a Jeryl Lynn containing vaccine had been approved ; but that doesn’t mean that the company, despite their interest, was able to produce the quantities necessary as indicated in the above document. In addition, the UK had decided to use the Urabe containing MMR and it wasn’t until after they learned of the Province of Ontario’s recall on July 18, 1988 of the TRIVIRIX that they looked into it and decided to obtain Jeryl Lynn containing vaccines. This means than the URABE containing vaccine, Pluserix, would have been in production and once they agreed to MSD, MSD would have had to play catchup. So, as usual, it is you who overplay your hand. Once again, as made clear in quote from UK document, the manufacturers of Jeryl Lynn containing MMR had production difficulties. DO YOU UNDERSTAND? ? ?

As for: Additionally, the Minutes of the JCVI meeting on 6th November 1992 record how
“Department of Health officials visited the MSD factory in Philadelphia and obtained agreement for the supply of the additional amounts required by the UK”.

Incredible. You don’t understand the basics of calendar time. November 6, 1992 is four years after the UK started the vaccination program. And the report doesn’t mention anything about the production capabilities of the MSD factory in Philadelphia, that is, at what time was their facility capable of both supplying US and UK? There is NO indication from any document I have obtained that they could have done so in Fall of 1988. Otherwise, why would MSD, after indicating their interest in marketing their vaccine, not avail themselves of their production capabilities in Philadelphia? Why did UK document from 1993 discuss difficulties in production by manufacturers of Jeryl Lynn containing MMR?

And still, you refuse to simply state something endorsing use of the current MMR, obsessing on the Urabe. I guess given your inability to actually understand simple dates, why should one expect more of you?

And, again, you posted in a comment some time ago that you would send me the documents related to your daughter’s case; but I guess that won’t happen?

I am busy proof-reading a microbiology textbook which will be used by thousands, a much more valuable use of my time.

Joel @119

“And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn”.

Joel, it is acknowledged that that the “problems in Canada” were known to the UK authorities long before Pluserix entered the market. It is not correct to say that ONCE awareness of the problems in Canada became known, supplies of MMR II were obtained.

In case you missed it, the MMR II proportion of the UK market INCREASED (ie from the 15% share of the entire UK market it had held since 1988) in 1992 after the withdrawal of the two urabe containing brands at which time MMR II became the only brand used. This came about when the laboratory confirmed rate of urabe vaccine induced aseptic meningitis was found by a UK Public Health Laboratory to be much higher than previously thought. The Chief Medical Officer of the time, Dr Kenneth Calman, distributed an official letter to all doctors etc in the UK on 14th September 1992 advising them of the new statistical findings from the UK facility and how, from then on, only MMR II vaccine would be available.

That all took place long AFTER the “problems” in Canada were known about and two years AFTER the Canadians had removed the licence for Trivirix. The situation in Canada was not the catalyst for either the decision to remove the urabe containing MMR’s in 1992 or the timing of a decision to switch to only MMR II. That all came about solely as a consequence of our scientists determining that the rate at which aseptic meningitis was occurring in UK children was much higher than originally thought.

If your article states anything other than that to be the sequence of events, then it is wrong

@ Wendy Stephen:

You write: “It is not correct to say that ONCE awareness of the problems in Canada became known, supplies of MMR II were obtained.”

But that is NOT what I wrote, which was:

“And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn.”

The UK started an effort to obtain the MMR with Jeryl Lynn. Thank you for once again proving my point that you really don’t read carefully or understand what people write. Try carefully reading my article.

And once again, you refuse to admit you were wrong, wrong about claiming I “erroneously” used 1 in 100 000, wrong about using 1992 arrangement to get supplied from MSD in Philadelphia, ignoring that the UK MMR program began four years earlier and so it goes.

One other thing that, if you actually read my article you missed: “Note that the Canadian decision to withdraw the vaccine was based partly on laboratory data from the UK. . . . Canada was not the only country to base its decision partly on data from the UK; but “the [JCVI] committee was told that all the countries which had had a choice had switched from Urabe to Jeryl Lynn; the UK data had been accepted by all these countries” [79]. In other words, it was the quality of the UK surveillance data that prompted its worldwide use for vaccination decisions; and although the “UK’s quality of surveillance was unsurpassed . . . Many lessons had been learnt from MMR. It was agreed that better surveillance was needed as well as a consideration of how adverse events were followed up [79].”

You claim that all you want to do is: “What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.” AND "If your article states anything other than that to be the sequence of events, then it is wrong," So, you are commenting on what I wrote; but have obviously NOT read it. How pathetic!

Yet, that is NOT what you are doing. Your daughter lost hearing in one ear and you want to blame someone. You need to portray the British decision and those who made it as either incompetent or worse. You need to claim that I downplayed the risks and problems with the Urabe strain containing MMR. What you refuse to accept is that, as with anything that people do, they do their best and then learn from their mistakes. I simply described in my paper the events as they transpired and that, in fact, at the time, the UK surveillance for adverse events was probably either the best in the world or up there.

You criticize the sample sizes and follow-up times; but they were not out of line with most studies of this type. Years later, in the US we approved the first rotavirus vaccine based on a study sample of over 10,000 and on post-marketing surveillance a rare problem, intussusception, was found, so it was taken off the market. Until the next vaccine based on a sample of 72,000 was approved, each year several dozen children died and 10s of thousands were hospitalized to prevent a dozen or so cases of intussusception and one possible death. I’m sure you approve.

You claim to NOT be an antivaccinationists; yet I asked you, not only in this exchange, but numerous others to simply state something like: “Based on my understanding several decades ago an MMR vaccine containing a strain of the mumps called Urabe was associated with unacceptable adverse events and I believe this could have been avoided if the decision process had been better. With that said, today’s MMR vaccine has an excellent safety profile and I recommend that all parents should vaccinate their children.”

If you can’t say something positive about current vaccines and continue to twist and distort what happened 20 years ago, then YOU ARE AN ANTIVACCINATIONIST.

And once more you fail to answer if you will send me the documents on your daughter’s case. As I wrote, I am working on an article on mumps and intend to create numerous tables, including one for hearing loss, both stats on natural disease and vaccines, as many papers as I can find. I don’t down play anything as I think, as I’ve written numerous times, that even one injured child is a tragedy; but, living in the real world, one has to make choices and I choose vaccination over the natural diseases. Who would you be blaming if UK had withdrawn MMR and your daughter was injured from one of the natural diseases which would have had, without vaccines, a much higher probability of occurring?

So, post a comment promoting the current MMR and answer if you intend to send me the documents on your daughter’s case.

And just to be clear, you come across as not only an antivaccinationist; but a bitter obsessed person.

Joel @121

“I simply described in my paper the events as they transpired and that, in fact, at the time, the UK surveillance for adverse events was probably either the best in the world or up there”.

You certainly did cover the adverse event surveillance system in place AT THE TIME but it’s a pity you got that wrong as well. And as for being “the best in the world or up there” it might surprise you to know that even our own authorities acknowledged that in respect of urabe, the system had failed to identify the scale of the problem.

In your article you asked what type of surveillance system did the UK use? In response to your own question you mention the Yellow Card Scheme and say that “suspected ADR’s can be reported by anyone; this is usually done by healthcare professionals …including doctors, pharmacists and nurses…………but patients and care givers also made reports”

Given that you are talking about what was in place AT THE TIME you should be aware that nurses were only allowed to report via the Yellow Card system after November 2002 (ten years after Urabe was withdrawn), Pharmacists in November 1997 (5 years after Urabe was withdrawn) and patients and caregivers since November 2005. What you have described is the scope of the yellow card system today not how it was back at the time you are talking about.

The BMJ (vol 301 1st December 1999) “The Yellow Card Mark II) said of the system.....

"There is of course considerable under reporting"

Additionally, the 1995 edition of POST (Parliamentary Office of Science and Technology) stated the following……..

"The Urabe experience was exacerbated by the failure of the yellow card surveillance system to detect the scale of the problem.............."

Also from the Minutes of ARGOS (Adverse Reaction Group of Sear) (CSM 1992 8th meeting) it was said of the Urabe problem that……….
"The BPSU has failed to adequately identify an important public health problem"

If the BMJ, POST and ARGOS are all willing to concede the failures in respect of urabe surveillance and the limitations of the yellow card scheme, why cant you?

@ Wendy Stephen:

You write: "it might surprise you to know that even our own authorities acknowledged that in respect of urabe, the system had failed to identify the scale of the problem."

So what. At the time they did the best they could. Admitting later that in hindsight they could have done better is not an admission of negligence. It has normal rational people progress and improve things. You obviously are not rational.

And my article doesn't just give the Yellow Card Scheme as the only source. You are really dishonest when you take only one of the ways that the UK conducted surveillance which my article covers. Typical antivaccinationist. They think the Vaccine Adverse Events Reporting System in the US is the only program for post-marketing surveillance of vaccines; but it is only one of several.

And you keep ignoring that the Urabe was still much safer than the natural disease and that all experts considered aseptic meningitis as a benign condition and the risk of hearing loss from the vaccine exponentially less than from the natural disease.

So, I gave what was used at the time, which was the basis for decisions in many other countries. And you continue to fail to admit the erroneous claims against me that you have made in previous comments on this exchange.

I've tried to be polite; but you are either psychologically disturbed or just plain dishonest. You want to blame people based on hindsight and, again, you refuse to endorse current vaccines or to answer if you will send me documents on your daughter's case.

I sincerely suggest you seek therapy!

Joel @ 123

“And my article doesn’t just give the Yellow Card Scheme as the only source. You are really dishonest when you take only one of the ways that the UK conducted surveillance which my article covers. Typical antivaccinationist”

Well, if you really want to go there!

The other types of surveillance you identify in your article were….

(1) The BPSU which I have already pointed out was described in the ARGOS Minutes as having failed to adequately identify the Urabe problem.

"The BPSU has failed to adequately identify an important public health problem"

(2) “Adverse Reactions Surveillance – Dr. Bowie advised that active surveillance of MMR vaccine in Somerset had just started”

The JCVI in their Minutes of the Meeting on 7th March 1990 noted………..
“the surveillance of MMR vaccine in Somerset is unlikely to detect issues of concern, problems exist with under reporting”

(3) The surveillance diaries given to vaccinated children

The three week follow up diaries given to vaccinated children as part of the surveillance would have missed a significant number of cases of aseptic meningitis which occurred after the 21 day cut off.

Miller, E. et al in their paper “Risk of Aseptic Meningitis After Measles, Mumps and Rubella vaccine in UK Children”, published in the Lancet, Vol 341, April 17th, 1993 noted that “half the aseptic meningitis cases identified in children aged 12-24 months were vaccine associated with onset 15-35 days after vaccine”

The Canadian Medical Association Journal, Vol 138, January 15th 1988 reports on a case of mumps meningitis in a 14yr old, twenty six days post vaccination with the urabe containing Trivirix.

In their paper “Clinical and Epidemiologic Features of Mumps Meningoencephalitis and possible Vaccine-related Disease”, Vol 8, Paediatric Infectious Disease Journal November 1989, McDonald et al report on a 4yr old who developed mumps meningitis twenty six days after receiving Trivirix.

The Canadian Diseases Weekly report 5th September 1987 "a history of recent vaccination suggested an association between the vaccine and the development of meningitis although the time between the 2 events was 26 days - somewhat longer than the incubation for the wild virus"

In your article you stated that……..
“It is highly unlikely that many, if any, cases of aseptic meningitis would have been missed.”

I put it to you based on all the material I have placed before you from reputable sources, it was more likely than not, that a huge number of cases were missed.

If you don’t get that, it’s not me what needs therapy.

@ Wendy Stephen:

Again, it was the best surveillance system for the time. Yes, it missed cases; but, in your immense STUPIDITY, you fail to accept that it was cases of a BENIGN condition. Do you understand the word "BENIGN."

And you continue to use studies and data conducted later to blame something that occurred in the past. How really really STUPID.

And, again, for the umpteenth time, you fail to endorce the current MMR vaccine and to let me know if you intend to send to me documents related to your daughter's case.

Just for your dense brain, there is NO surveillance system that I know of that captures everything and it was NOT necessary because the cases of aseptic meningitis reported in Canada and the UK were enough to decide on halting use of the URABE. Does it really matter if they didn't capture all or even close to all cases if they captured enough to make a valid decision? Don't you understand anything?

I suggest you post regularly on Age of Autism. You can state that the world is flat and it is vaccines that distort of perceptual abilities and I'm sure some comments will applaud you.

Since you fail continuously to respond to my questions and continue to drag up the future to criticize the past and since you fail to understand that the surveillance systems at the time captured enough cases for decision making, there is only one way to describe you, STUPID ON STEROIDS!

Joel@127

“Again, it was the best surveillance system for the time. Yes, it missed cases;”

Joel, in your article you argue against the fact that the UK surveillance system for adverse events was “inadequate” saying that to be, “not true”

Now you agree that it missed cases, what is that if not inadequate? Many of the references I have provided to you in previous posts from reputable bodies readily acknowledge the inadequacy of the surveillance.

That has got nothing to do with it being the best that was available at the time, and I agree that no system would be entirely effective in capturing everything. The point is that not only do you present an inaccurate picture of the state of the UK surveillance system in your article, suggesting it to be entirely capable of detecting a problem with Urabe were it to be occurring, you steadfastly reject any suggestion that it was inadequate.

And as for this bit……….

"Does it really matter if they didn’t capture all or even close to all cases if they captured enough to make a valid decision?"

I can only draw you back to this quote from one of my previous posts……..

"The Urabe experience was exacerbated by the failure of the yellow card surveillance system to detect the scale of the problem.............." POST July 1995

Consider this. Had the system not been so flawed and the “scale” of the Urabe problem picked up on earlier, that “valid decision” you speak of, would have been made much earlier. When the issue is one of adverse reactions following administration of a medicinal product, I put it to you that it DOES “really matter” that (a) problems are detected (b) the scale of the problem is accurately (as far as possible) recorded and (c) immediately acted upon as necessary.

@ Wendy Stephen:

In a previous comment I wrote that NO surveillance system is perfect, that is, captures every case. The reason for, as the UK had in 1988, having several different surveillance systems is that each has its strengths and weakness and each will capture some cases not captured by one of more of the other systems. So, the sum of cases captured by all the systems will be greater than any one of them. However, NO system, even today captures ALL or even most cases. Typical antivaccinationist, either or, black and white.

And I stand by what I wrote: “Does it really matter if they didn’t capture all or even close to all cases if they captured enough to make a valid decision?”

I remind you that the Canadians decided to stop using the Urabe based on only 15 days follow-up (not at the time knowing that Miller four years later would find they needed a longer follow-up time) and their less than perfect surveillance system and the UK decided to try to get Jeryl Lynn based on what they learned from the Canadian’s, that the decision was actually made prior to the data obtained from their surveillance systems. The UK surveillance data did not change the decision to switch to the Jeryl Lynn; but it did lead to the Urabe completely losing its approval. Newspapers go by the motto: “if it bleeds it leads”, that is, they exaggerate. Typical of an antivaccinationist that you cherry pick articles where you can find them, regardless of their validity and the article only refers to one of the UK surveillance systems.

You write: “Consider this. Had the system not been so flawed and the “scale” of the Urabe problem picked up on earlier, that “valid decision” you speak of, would have been made much earlier. How could it have been made earlier than when they learned about the Canadian report? If not for the Canadian report, the UK would have begun using the Urabe and then waited until reports came in from their surveillance systems. Even if they caught every single case, it would have delayed the decision to switch to the Jeryl Lynn. It would have delayed their trying to obtain Jeryl Lynn from the very beginning. You are totally illogical.

You write: “When the issue is one of adverse reactions following administration of a medicinal product, I put it to you that it DOES “really matter” that (a) problems are detected (b) the scale of the problem is accurately (as far as possible) recorded and (c) immediately acted upon as necessary.”

First, as I wrote above, they did early on decide to try to obtain Jeryl Lynn. The problem was detected. In the US, our Vaccine Adverse Events Reporting system received reports of intussusception associated with the rotavirus vaccine. Only a very few; but immediately an investigation began. Investigators went out to the various hospitals to double check the actual records. They didn’t need to get every case to act. The problem was detected. As for the scale of the problem, again, once they realized that the Urabe was associated with aseptic meningitis, they did act, they began trying to obtain Jeryl Lynn; but as I’ve written umpteen times, aseptic meningitis is a benign condition, the risk of it from the natural disease is much higher, and the natural disease causes several other more serious problems, so, they had the choice of halting vaccinations until they could get enough Jeryl Lynn (and as I cited in a previous comment, there were production problems with the Jeryl Lynn), or risk a benign condition from the vaccine or the greater risks from the natural disease. Even if you doubled the number of cases captured of aseptic meningitis associated with the Urabe it would still have been better to use it than the natural disease. And they still would have needed to get the Jeryl Lynn. And the system wasn’t “so flawed”, it captured enough to make a decision and that is all one can expect. We do have better systems; but they developed based on what we learned from earlier ones and even they do NOT capture everything.

The UK system was NOT inadequate as it obtained the data needed to make a valid decision. You can cite all the studies you can find that they didn’t capture all the cases; but it doesn’t matter. Decisions aren’t based on perfect or complete data, except in the minds of antivaccinationists.

So, in 1988 when the UK had already contracted for the Urabe vaccine and it was in production, based on what they learned from Canada, they decided to switch. If their surveillance systems had captured every single case it would have made NO difference. You fail to understand this. You fail to understand that using several systems the UK data was considered the best available at the time and was used by many other countries.

It is really a shame that you hadn’t contacted the UK Vaccine Committees in 1987. I’m sure your immense knowledge, including of future developments, would have been welcome. You really are STUPID ON STEROIDS.

If one used your approach, we would have very little modern medicine because early approaches would NOT have proceeded because years in the future there would have been better treatments and better data.

As I wrote, you are obsessed with the Urabe. In your obsession you twist and distort events. And you NEVER once state that, despite what happened in the past, the current MMR vaccine has a good safety profile and you recommend it.

It is a tragedy that your daughter may have lost hearing in one ear from the Urabe vaccine. I say may have because what you have said is that the decision was that it was “likely” not certain; but people die from the common cold. You are so bitter at what happened to your daughter that your are obsessed.

When I wrote that the WHO continued to use the Urabe, you needed to point out that they discontinued it in 2015, which means they used it on millions of children with an excellent benefits/risk ratio for over a decade after Canada and the UK stopped its use. I’m sure that sometime in the future they will replace the Jeryl Lynn with a better vaccine, so I guess at that time you will point it out as if it was wrong to have used it all the years prior.

You are a disturbed individual and what you write, since it implies incompetence and dishonesty by those who decide vaccine policy, could influence parents to not vaccinate their children today. Nowhere do you clarify that vaccine surveillance and vaccines have improved. You are both tiresome and keep making a fool of yourself.

And, once again, you fail to respond to two questions I have posed umpteen times:

Do you recommend that parents vaccinate their children with the MMR vaccine currently being used in the UK?
Are you going to send me the documents related to your daughter’s case?

Are you totally incapable of giving two simple answers to two simple questions? Given how you twist things and what I and others have written, I wonder what the documents regarding your daughter’s case actually say? What are you hiding?

Another zombie antivaccine study rises from the grave

oracknows — Fri, 24 Feb 2017 06:00:59 +0000

Another zombie antivaccine study rises from the grave

There are a thousand crappy studies out there carried out with the explicit (although often unspoken) goal of demonizing vaccines by "proving" that they cause autism. Indeed, over the last 12+ years that I've been blogging here, I've deconstructed more such studies than I can remember—or would care to remember if I could. Unfortunately, if there's one thing I've learned about some of these studies, it's that they're like the killers in 1980s slasher flicks. You remember them? Killing machines like Jason Voorhees or Michael Myers, who mowed through teens misbehaving (often by having sex) for the whole movie, only to be killed at the end of the movie. Wait. Strike that. Instead say: to appear to be killed at the end of the movie. As any horror flick fan knows, the killer (or monster, come to think of it) might appear to be dead at the end of the movie, but they always, always, always come back in the sequel to kill again, at least if there's money to be made. Antivaccine pseudoscience is a lot like that. Whenever a truly awful study that should never have been accepted in the first place for publication in a peer-reviewed journal is retracted, you can be sure that it won't be too long before it is magically resurrected and rears its ugly head again in some form or another, to be wielded not just as a weapon to frighten parents with but as a bogus example of how the peer-reviewed medical literature "suppresses" science that doesn't support vaccines, to be used to feed the conspiracy theories behind the antivaccine movement. Same as it ever was.

So it was with some amusement that I saw not just one, but two posts over at that now demoted lesser wretched hive of scum and quackery, Age of Autism, touting a "suppressed study." (Natural News is now the Big Kahuna when it comes to being the One True Wretched Hive of Scum and Quackery. Besides, compared to NN, AoA is truly a piker.) First, there's Kevin Barry, author of the definitive "CDC whistleblower" conspiracy theory magnum opus, dropping a turd entitled First Peer-Reviewed Study of Vaccinated versus Unvaccinated Children (Censored by an International Scientific Journal) Now Public. Not to be outdone, Mark Blaxill (remember Mark Blaxill?) laid down an equally stinky bit of brown entitled Stunner in First-ever “vax/unvax” study: Vaxxed Kids Have 4.7 Fold Higher Risk of Autism. Elsewhere, there's a post referenced by Barry by James Grundvig entitled Censored Study of Vaccinated vs. Unvaccinated sees Daylight. You can see right away elements that antivaxers love, in particular a "study" (if you can call it that) that purports to validate their belief that vaccines cause autism, neurologic damage, and autoimmune diseases—human sacrifice, dogs and cats living together, mass hysteria. Then, of course, there has to be a coverup. In the case of the "CDC whistleblower" conspiracy theory it's supposedly the CDC covering up slam-dunk evidence that vaccines cause autism. Here, it's, well, someone covering up the results of this "vaxed versus unvaxed study."

Let's see what's got the antivaxers so excited. First, Mark Blaxill:

In a development that autism parents have long anticipated, the first-ever, peer-reviewed study comparing total health outcomes in vaccinated and unvaccinated children was released on line yesterday. According to sources close to the project, the study had been reviewed and accepted by two different journals, both of which pulled back on their approval once the political implications of the findings became clear. That’s largely because, as parents have long expected, the rate of autism is significantly higher in the vaccinated group, a finding that could shake vaccine safety claims just as the first president who has ever stated a belief in a link between vaccines and autism has taken office.

Well, no. Not exactly, as you will soon see. But what about Barry:

Today, a groundbreaking new study of the overall health of vaccinated and unvaccinated children has been released to the public for the first time. The critically important new pilot study has been posted on line.

The paper was leaked to journalist and author James Grundvig, who published an article describing aspects of the study on Medium on February 22, 2017. Grundvig describes how the paper was leaked to him (and others?), and he describes how he authenticated it with the study’s author and with the journal which censored it.

Oooh. The story was leaked! Let's see what Grundvig claims:

After 30 years of the government immunizing the vaccine makers from harm, the long-delayed, first-of-its-kind study on “vaccinated versus unvaccinated” children has arrived. From five years of designing and conducting the epidemiology survey to more than one censorship roadblock from scientific journals to thwart the study’s findings — a damning indictment against vaccines being a false flag cure-all — it appeared in the public domain.

For six hours on Valentine’s Day, the 34-page study breached daylight for six hours before the url link vanished. Leaked from a source, giving the release the half-life of a firefly, afforded enough time to download the document and share with the study’s author, who confirmed its authenticity.

Vaccination and Health Outcomes: A Survey of 6- to 12-year-old Vaccinated and Unvaccinated Children based on Mothers’ Reports, by Anthony R. Mawson, et al., reads like dozens of Centers for Disease Control (CDC) population-based studies that found “no association” between vaccines and autism. Except this came out of Dr. Mawson’s School of Public Health Initiative at Jackson State University, Jackson, Mississippi, co-financed by non-profit organizations in Generation Rescue, Inc., and the Children’s Medical Safety Research Institute, with not a single government dime spent.

Wait, what? This study was funded by antivaxers? After all, Generation Rescue was founded by J.B. Handley to promote the idea that mercury in vaccines causes autism, and later Jenny McCarthy herself became its president. Children’s Medical Safety Research Institute is about as antivaccine as it gets. Indeed, I just mentioned the CMSRI three weeks ago, when it was promoting a study that claimed to show that vaccines were hopelessly "dirty" and "contaminated" but in reality showed nothing of the sort. Just peruse the CMSRI website. Look at its Scientific Advisory Board, which is packed to the gills with "luminaries" of antivaccine pseudoscience, such as Chris Shaw, Yehuda Shoenfeld, Stephanie Seneff, and more. Antivaxers might scream "Unfair!" at my harping on the funding source, but they do exactly the same thing—and actually, to some extent, rightly so—when examining pharmaceutical company-funded studies showing vaccine safety. Unfortunately, they appear not to apply the same standard to studies they like.

Be that as it may, this study sounded very, very familiar to me. So I typed "Mawson" into the search box of the ol' blog, and, sure enough, it wasn't long before I found an old post entitled Antivaccinationists promote a bogus internet “survey.” Hilarity ensues as it’s retracted. It was the study that Barry promoted near the end of his book Vaccine Whistleblower: Autism Exposing Research Fraud at the CDC and that CMSRI promoted. Remember, CMSRI is Claire Dwoskin's antivaccine group, and the Dwoskins are known for spreading their wealth around to antivaccine causes. The article was also only ever posted in abstract form on Frontiers in Public Health and then removed, as explained in a Tweet (geez, is everything explained in a Tweet?) not long after in response to a question about why there was no full text of the study available:

This article was provisionally accepted but not published. In response to concerns raised, we have reopened its review. @70Hertz

— Frontiers (@FrontiersIn) November 28, 2016

Grundvig wrote the editors:

The paper, however, wasn’t retracted; it was “unaccepted,” according to Mawson via email. That means Frontiers didn’t retract it, since it was never officially published. What’s left for a study after its accepted, reviewed 80,000 times in less than 100 hours? . . . Censorship.

Beyond that clarification, Mawson wrote: “I am not allowed to comment on the paper/work by my Dean.”

Melissa Cochrane, the communications manager for Frontiers Journal, which is headquartered in Lausanne, Switzerland, replied via email:

“As we have previously noted, this article was provisionally accepted but not published. In response to concerns raised regarding the abstract and the provisional PDF — which were made provisionally available online — Frontiers then reopened its review. Following further manuscript assessment by the Field Chief Editor of Frontiers in Public Health, in consultation with an external expert, the manuscript was subsequently rejected, not retracted as retraction can only occur once a paper has been officially published and indexed.

“The rejection was due to severe limitations in the validity of the results.”

First, I find it rather unlikely that Mawson's dean told him not to comment on the paper. This is the sort of thing that would very much go against academic culture. Second, Frontiers journals tend to be very poor quality, with highly dubious peer review. That's been my experience and the experience of quite a few academics with whom I've corresponded. No doubt the same thing happened with Mawson's paper, given that it was reviewed by a chiropractor and Indian psychiatrists who appeared to have none of the expertise necessary to review such a paper. That's why it actually surprised me that the editors "unaccepted" the paper, no matter how bad it was. (And, as I recounted, it was very, very bad indeed.)

And now it's back, just like Jason or Michael Myers killing his first teen at the beginning of a sequel to the last movie, where he appeared to be almost certainly dead. So what, if anything, has changed in the new version of the study? It's really damned hard to say. Again, like last time, there appears to be nothing more than the abstract, which is apparently what Barry and Blaxill mean by the "leaked" study, but unlike last time there are a few bullet points supplied by Blaxill It still reports data from 415 mothers providing data on 666 children in an anonymous survey of home-schooled children (which, of course, is already an unrepresentative source). In any case, here's what Blaxill claims that Mawson found:

Vaccinated children were significantly less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but significantly more likely to have been diagnosed with other infections, allergies and NDDs (defined as Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, and/or a learning disability).

At least mMawson found that the pertussis and chickenpox vaccines work. I suppose that's something. And, here is what he refers to as the chronic illness detail:

Vaccinated children were significantly more likely than the unvaccinated to have been diagnosed with the following chronic illnesses:

7-fold higher odds of any neurodevelopmental disorder (i.e., learning disability, ADHD, or ASD)

2-fold increase in Autism Spectrum Disorder (“ASD”)

2-fold increase in ADHD

2-fold increase in learning disabilities

1-fold increase in allergic rhinitis

9-fold increase in other allergies

9-fold increase in eczema/atopic dermatitis

4-fold increase in any chronic  illness

No significant differences were observed with regard to cancer, chronic fatigue, conduct disorder, Crohn’s disease, depression, Types 1 or 2 diabetes, encephalopathy, epilepsy, hearing loss, high blood pressure, inflammatory bowel disease, juvenile rheumatoid arthritis, obesity, seizures, and Tourette’s syndrome. However, larger samples would be needed to detect group differences in these less common conditions.

And acute illnesses:

Vaccinated children were significantly less likely than unvaccinated children to have had chickenpox or whooping cough (p<0.001).

Vaccinated children had a 3.8-fold increased odds of middle ear infections and a 5.9-fold increased odds of being diagnosed with pneumonia compared to unvaccinated children.

No significant differences were seen between the two groups with regard to Hepatitis A or B, high fever in the past 6 months, measles, mumps, meningitis (viral or bacterial), influenza, or rotavirus.

And finally:

In regression analyses, vaccination was associated with a significant 3.1-fold increased odds of neurodevelopmental disorders (combining the diagnoses of ASD, ADHD, and learning disability), after controlling for other factors. An important detail emerged regarding a possible synergism between vaccination and preterm birth. In a final adjusted statistical model, vaccination but not preterm birth remained associated with NDD, as defined, while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% Confidence Interval: 2.8, 15.5).

Not surprisingly, an antivaxer ate it up:

"I am delighted to see a properly analyzed study on vaccine safety" said Dr. Lyons-Weiler, CEO and President of the Institute for Pure and Applied Knowledge. “Unlike past studies, which ignored the interaction term, Dr. Mawson and colleagues followed appropriate steps toward interpreting the significance of the interaction between variables. The study reported a significant interaction effect between pre-term birth, and vaccination as a 6.6-fold increase in the risk of neurodevelopmental disorders.”

“This study, however, as a survey study, is potentially subject to variation due to responses from well-intended participants. The next logical step would be additional, larger studies that would try to replicate the results using electronic medical health records - by independent investigators not involved in profiting from vaccines”, said Dr. Lyons-Weiler.

Um, no. This report by Blaxill gives us a bit more detail than the previous abstract, but not much more. As far as I've been able to tell, the actual paper has not yet been published anywhere in the peer-reviewed literature. In fact, if the paper had truly been accepted for publication, "leaking" it and letting antivaxers publish its abstract plus other findings would very make most reputable journals quite cross (as my British friends would say) and might even endanger the publication of the paper. Be that as it may, we still don't have what we need to critically evaluate this study the way it needs to be evaluated. Even so, from what I can see now, nothing has changed in regards to what a piece of crap this survey is. Again, this survey questioned 415 mothers of 666 children educated at home. Not only is that not a representative sample, given that all the children are home-schooled, it’s not even a very big sample. Remember when I discussed the statistical issues in doing even an epidemiological “vaxed versus unvaxed” study? To find any statistically significant, much less clinically significant differences in health outcomes between vaccinated and unvaccinated children would require huge numbers, and who knows if Mawson controlled for confounders properly. I tend to doubt it, and there were probably a lot of confounding factors to deal with.

As I've related before, parents who choose to home school are not like your average parents. There are likely to be a lot of confounding factors that go along with home schooling, including the association between home schooling and antivaccine views. This association showed up in this very survey in its originally (briefly) published form in that it reports that 39% of the children in the survey were completely unvaccinated. This is not representative of the general population, by any stretch of the imagination, where in general the number of totally unvaccinated children number in the low single digits. Add to that the likelihood of selective memory and reporting, and the likelihood of this survey providing useful information is vanishingly small. Of course, surveys are not the best means of gathering health data. Yes, I know. The NIH does surveys. I’ve even discussed one of them, specifically in relationship to how much “complementary and alternative medicine” (CAM) people use. However, while such surveys can be useful for assessing the sorts of treatments people partake in, they’re not quite as useful for assessing whether there are correlations between health practices (e.g., vaccination) and health outcomes (e.g., autism and ADHD).

It is, of course, a myth that no studies have compared the health of vaccinated versus unvaccinated children. There have been several, and all of the ones not done by antivaxers have found either no difference in chronic disease or better health outcomes in the vaccinated population. Yet, antivaxers believe beyond faith and evidence that a "vaxed/unvaxed" study will validate their belief in the evils of vaccines, which is why the latch on to lousy studies like Mawson's It's also why his crappy anonymous survey of an unrepresentative population of children that was so bad that a Frontiers journal actually "unaccepted" it has risen from the grave again to be sold as having been "suppressed" and now "leaked" to the antivaccine faithful as slam-dunk evidence that mandates a much bigger "vaxed versus unvaxed" study.

Same as it ever was.

oracknows Fri, 02/24/2017 - 01:00

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autism

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https://www.youtube.com/watch?v=QvIDlkuEstM

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I'd be curious on things like the timing of the decision to homeschool. Some parents of special-needs kids chose to homeschool if they feel their local public school special ed program just isn't' addressing their child's needs. Those kids are likely to have been vaccinated. However, parents who both unvaccinate and homeschool are likely to have made those choices in their child's infancy, so their kids would not have been exposed to the kind of screening kids in public school get, making them less likely to be diagnosed with certain conditions, regardless of if they have it or not.

As I was just wondering - it is certainly possible that some of these parents decided to homeschool their children _because of_ their NDDs. Which would make the sample even more unrepresentative.

The survey for this "study" can be viewed here. The abstract for the study presents their "research" as being completely based on this survey, which is completely unacceptable for obtaining a vaccination history. As a pediatrician, I've caught parents forging vaccine cards and you can find online discussions from AVers on how to forge them, so why should we expect all survey respondents here to be truthful about their child's vaccine history (not to mention people with ulterior motives simply doing the survey to spike the results towards their belief that vaccines cause every disease known to man).

I also view these "studies" as turds that are such big POS's that they never quite flush, always floating back to the surface even stinkier than the last time we had to endure them. There are, however, with the exception of Bill Murry in Caddyshack, very few movies from which to draw a good Hollywood comparison.

I find it rather unlikely that Mawson’s dean told him not to comment on the paper.

I agree. I see two possible explanations for this statement, neither of which reflect well on Mawson:
1. Mawson is lying about having been told not to discuss the paper.
2. Mawson was indeed told not to discuss the paper, but by his lawyer, not his dean.
The trouble with explanation 2, and the thing that makes it look bad for Mawson, is that AFAICT there is no obvious reason for Mawson to have lawyered up here.

Orac writes,

Unfortunately, if there’s one thing I’ve learned about some of these studies, it’s that they’re like the killers in 1980s slasher flicks.

MJD writes,

If there's one thing I've learned about medical science, it's like the movie "Miracle (2004)" wherein the legendary hockey coach Herb Brooks says, "The legs feed the wolf".

Persistence and hard work does eventually affect the outcome.

A number of these health concerns are based on 'diagnoses'. It seems like anti-vax, homeschooling parents would be less likely to bring their child to an actual doctor anyway.

Two more points:
A. Re measles, chicken pox etc': I would really want a medical diagnosis there. Online experience suggests anti vaccine families self diagnose measles, which makes those diagnoses, for me, well, questionable. Having enough measles in such a small sample to make comparisons, given its low rate in the state, is suspect.

B. Barry is a lawyer. He should know better than to use the term censored for a journal's decision not to publish a study. You're not owed acceptance by an academic journal.

Dr. Lyons-Weiler, CEO and President of the Institute for Pure and Applied Knowledge.

Sounds legit!

Vaccination and Health Outcomes: A Survey of 6- to 12-year-old Vaccinated and Unvaccinated Children based on Mothers’ Reports

So the "study" wasn't a study but a survey based on subjective reporting.
What a load of old cobblers.

Still unable to figure out blockquoting, a latex-obsessed dingbat writes:

MJD writes,

If there’s one thing I’ve learned about medical science,

That's an awfully huge "if".

The paper was leaked to journalist and author James Grundvig, who published an article describing aspects of the study on Medium on February 22, 2017. Grundvig describes how the paper was leaked to him (and others?)

OFFS. The "leaked paper" has remained available since November last year.

I find it rather unlikely that Mawson’s dean told him not to comment on the paper.

Remember that his previous university had sacked him, so he may receive special scrutiny.

Children’s Medical Safety Research Institute is Claire Dwoskin. She is the wealthy person who put on the Jamaica junket years back where people like Andrew Wakefield were wines and dined in style in return for giving lectures.

Her email address was something like novaccine4me@.... which gives you an idea

She funds junk research by a whole raft of luminaries in the junk science field.

If memory serves she is a past board member of NVIC.

"Dr. Lyons-Weiler, CEO and President of the Institute for Pure and Applied Knowledge."

An organization (basically him) which constantly has its hand out. Basically "will shill bad science for dimes".

At least Wakefield was able to get hundreds of thousands of dollars for selling his name and reputation.

@Antaeus Feldspar (#10),

You really should take the us out of Antaeus.

@ Orac,

I've never seen any of the movies you describe in this post. Did you enjoy those movies? If the answer is yes you're definitely Sid in the Disney movie "Toy Story".

I wonder if parents of completely unvaccinated kids would ever admit their kid had autism, even if diagnosed by a doctor. "My son can't be autistic, he's never had vaccines, GMOs, OR gluten!" I guess just another reason doing this entirely by survey is a terrible idea.

Even if we were to assume that the parental reporting was totally accurate (and you even assume that in any study ever), there are more confounders than results!

To expand upon Terrie and Alia's comments: if the oldest child in a family is vaccinated, goes to school, then is diagnosed with some form of autism and the parents pull that child out of school for home schooling, and then never vaccinate younger siblings or put them into regular school, well, that can account for a lot of the findings.
Older, vaccinated child was around other kids (therefore more likely to pick up illnesses including ear infections).
Now that none of the kids go to school they all have much less contact with other kids, so they are less likely to catch *any* illness, be it an ear infection or a VPD.

At the very least I would want to know about birth order relative to vaccinations, ASD diagnosis, and entry into home school (did the child ever attend public or private school, including pre-school?)

My infectious disease and survey professors would have a field day with this study, but probably wouldn't use it in class because we'd get off-topic.

Bob @14: Right! That was going to be another thing I would want to see: who diagnosed these kids? And not just with autism, but all the other things as well.

And as for learning disorders, well, teaching is hard, and it takes a lot of learning and training and if the parent's teaching style doesn't mesh with the child's learning style, I could see assuming learning disorders as well.

I find it rather unlikely that Mawson’s dean told him not to comment on the paper.

Mawson is a Visiting Professor at JSU. There is every possibility that the Dean has had a quiet word to him about what is acceptable behaviour in a Visiting Professor.

First, I'm happy to see several others pointing out the possible or even expected confounding. There are many.

"To find any statistically significant, much less clinically significant differences in health outcomes between vaccinated and unvaccinated children would require huge numbers" is not right. It depends. It depends on the size of the effect, and the frequency of the outcome of interest! In the old post linked to was a power calculation based on a 10% change in an uncommon outcome, and there it's true you'd need a big study. But if it's more common, like allergies, and it's a 9-fold change, you don't need very big samples at all. There are online power calculators for tests of two proportions - try them out sometime.
And follow this rule: never complain about sample sizes when the other guy got a small p-value, cause it makes no sense.

Speaking of studies, I wonder how much play this study will receive at AoA, TMR, etc.?

http://www.sciencemag.org/news/2017/02/herpes-virus-may-be-trigger-auti…

CNN is running a story slightly more critical of the herpes/autism link

http://www.cnn.com/2017/02/22/health/autism-herpes-pregnancy-study/inde…

However, three experts who were not involved in the new research say it does not provide enough scientific evidence for worry.
"Unfortunately, the analysis conducted in this study has significant flaws, and in fact, the data does not support the claims made by the authors," said Mathew Pletcher, vice president and head of genomic discovery at Autism Speaks.
According to Dr. David Winston Kimberlin, a professor of pediatric infectious diseases at the University of Alabama at Birmingham, "pregnant women should not be worried about HSV-2 (genital herpes) as a cause of autism based upon the findings of this single exploratory research study."
Amalia S. Magaret, a research professor in the department of laboratory medicine at University of Washington, also said the conclusions "are subject to concern."

Still, it might be enough to put the AoA loons into a tizzy.

And follow this rule: never complain about sample sizes when the other guy got a small p-value, cause it makes no sense.

It does rather depend on how they got there. Witness Brian Hooker.

@ Herr Doktor Bimler #11: "The “leaked paper” has remained available since November last year."

The paper you linked was only the abstract, mysteriously published on the Frontiers website, and then even more curiously removed a week later. The entire paper (all 34 pages of it) can be found here:

https://www.yumpu.com/en/document/view/57028136/provisional/6

Hi Orac,

Love the name. You might to look at this https://www.youtube.com/watch?v=eQT5RNVf4GM

ORD says MJD says MJD says:
"Persistence and hard work does eventually affect the outcome."
Of course persistence and hard work can equally be put to the service of wishful thinking and mediocrity. Since we seem to be invoking movies here, Ed Wood is a standout example. If you need more proof, just read over your posts.

Dorit at #7 -- "Re measles, chicken pox etc’: I would really want a medical diagnosis there. Online experience suggests anti vaccine families self diagnose measles, which makes those diagnoses, for me, well, questionable. Having enough measles in such a small sample to make comparisons, given its low rate in the state, is suspect"

It is suspect. There are several harmless exanthems mistaken for the disease, as well as underestimating the possibility of meningitis, which can be disastrous.

According to a story in The Guardian [http://tinyurl.com/j3dw3tk] Trump's rhetoric, and the whole 'altenative facts' thing may actually be a triumph of science – specifically computer science in AI and data analytics. It's a disturbing read. Check it out.

Old Rockin' Dave says (#25),

If you need more proof, just read over your posts.

MJD say,

I've made 11% of the responses (i.e., 3 of 27) at this point with one video up-link.

That's pretty damn good for a science blog that gets ~ 20,000 hits per day.

Looking over the comments regarding the article in question, I also have concerns as many of you expressed above and, quite frankly, surveys are more of a subjective investigation. That said, they do serve as a signal for review and concern. The fact that there are arguments, legitimate, on both sides of the fence demonstrates the need for objective, unbiased analysis. I do see the legitimate concerns of funding, whether it be from a pharmaceutical organization or from any special interest group.
As for IPAK, the assumption that we are driven solely by anti-vaccination groups would be incorrect. Our research areas Including publications, presentations, and contributions (RR, JLW, TF, GMS) over the past 2 years have included the following. It should be quite evident from this list that our research interests go towards the best interest of global public health in many areas.
1. The Glycoprotein Mucin-Like Domain (MLD) in the Zaire ebolavirus (EBOV) may be responsible for the manifestations of Post-Ebola Virus Disease Syndrome (PEVDS) (RR, LR)
2. Predictive SVM Model of a Novel miRNA in the Zaire Ebolavirus (RR)
3. Areas of Research and Preliminary Evidence on Microcephaly, Guillain-Barré Syndrome and Zika Virus Infection in the Western Hemisphere (JLW,GMS,RR,TF)
4. Teratogenicity of the Zika Virus: Sequence Homology with Rubella Capsid Domain p53 Apoptosis Pathway (RR,JLW)
5. Multiple Apoptotic/Necrotic Pathways may be Involved in Zika Virus Neurotropic Brain Injury (RR,JLW)
6. Zika Action Plan (submitted to OSDH) (RR)
7. The Zika Virus sfRNA Secondary Structure Reveals a miR-147a Homologue that Targets Neurofascin as a Potential Cause of its Neurologic Syndromes (RR,JLW)
8. Zika Virus Induced Neurotrophic Brain Injury: Lessons for the Study of Disease Etiology and Vaccine Development Against Pathogens (RR, JLW)
9. Atmospheric Oxygen and the Evolution of Glutathione: Perspective and Relevance to HBOT in Neurologic Healing (TF, RR)
10. Diagnostic Strategies in Schistosomiasis (RR)
11. Review of Diagnostic Methods for Soil Transmitted Helminthiasis (RR)
12. India Mission Report: Leishmania Filariasis in Telengana State and Delhi, India (RR)
13. Narcolepsy and Influenza A H1N1 pdm2009 (RR,JLW)
14. B and T-Cell epitope Screening: Human Papillomavirus(JLW,RR)
15. B and T-Cell epitope Screening: Rotavirus (JLW, RR)
16. B and T-Cell epitope Screening: Hepatitis B virus ((JLW, RR)
17. Autoimmune Cytopathogenesis of Influenza A Nucleoprotein (RR)
18. Mumps Outbreak in the Marshallese Population: Implications for Genetic Testing (RR)
19. RNA Binding Domain in Influenza A Nucleoprotein as a Novel Mechanism of Translational Repression (RR)
20. Shared ICAM-1 Receptor between Human Rhinovirus and Ebolavirus May Allow for Droplet Transmission (RR)
21. Molecular Modeling of the Influenza A Nucleoprotein (RR,JLW)
22. Reconsideration of the Immunotherapeutic Pediatric Safe Dose Levels of Aluminum (JLW,RR)
23. Emergence of Filoviridae in the New World (RR)
24. Oncogenic potential and molecular mechanism of integration of Human Papillomavirus

Feel free to contact me regarding our research activities at IPAK.

Let's see. Here's a page from the IPAK website:

http://ipaknowledge.org/CDC-Accountability-Project.php

Quote:

For the past ten months, IPAK scientists have been working with a legal team to work out the basis of a complaint against the CDC for their handling of vaccine safety science. The public is invited to participate as co-plaintiffs by joining the CDC Accountability Project. Our approach is based on legal theory researched by Prof. Mary Holland, who recently told the world about the threats to informed consent during her presentation at the United Nations.

We will reveal the legal theory behind our complaint, and the likely suit, when we file the complaint. All donors will receive a copy of the complaint via email.The relief we seek is to have CDC stop misinforming the public on the state of science linking vaccines and autism.

Join the CDC Accountability Project below, and share on Facebook and Twitter. Help make autism history.

Sure sounds antivaccine to me. As does this "HPV Informed Consent Flyer," which peddles antivaccine bullshit with other "questions":

http://ipaknowledge.org/IPAK-INFORMED-CONSENT-FLYER.php

As does having Mary Holland on your advisory board:

http://ipaknowledge.org/Main.php

And having Dr. Bob Sears, Yehuda Schoenfeld, Toni Bark, and Paul Thomas as speakers at your meeting:

http://ipaknowledge.org/ipak-focus-2017.php

That alleged informed consent form is extraordinarily misleading and clearly designed to scare parents from vaccinating.

An organization that created it cannot sincerely call itself anything but anti vaccine.

Nor is Ms. Holland the only anti-vaccine activist on the board - Josh Mazer and Anne Nans, at the least, also qualify.

"Institute of Pure and Applied Knowledge" still sounds to me like one of those parasite-publisher dumpsters, along the lines of "Global Journal of Advanced Research" or "International Journal of Innovative Studies". Or something that an evil Mad Scientist might call his under-a-volcano laboratory, after titling himself "Master of All Scientific Knowledge".

All of you commenting here are closed minded, narsisistic, fools. You must all be in Big Pharma's back pocket. It is so obvious in your responses to this study. Anti vaxers used to be pro vaxers until they or their children were injured. Do any of you have a child that has Autism spectrum disorders, cancer, cognitive impaired, allergies, eczema, etc., or have a child that died? Did you vaccinate your children or yourselves? For supposed educated people, if I were your mother, I would be utterly ashamed at the way you have attacked a group of people because they do not follow your thinking on this study.

Sigh, it is the old boring stale fact free Pharma Shill Gambit.

Come back later when you have PubMed indexed studies by reputable qualified researchers that any vaccine on the present American pediatric schedule causes more harm than the disease, and any of the stuff you listed.

if I were your mother, I would be utterly ashamed at the way you have attacked a group of people because they do not follow your thinking on this study.

My mother was a public health nurse. She would despise you.

It seems to have become an article of faith in the AoA readership that Mawson's paper was suppressed, retracted, CENSORED because of an orchestrated and well-funded campaign to put pressure on Frontiers.

In the real world, it only took Leonid Schneider pointing and laughing (someone tipped him off) and the publishers realised within hours that their systems had screwed up bigly.

You must all be in Big Pharma’s back pocket. It is so obvious in your responses to this study

What an interesting combination of arrogance and paranoia -- you are convinced anyone with a different opinion must be part of a worldwide paid conspiracy.

You must all be in Big Pharma’s back pocket.

In fact Big-Pharma is a species of kangaroo, and we are actually in its front pocket. The view is a lot better from there.

In this trial (see below) unvaccinated children performed worse compared to vaccinated.
And today we have more potent vaccines.

And children have the right for vaccination, according to art.24 Childrens Rights Convention.

One form of child abuse is child neglect, and can present clinically in different forms. One ist: poor attendance for immunisations and school. (Source: Illustrated Textbook of Paediatrics page 79 ; Tom Lissauer , Grahay Clayden (eds) 2002 . ISBN 0723432430

and here is the paper - a small study, but comparing vaccinated versus unvaccinated children over 5 yrs.

Trop Geogr Med. 1990 Apr;42(2):182-4.
Vaccinated versus unvaccinated children: how they fare in first five years of life.
Epoke J1, Eko F, Mboto CI.
Author information
Abstract

Twenty five children who had undergone their full course of childhood immunization schedule were compared with 25 children who did not have any vaccinations for a period of five years. Parameters for comparison were measles, pertussis, poliomyelitis, tetanus and tuberculosis. Out of the 25 vaccinated children, only one child had mild measles at 2 1/2 years while 4 had suspected whooping cough at different points of the study period but not clinically diagnosed as pertussis. Among the unvaccinated group, 2 died of measles before the age of 3 years while 11 others went down with measles during an outbreak in 1986. An unvaccinated child also died of tetanus within the study period. In this paper we advocate the total integration of every community in the ongoing Expanded Programme for Immunization in Nigeria.

Wolfgang:

Sadly, I believe the US never ratified the Convention on the Rights of the Child. The sticking point IIRC was the concept of being able to try juvenile offenders in adult criminal courts (which makes children in the US potentially eligible for the death penalty and life imprisonment). We are the only nation to have signed but not ratified it.

Because of this, the US is the only member of the United Nations which is not bound by the Convention. This is deeply ironic, considering that the US was one of the most ardent proponents of the Convention when it was being drafted, and one of the first signatories -- but it has never been submitted to the US Congress for ratification.

Every time I read anything by Mr Orac I become more convinced that he must get paid by the word. Good grief, so many words...yet in the end you have only two real actual criticisms of this study, which come at the very end of your Op/Ed:
1) The children in this study were all home-schooled so this is not a truly representative sample
2) There were too few children in this study

Perhaps you missed the word "Pilot" in the title of this study? You know what means right?

Regarding your concerns, I would absolutely agree with you that the fact that all children in this study are homeschooled makes this study difficult to generalize to the population as a whole. And yes, absolutely, we need studies like this which involve many many more children. We have been demanding such studies for decades. So glad that you agree with us Orac! So instead of simply dismissing this study, why are you not asking that this be repeated with a larger sample size taken from more typical families?

But tell me, what do you think about the actual findings of this relatively small survey of homeschooled children? Do they concern you at all? Of course you take the authors' findings that vaccinated children have lower rates of chickenpox and whooping cough at face value...because that MUST be true. But all the other results...those must be rubbish.

Only someone with a pre-ordained agenda could exhibit such blatant bias and lack of scientific curiosity.

You should read Orac's article again. That was not the thrust of his argument.

The article in question has never passed peer review. The high imbalance of vaccinated children in the cohort is why it is not representative of the general population. N numbers do matter, but it's the other problems in the article that really matter.

Only someone with a pre-ordained agenda could exhibit such blatant bias and lack of scientific curiosity.

The management of Frontiers didn't think the study was worth publishing. What more need be said?
(OK, Orac did find a lot more to say).

Panacea you should actually learn about what happened with this study before it was posted in a public access Journal. The study did undergo proper peer review...two months of peer review and was then posted provisionally by Frontiers for its onboard science editors. It was only after this peer review that there was backlash from the study which brought it down. The editors worked with an "external expert" and decided to pull it. I would love to know who that "external expert" was. I can guess.

Herr Doktor Bimler...Frontiers provided peer review, the study passed review, and was then posted for its internal online editors, with the plan to officially publish. But there was such a strong reaction from the study, once folks realized that it found that vaccinated children had a much higher risk for autism, that Frontiers was forced to bring it down.

https://healthcareinamerica.us/censored-study-of-vaccinated-vs-unvaccin…

"Frontiers Journal received the study on September 17, 2016. After a two-month peer review process, published it on November 21 for its “68,000 on board editors” from institutions around the world (www.frontiersin.org), with the National Institute of Health (NIH) and Harvard University being the top two providing the science editors.

Over the course of four days, more than 80,000 views of the study found it important enough to read, going “viral” according to one familiar with its release. Then on November 28, the bottom fell out when Frontiers scrapped the publication. In one week, it went from being accepted, published, and then retracted. The abstract can still be found online.

The paper, however, wasn’t retracted; it was “unaccepted,” according to Mawson via email. That means Frontiers didn’t retract it, since it was never officially published."

I missed Orac's link to his other blog entry about this study, but if you leave out the typical ad hominem attacks, smear by association, and requisite jerkiness, the only criticism he makes of this study is the sample size and the fact that the children are all homeschooled. Both would be valid criticisms for studies which claim to draw firm conclusions, however these ring hollow for a study which includes the word "Pilot" in the title, and makes it clear in the discussion that this is only preliminary information which requires more detailed study "with a stronger study design" and larger sample sizes.

This study is a first baby step which the CDC should have taken decades ago. Me thinks Orac doth protest too much.

Herr Doktor Bimler…Frontiers provided peer review, the study passed review, and was then posted for its internal online editors, with the plan to officially publish. But there was such a strong reaction from the study, once folks realized that it found that vaccinated children had a much higher risk for autism, that Frontiers was forced to bring it down.

Nope, nope. The "strong reaction" amounted to scientist / journalist Lionel Schneider pointing and laughing through Twitter after someone tipped him off, and a half-dozen or so of Dr Schneider's readers pointing and laughing as well. If you can document a stronger reaction than that, I would welcome the opportunity to learn. Orac himself declined to get involved at that point, on account of only the Abstract being available, not the entire paper.

Frontiers cannot be forced to do anything. Many people have tried. If higher-echelon editors decided to overrule the two peer reviewers who had passed the paper, it is because it was crap.

In one week, it went from being accepted, published, and then retracted.

Please. The study was never published. Its Abstract went on-line at the Frontiers website, and copies can be found on the Internet Archive and elsewhere. Copies of the complete manuscript from that date are not archived, for the simple reason that it never went on-line. The release of the Abstract is not part of the usual Frontiers protocol, and it is anyone's guess how it occurred.

If you want documentation for this version of the series of events, I am happy to obliged, but first I need to know what level of detail would be enough to convince you that you are mistaken.

The study now appears to have been published, in the Journal of Translational Science. The complete text is here:

http://oatext.com/Pilot-comparative-study-on-the-health-of-vaccinated-a…

Apparently the study did find a publisher: Journal of Translational Science. I couldn't find it on Beall's List but I have no idea as to the quality of that journal.

Washington Post just did an article on the Somali outbreak of measles and an antivaxxer in the comment section is posting a link to Mawson's study every few sections. Fortunately the other commenters (including me) are shooting him down quick.

I just checked the paper's title on PubMed, there were no results. It was not found.

The article is in prepublication, but you can find it online here: http://www.oatext.com/Pilot-comparative-study-on-the-health-of-vaccinat…

I doubt PubMed has had a chance to index it yet.

I guess so, because PubMed does index papers from the Journal of Translational Science. I waiting for that "study" to get the drubbing is so much needs, again.

"Every time I read anything by Mr Orac I become more convinced that he must get paid by the word. Good grief, so many words"

Says the guy with some of the longest posts in this discussion.

I'm reminded of online debates where someone, after having repeatedly posted long diatribes for an extended period, bugs out of the discussion with a haughty comment about all the important stuff he has to do while opponents "must have a lot of time on their hands". :)

Apparently the study did find a publisher: Journal of Translational Science. I couldn’t find it on Beall’s List but I have no idea as to the quality of that journal.

Jeffrey had a lot to say about it:
https://web.archive.org/web/20161227042023/https://scholarlyoa.com/2015…

Run by Navaneeth Reddy and Khalid Mohammad, two alumni from OMICS, operating through Reddy's Hyderabad-based company "Research Wallet":
https://www.zaubacorp.com/company/RESEARCH-WALLET-SERVICES-PRIVATE-LIMI…

The claim to conduct peer review is as mendacious as the claim to be London-based.

A Goofle search for "OAText" + "predatory" tells us all one needs to know about the sinkhole that Mawson chose to throw his money down.

But there was such a strong reaction from the study, once folks realized that it found that vaccinated children had a much higher risk for autism, that Frontiers was forced to bring it down.

Nope, nope. The “strong reaction” amounted to scientist / journalist [Leonid] Schneider pointing and laughing through Twitter after someone tipped him off, and a half-dozen or so of Dr Schneider’s readers pointing and laughing as well.

Actually I exaggerate. Dr Schneider tweeted Frontiers at 4:14 AM, 28 Nov 2016, and they had taken down the Abstract by 7:46 AM, even before his readers joined in the hilarity. So the concerted, coordinated campaign to suppress the paper and its results consisted of a single critical tweet.

Contrary to impressions (and Donald Trump's antivaccine views) most Americans support vaccine mandates

oracknows — Fri, 03 Feb 2017 05:00:01 +0000

Contrary to impressions (and Donald Trump's antivaccine views) most Americans support vaccine mandates

Being as involved as I have been refuting antivaccine pseudoscience as I've been over the last 12 years, I frequently forget that antivaccine views are not the mainstream. It's an easy thing to do. If you were to immerse yourself in the antivaccine echo chamber as much as I do, you too would start to think that enormous swaths of the country, if not an outright majority, think that vaccines cause autism, sudden infant death syndrome, asthma, a wide variety of neurological disorders, and basically every autoimmune disease under the sun. I know that that's not true, but often it doesn't feel that way. In particular, I've been concerned ever since Donald Trump became President, given his long sordid history of antivaccine ramblings, his having met with Andrew Wakefield leading to antivaccinationists thinking that he will be satisfying some of their deepest darkest wishes with respect to the CDC, and his having met with Robert F. Kennedy, Jr. to discuss (if you believe RFK Jr.) a vaccine safety commission or an autism commission (if you believe the Trump administration. When the President of the United States is an antivaxer, you know we could be in for trouble when it comes to public health.

That's why it's good to be periodically reminded that the vast majority of Americans don't support antivaccine views, as I was by an article by Lena Sun in the Washington Post telling us that Trump’s vaccine views are at odds with those of most Americans, study says. Basically, it's a news story about a Pew Research Center survey about the benefits of vaccines and school vaccine mandates. It was a Pew Research survey conducted among a nationally representative sample of 1,549 adults, ages 18 or older from May 10-June 6, 2016 (before the election) whose results are being published now. It's mainly about the MMR (measles-mumps-rubella) vaccine because that's the vaccine that Andrew Wakefield cast doubt upon and is therefore the most famous and commonly mistrusted vaccine.

First things first, though. Before I get to the support for vaccination, the pedant in me can't resist mentioning that this study confirms what I've been saying all along, that support for vaccines is pretty much even on the left and the right, or, as I like to put it, antivax is the quackery that knows no partisan boundaries:

The new Pew Research Center survey finds Republicans (including independents who lean Republican) hold roughly the same views as Democrats (including leaning Democrats) about the benefits and risks of the MMR vaccine, consistent with a 2015 Pew Research Center survey on this topic. Republicans and Democrats (including those who lean to either party) are about equally likely to support a school-based vaccine requirement. However, political conservatives are slightly more likely than either moderates or liberals to say that parents should be able to decide not to have their children vaccinated, though majorities of all ideology groups support requiring the measles, mumps and rubella vaccine for all children in public schools because of the potential health risk to others.

On the other hand, there is a significant difference in how conservatives and liberals perceive school vaccine mandates:

Conservatives (25%) are a bit more likely than either moderates (15%) or liberals (9%) to say that parents should be able to decide not to have their children vaccinated even if that creates health risks for others. At least seven-in-ten of all three ideology groups say that the MMR vaccine should be required for healthy schoolchildren, however. There are no significant differences in views about this issue by political party in this survey.

Even with a margin of error of 4%, I'm hard pressed to look at figures that show 25% of conservatives believe that parents should be able to decide not to vaccinate their children even if that may create health risks for others while only 9% of liberals do to be a "bit more likely." That's almost three times as likely. If these figures are reasonably accurate and generalizable to the population at large, this would definitely explain why otherwise moderate Republicans like Chris Christie would pander to the antivaccine movement during the run-up to the Republican primaries in 2015. It's why antivaccine dog whistles have become more prominent on the right than on the left. Heck, my very own state senator panders to antivaxers.

OK, I've taken this opportunity to indulge my pet peeve and point out yet again that it is a myth that antivaccine quackery is somehow the purview of the left. What else does this study show us? First, most Americans support a school-based vaccine requirement:

An overwhelming majority of Americans (82%) support having a school-based requirement that healthy children be vaccinated for measles, mumps and rubella. Older adults, ages 65 and older, are especially strong in their support for requiring the MMR vaccine.

Seniors, ages 65 and older, support a school-based requirement for the MMR vaccine by a margin of 90% to 8% who say that parents should be able to decide this. Smaller majorities of younger age groups support a school requirement for the MMR vaccine.

That's not to say that there isn't somewhat concerning information in this poll. Take a look at these graphs:

As you can see, the overwhelming majority of adults support school vaccine mandates, but there are disturbing differences in the level of support based on age and whether or not the adults have young children. For example, only 8% of adults 65 and 14% of adults aged 50-64 and older say that parents should be able to decide not to vaccinate their children even if that may create health risks for others, 21% of adults under 50 say this. Even worse, 22% of parents of children age 0-4 years say this, compared to only 15% of parents with no children under 18.

Not surprisingly, adults who have tried alternative medicine are considerably more likely to believe that parents should be able to decide not to vaccinate their children even if that may create health risks:

Surprisingly, though, the absolute numbers are much smaller than I would have expected, with 13% of adults who have never used alternative medicine anbd 12% of adults who take over-the-counter medication right away when sick answering this way compared to 26% of those who have ever used alternative medicine rather than conventional medicine and 33% of those who never take over-the-counter medication when sick, respectively.

There's also an unsurprising result in the survey. While 88% of respondents agreed that the benefits of the MMR vaccine outweigh the risks, which is good, there are definite disparities in this belief based on science knowledge. Basically, those with a high knowledge of science accept that the benefits of the MMR outweigh any risks, while those with low science knowledge are far less likely to accept that the benefits of the MMR outweigh the risks:

On the other hand, contrary to the commonly held stereotype that it is affluent (usually liberal) white people who distrust vaccines the most, the higher the income, the more the trust in the MMR vaccine, with the lowest percentage of people believing that the benefits of the MMR outweigh the risks belonging to the group making less than $30,000 a year. Similarly, in the graph above that looked at how people with young children view the MMR vaccine, you'll see that significantly fewer African-Americans and Hispanics reported that the benefits of the MMR outweigh the risks.

As the Pew Research survey report puts it:

Reports that affluent communities have lower vaccination rates lead some to speculate that people with higher incomes hold more concerns about the safety of the MMR vaccine. The Pew Research Center survey finds, however, that people with higher family incomes tend to rate the risk of side effects from the MMR vaccine as low. Those with higher family incomes are especially strong in their support for a requirement that all children be required to be vaccinated against MMR in order to attend public schools.

I think I might be able to reconcile these two disparate observations, although I admit that my explanation is speculative, albeit speculative based on my 12+ years of observations. It might well be that affluent parents have a greater tendency to accept the benefits of vaccines and support school vaccine mandates. It may well also be that more education correlates with greater support for the MMR> However, there appears to be a subset of these parents who, highly educated and full of the Dunning-Kruger effect, tend to cluster together into communities that self-reinforce antivaccine views. In other words, there is another factor that, when added to high education and high income, promotes antivaccine views. More importantly, for purposes of promoting antivaccine views and persuading others that vaccines are dangerous, these highly educated, largely white, affluent people are much more talented at using social media and their connections to promote antivaccine pseudoscience than, say lower income people and minorities.

Whether my speculations are on the money or way off, there was another finding that was simultaneously reassuring and concerning:

Public perceptions of medical scientists and their research are broadly positive. Some 55% of Americans perceive strong consensus among medical scientists that the measles, mumps and rubella vaccine is safe for healthy children. Nearly half of Americans (47%) say that medical scientists understand very well the risks and benefits of the MMR vaccine, 43% say medical scientists understand this fairly well and just one-in-ten (10%) say medical scientists do not understand this at all or not too well.

In fact, medical scientists understand the risks and benefits of the MMR vaccine very well. Still, it is reassuring that only 10% of adults seriously doubt this. This is also reassuring:

Fully 84% of Americans say they have a great deal (24%) or a fair amount (60%) of confidence in medical scientists to act in the public’s best interests. About eight-in-ten or more report at least a fair amount of confidence in medical scientists to act in the public interest across a range of subgroups including gender, age, parents, race and ethnicity, education, political party and ideology and religion.

It would be a bit nitpicky to hope that more Americans would have a great deal of confidence in medical scientists than a "fair amount," but I'll take what I can get. Overall, this survey suggests that, by and large, Americans trust medical scientists on the MMR, that the vast majority of Americans believe that the MMR's benefits outweigh the risks, and support school vaccine mandates.
There's even another little tidbit in this survey that finds that 74% of adults say conflicting news reports about disease prevention are understandable because “new research is constantly improving our understanding,” while only 23% of adults say such research “cannot really be trusted because so many studies conflict with each other.” That's better than I would have expected.

The bottom line is that antivaxers are a minority. The are cranks. They are, for the most part, marginalized, which is as it should be. Unfortunately, they have an outsized influence on reasonable parents who just don't have the scientific background to recognize their misinformation and pseudoscience for what they are, contributing to vaccine hesitancy. Also, Americans, by and large, trust medical science and MMR vaccine safety. After two weeks in the age of Trump, which followed 12 years of dealing with antivaccine pseudoscience, I find this oddly refreshing. It is a good way to end the week.

oracknows Fri, 02/03/2017 - 00:00

Tags

https://bjforshaw.wordpress.com/2017/02/02/selling-sanctuary-the-poison…

Politics

I would be careful using the terms cranks to refer to parents who don't vaccinate as opposed to those who promote anti-vaccine misinformation (including those active online). Your micro community matters, after all. I can easily see a parent in a community where not vaccinating is a thing being scared enough by friends and neighbors not to vaccinate. A parent can be perfectly reasonable and still be scared by her network and community.

it's still very, very good to have this information. It's important to remember, as you say, that the vast majority of Americans realize the benefits of vaccines.

I wonder whether in four years, Trump would have made a difference to the political distribution.

Oh, look who's back......and being an unoriginal copycat.

Dorit is correct and I'm usually a bit more careful than that (and usually am, as my history shows). So I added a couple of sentences distinguishing antivaccine cranks from the merely vaccine-hesitant.

Also, I'll mention this here as well. Fendlesworth has taken to impersonating regular commenters (like Dorit) now. If the e-mail you use is publicly accessible (e.g., you use a university address to post here), you could potentially be a victim. I think he’s figured out that I’ve gotten pretty good at recognizing him in his first benign-seeming comment that he posts in order to get me to approve them, which then lets him comment without moderation, after which he starts trolling. There have been a lot of attempts over the last couple of days, and I’ve denied them all. What bothers me is that it’s certainly possible that one or more of those attempts might have been someone other than Fendlesworth trying to post. I doubt it, but the longer the increased vigilance goes on, the more likely it is that I’ll inadvertently shut out new commenters who aren’t Fendlesworth socks.

In any case, keep an eye out for posts by regulars that don’t sound like them. Help each other out, in case the person being impersonated doesn’t see the comment impersonating him or her.

Nice article. I think they could have asked the subjects a loaded question, or one that is likely to give positive responses. Do you know what questions were asked specifically?

Looking at the survey, I'm not nearly as hopeful as you are Orac. Twenty-three percent of those surveyed are complete and utter morons who value their misconceptions more then the health of those around them. Saying that there are approximately 250,000,000 adults in the US, that means that around 57,500,000 people are disease vectors in the making. That is almost twice the number of Canadians of all ages. That's far more than the population of your three largest cities, New York city, Los Angeles and Chicago (~13 million total), combined. That is a whole heaping serving of idiocy.
I'm curious if the clumping effect applies to other groups beyond the affluent and educated. I wonder if the next epidemic will jump from cluster to cluster, and lead to people blaming the government because of it being clustered instead of generalized. It must be 5 o'clock somewhere, and now I need a drink.

Orac@5: Thanks for the heads up. I don't always follow threads, especially if they are more than a day old, and my e-mail is publicly accessible.

Once in a while I attempt to parody an alt-med position, but being cognizant of Poe's Law, I usually indicate that I am attempting a parody.

AP@8: The herd immunity thing is cause for concern, but remember that we are dealing with Americans. The canonical number for crazy in the US is 27 percent:

Obama vs. Alan Keyes. Keyes was from out of state, so you can eliminate any established political base; both candidates were black, so you can factor out racism; and Keyes was plainly, obviously, completely crazy. Batshit crazy. Head-trauma crazy. But 27% of the population of Illinois voted for him. They put party identification, personal prejudice, whatever ahead of rational judgement. Hell, even like 5% of Democrats voted for him. That's crazy behaviour. I think you have to assume a 27% Crazification Factor in any population.

So has MJD sunk even lower or is Fuckallworth imperson(?)ating him?

He's being impersonated. I just took care of it. His e-mail address is publicly available. So he's a good target. My bad for not noticing and letting it through.

Well if I start kissing an anti vaxxer's ass, you'll know it's not me ;)

@vinu: if you go to the Pew Center page (Orac linked it in his post) you can get a PDF of the entire report, which includes a copy of the survey questionnaire. The Pew Center is non-partisan and does a pretty good job with their surveys; they're considered fairly reliable as polls go. You're going to have to be pretty convincing if you want to poke holes in the questions.

Good article on how the anti-vaccine cult operates.

These anti-vaccine leaders are luring well-intentioned but naive parents astray by feeding them a diet of lies and half-truths. Instead of helping their autistic children, they end up harming them because the whole belief system of the cult rests on convincing parents that their children are damaged. That autism is a burden, a curse, a judgement from on high against them.

This is certainly new, what did I miss? The usual Fendlescat?

He's been impersonating regular commenters for whom he can find their e-mail address online.

Someone obviously has too much time on their hands....

Any idea on who he really is? Perhaps a regular over at AoA?

Gerg again?

Well. I hope he doesn't see this.

I can easily see a parent in a community where not vaccinating is a thing being scared enough by friends and neighbors not to vaccinate. A parent can be perfectly reasonable and still be scared by her network and community.

Indeed, or parents can probably even end up not vaccinating because they're following their "mommy/daddy intuition," which, of course, is often wrong. The thought of your tiny baby getting jabbed multiple times with needles is enough to make any parent cringe, I would imagine. Add a little exposure to the anti-vaxx message...

That can't be right. It's like a crazy making thing I heard recently: a business leader was claiming that in recent generations people have become less racist. In my experience, people- especially those my age or younger- are more racist then society was in the 1950s. Heck in the 1950s, it was at least reasonably acceptable to punch nazis and heckle them.

And just to be balanced. Canada is not any better statistically for immunization rates. This article from 2015 (http://scienceblogs.com/insolence/2017/02/02/antivaccinationists-try-to…) shows that we are doing better for MMR at 89%, but are sucking hind tit when it comes to chicken-pox at 73% and DTP at 77%. We're not as stratified by income and education as they are in the USA however. The stupidity is evenly distributed here. I would bet that a slightly higher percentage of non-vaccinations in Canada are coming from the religious morons. I fear that things will only get worse until we do have a serious and lethal epidemic of a disease that can be easily and consistently prevented by vaccines. That's why, in my opinion, that another 1918 flu epidemic won't change people's minds. The influenza hit/miss rate due to seasonal variants is to erratic for people to trust it.

Any idea on who he really is?

Travis Schwochert of Wisconsin.

Perhaps a regular over at AoA?

He didn't seem to get enough attention to suit himself when he was posting as me over there.

90% of those who remember all three disease are in favor of the mandate, compared to 77% of those who remember none of them. People need to listen to their grandparents more, I guess!

The number opposed sounds like a lot, but keep in mind, it's opposition to the MANDATE, not to the vaccine itself. A certain percentage of people will want to jump off a bridge the minute the government tells them not to.

Polls have taught us so much this past year, especially that Hillary Clinton would be president.

Oh wait...

Another reason that anti-vaccine actions skews more to the affluent parents, may be that they have more resources to go shopping around for an anti-vaccine doctor.

And yet the vast majority of people in the US get vaccinated....kind of blows your theory out of the water, Jake.

Indeed, even the vast majority of Trump voters.

As for the polls, they were actually pretty accurate in that they predicted the popular vote margin pretty well, with Clinton winning by nearly 3 million votes, or 2.1%. Trump's trifecta of carrying three key battleground states that he wasn't expected to win (and, then, by a very small margin, particularly here in Michigan), victories that gave him the Electoral College victory, is something that would have been hard for any poll to predict, as more than a little luck was involved.

People need to listen to their grandparents more, I guess!

The problem is that most people don't realize this until it's too late. The concept is captured in this memorable exchange from Hitchhikers' Guide to the Galaxy:

ARTHUR: It's times like this I wish I'd listened to my mother.
FORD: Why, what did she say?
ARTHUR: I don't know, I wasn't listening!

I don't get to post often but if I started going anti-vax you know it isn't the real me. :) I'm ashamed of your education Jake, since I thought you went for an MPH. Surely you took basic statistics. Polls all have a margin of error. The election polls all had Orange Thinskin polling in the margin of error in many places. They weren't wrong. Most of the pollsters (and the majority of voters given HRC 2.9 million popular vote win) didn't want to believe that their fellow countrymen could possibly be that stupid. A narrow electoral college victory (due to a very small number of mid-western voters) and a massive popular vote lost do not a popular president with any kind of mandate make. Vive la resistance.

Beware of fake Bimler above at #14, #17. Accept no imitations.

Go away Fendlesworth.

Blow me Julian.

Orac will have to sort out which is the real Spock bimler. I have a beard so I may be the evil version.

Somebody is about to learn about something called an I.P. Address.

His home base was previously CIDR 66.206.48.0/20, Marquette–Adams Telephone Cooperative. If he's still using their netblocks, our gracious host could always contact abuse@maqs.net, +1-608-586-4111.

^ G-d, I hate that autolinking.

Heh. I did have the sense to save a copy of your Disqustink comments before you deleted the account, Travis.

as more than a little luck was involved.

Because voting apparatus is like a slot machine.

A narrow electoral college victory (due to a very small number of mid-western voters) and a massive popular vote lost do not a popular president with any kind of mandate make.

You must be new to this universe. Any Republican win, no matter how narrow or technical, is viewed as a mandate. Any Democratic win, no matter how convincing, is not a mandate. At least, that's how the Republican Party and the so-called mainstream media view it. The Republican Party has had this view since at least the Carter presidency (I'm too young to have been aware of politics before Carter's election), and the media had adopted that view by the time Bill Clinton was elected in 1992.

A Democrat arguing that the world was flat would be correctly viewed as a nut. If a Republican were to argue that the world was flat, the New York Times headline would be along the lines of, "Opinions Differ Regarding Shape of Earth".

Please continue to push back on Trump, but don't assume that media coverage will be friendly.

@ kiiri:

'Orange Thinskin'! Very good.

People who study statistics know about these things. Or they SHOULD.

Unfortunately. a few days before the election I kept seeing numbers that upset me: Silver's website showing shifting numbers and odd changes in the Midwest states. What really bothered me was a shift to higher odds FOR DJT- around 30% overall, when a week previously, it had been lower consistently.
Then, I saw a wonk I watch on television texting furiously.

A few things happened that, coinciding, gave him the election.

It was by no means a massive blowout in his favour.

Other measures will show that he hasn't HUGE support :
- lower support figures than Obama had leaving
- protests for more than a day
- more support for the protestors' ideas ( 60%- MSNBC) than his own
- constant comment from his team on television clarifying things
- international commentary that shows worry

I predict that we'll have lots of fun following his exploits
( I'm not sure whether I'm being sarcastic or serious)

@ Eric Lund:

I do see some hopeful signs of pushback against DJT.

There has been criticism of his antics at least on liberal channels. Also many jokes and snarks distinctly not on his behalf.

@ PGP:

I think that racism was not as openly discussed in earlier eras:
people just did it.

Unfortunately, even as little as 10-15 years ago, a common travel guide noted cautionary tales for 'interracial' couples and gay people in various southern areas.

People are more vocal these days. Doesn't mean that they acted in that manner. Also some may be reacting AGAINST changes that worked against racism.

Oddly enough, Travis is also commenter "Lao_Tzu" at my.proana.com.

Well, it has been a while since we had a White House that was this "leaky." And now more than a few GOP Congressmen are pushing back on the Mexican Border Wall (too pricey).

Trump doesn't understand that he is no longer a CEO - he's an employee with 310 Million bosses.*

*okay I realize this hasn't been the case for a long time, but does reflect the original intent of the Founding Fathers.

@Lawrence:

I understand that it has often been difficult getting through to congress via phone lines these past three weeks. People are calling.

Actually, after looking at those ' benefits outweigh risks' graphs, I venture that most people who looked at anti-vax websites' articles would feel as I do-
although those who write/ read those articles regularly would never guess that that is true.
e.g. they get upset that the Times doesn't love Polly Tommey

I don't think that was real PGP, Denice.

Sure it was misanthropic, and shows a lack of knowledge of recent history. But it says something nice about us baby boomers, and there's the then/than mix up, something I've never seen her do.

But just in case I'm wrong - PGP, you have to remember that racism wasn't just an idea or a custom in the 50's, it was the law. Rosa Parks wasn't kicked off the bus, she was arrested and put in jail.

I don’t think that was real PGP, Denice.

Paranoia much? If only there were some kind of test...

https://www.youtube.com/watch?v=i0IAwe_mxSY

I think that to the extent that the current generation is less racist than previous generations, I think it's because it's less white than the previous generations. There are certainly racist individuals in every generation but that tribalism is something that you've got to be carefully taught:

You've got to be taught to be afraid
Of people whose eyes are oddly made
And people whose skin is a different shade
You've got to be carefully taught

What's changed since my childhood is that the Trump campaign brought this racism back into the open. There was a period of time when using most of the common racial slurs was Simply Not Done in polite society. But the attitudes never went away. One possibly apocryphal story I heard during the 2008 campaign was of somebody canvassing in Pennsyltucky and, upon asking the white couple in one house who they were voting for, got the reply, "We're voting for the n****r." Trump replaced the dog whistles with klaxons and thereby made it acceptable once again to be overtly racist.

Paranoia much? If only there were some kind of test…

The tortoise lays on its back, its belly baking in the hot sun, beating its legs trying to turn itself over. But it can't. Not without your help. But you're not helping.

Voight-Kampff was highly subjective and prone to false assertions depending on the operator -- Today, we just have people pee on a strip to see if it turns blue or not.

Johnny: No, that was me. I was in a hurry, and didn't check my comment as carefully as I thought.
I understand that discrimination was legal back in the '50s, but I still think that my generation and the one below it (a lot of the youngsters) are a lot more racist than people growing up in the '80s were.
And at least in the '50s, the John Birch Society/nazism wasn't mainstream, like it is now.

Eric Lund: Trump replaced the dog whistles with klaxons and thereby made it acceptable once again to be overtly racist.

And everything else 'ist' too.

I've never seen a turtle. But I know what you mean. (Not exactly true - I'll occasionally find a box turtle in the yard, and keep it over the winter.)

It seems that both PGP and me were both wrong today.

The JBS was more of a 60's thing as I remember, and Nazis weren't really a thing back then, because we'd killed them all. But we had the KKK, and they'd advertise rallies out in the open in downtown storefronts. I know, because I've seen them.

Nobody other than a few skinheads will claim to be a Nazi, but the Klan was mainstream. Look magazine mainstream -
http://www.shorpy.com/node/16684

And not just in the south, here's California in 1964
http://www.shorpy.com/node/21164

So, no, I don't believe we've gone back to how it was back in the day. Yes, the election of Orange Thinskin (I am so stealing that) has emboldened a lot of the less tolerant to come out from under a rock. But despite what you and friend Eric believe, it's nothing like it was back in the day when I was a kid. Worse than yesterday, maybe, but not worse than several days before.

The John Birch Society was founded, IIRC, in the 1950s. Among the founders was the father of Charles and David Koch. They were rabidly anti-Communist, but were regarded as too extreme to be accepted in polite society back then. Somewhere along the line (not sure if it was the 1980s or 1990s) the Republican Party brought them into the mainstream

I'm too young to remember the 1950s and 1960s firsthand. Not that the 1970s and 1980s were free of racism, but the KKK were not so prominent, at least in areas I was aware of, and when Klan wizard David Duke ran for Governor of Louisiana, enough people were horrified at the prospect that they elected a former governor with known ethical issues ("Vote for the crook--it's important") instead.

Racism is definitely a more acute problem today than it was 30 years ago. And there is a large overlap between the vocally racist faction and the gun nuts. Among my worries is that we will start to see pogroms such as what happened in Tulsa in 1921.

More woo from Trumpians:

His pick for Secretary of Education doesn't know much about education or much about the brain either:
she's invested money bigly in Neurocore ( see website) which provides 'brain re-training' for people with various problems including ADHD, ASDs et a ( NYT) and remains un-divested when I looked last. It has locations in Michigan and Florida.
also they host a spiffy recipe site about eating fish to cure 'mood disorders' ( MSNBC)

So why isn't she smarter and perkier ?

Eric Lund: Among my worries is that we will start to see pogroms such as what happened in Tulsa in 1921.

I think we'll see more Dylan Roofs, unfortunately.

Denice@57: Betsy DeVos is among the Trump cabinet nominees I consider anti-competent (along with Sessions and Price, among others). She's a major player in the charter school movement, which is (I'm being generous here) 5% good intentions and 95% grift. Which means she's pretty much guaranteed to do the wrong thing. I distinguish that from an incompetent cabinet secretary, who might occasionally by accident do the right thing--I'd take an incompetent Secretary of Education over the anti-competent DeVos.

What percentage of each ideological group wants to ban vaccines entirely?

If vaccinated people are protected so completely by vaccinations, then why are non-vaccinated people such a medical threat to them? Let each group choose their own poisons,. Government should not punish non-vaccinated people by refusing to educate their children, demanding they be fired from work (even in non-medical oriented jobs), or refusing to treat their medical ailments. Lawyer-politicians should not be practicing medicine using vaguely worded opinion polls.

@genevieve reilly:

If vaccinated people are protected so completely by vaccinations, then why are non-vaccinated people such a medical threat to them?

What about those who are immunosuppressed and those too young to be vaccinated? Non-vaccinated people are a threat to them.

Government should not punish non-vaccinated people by refusing to educate their children...

Non-vaccinated children put the immunosuppressed and those too young to be vaccinated at risk. It's not about punishing those who refuse to be vaccinated, it's about protecting everybody.

...demanding they be fired from work (even in non-medical oriented jobs)...

Provide evidence that this is happening.

...or refusing to treat their medical ailments.

Provide evidence that this is happening.

genevieve reilly: "If vaccinated people are protected so completely by vaccinations, then why are non-vaccinated people such a medical threat to them?"

Please tell us your proven way to protect babies under the age of one from both measles and chicken pox. Provide verifiable scientific evidence that it actually works.

"Government should not punish non-vaccinated people by refusing to educate their children, ..."

No, no, no... you don't realize this is actually an opportunity! You can use this exclusion as a way to create a super special private school for all those special children who by some weird genetic quirk can be harmed more by a vaccine with a weakened pathogen... but are okay dokay with a full fledged infection from the wild pathogen.

Just create a new parochial school for the Sensitive Snowflakes Against Public Health Regulations.

And to prove how strong your students are, make sure that the restrooms are just outhouses without any facilities to wash their hands, and all safe food handling rules are ignored in the cafeteria. Because worrying about cross contamination is for sissies. Students with strong immune systems laugh at both salmonella and norovirus!

"Lawyer-politicians should not be practicing medicine ..."

Could you please talk to Robert Kennedy, Jr about this? Seriously, he seems to stuck in a fifteen year time bubble.

How should we deal with vaccine hesitancy, refusal, and antivaccine beliefs

oracknows — Mon, 08 Aug 2016 01:45:03 +0000

How should we deal with vaccine hesitancy, refusal, and antivaccine beliefs

As hard as it might be to believe, almost as long as there have been vaccinations, there has been an antivaccine movement, and as long as there has been an antivaccine movement, there have been parents who refuse to vaccinate. Indeed, in the 1800s, there were even groups with names like the Anti-Vaccination Society of America and the National Anti-Vaccination League. These days, antivaccine groups tend to hide their true nature with names like the National Vaccine Information Center and Generation Rescue, but the opposition to vaccinations is the same, just with different evils attributed to vaccines.

In a past that encompasses the childhood of my parents, polio was paralyzing and killing children in large numbers in yearly epidemics, the fear of which led to the closure of public pools every summer. In such an environment, the new polio vaccine introduced by Jonas Salk in the mid-1950s wasn't a hard sell. In fact, satisfying the initial demand for it was the problem, not parents refusing to vaccinate their children. Since then, more and more vaccines have been developed to protect more and more children from more and more diseases, to the point where the incidences of most vaccine-preventable diseases is so low that, unlike 60 years ago, most parents today have never seen a case or even known other parents whose child suffered from a case. Even as recently as the 1980s, Haemophilus influenza type B was a dreaded disease that could cause meningitis, pneumonia, sepsis, and death. Since the introduction of the the Hib vaccine a mere quarter century ago, Hib has been virtually eliminated. Most pediatricians in residency now have never seen a case.

As much of a cliché as it is to say so, unfortunately vaccination has been a victim of its own success, at least in developed countries. Parents no longer fear the diseases childhood vaccines protect against, which makes it easy for antivaccine activists to provide what I like to call "misinformed consent," by spreading misinformation that vastly exaggerates the risk of vaccines compared to the benefit of vaccinating. Parents who believe the misinformation conclude, based on a warped view of the risk-benefit ratio of vaccines, that not vaccinating is safer. Add to the mix fear mongering against the MMR based on Andrew Wakefield and his dubious 1998 case series that popularized the then-recent idea that vaccines cause autism, and it's no wonder that parents decide that not vaccinating is safer than vaccinating. If you believe the misinformation, it's not an entirely unreasonable conclusion. Then add to that the easy availability of "personal belief exemptions" to school vaccine mandates in many states, which include anything from religious exemptions to parents just signing a form that says they are "personally opposed" to vaccination, and it isn't a huge surprise that vaccine uptake has fallen in some areas to the point where outbreaks can occur. It was happening in California and my own state of Michigan.

The question then becomes: What to do about it? This question always brings up hard questions about how far the state should go to encourage vaccination, how many parents are vaccine-averse or even outright antivaccine, and the reasons why parents are vaccine-averse or antivaccine. Last week, Medscape published its Vaccine Acceptance Report for 2016, which looks at some of these issues.

Vaccine acceptance: The lay of the land

Early in the story, Medscape notes correctly:

The personal and public health impact of vaccine hesitancy, if it culminates in refusal, is substantial. Parents offer many justifications for declining vaccines for their children, and traditionally have not been easily persuaded by statistics about a vaccine's safety and efficacy, or horror stories about children who developed a vaccine-preventable disease. The burden on clinical practice in terms of time alone is significant, and providers must also grapple with such questions as how to provide quality pediatric care to unvaccinated children, how to protect other patients in the practice, and how to protect their own liability for any poor outcomes resulting from continuing to provide care to unvaccinated children.

The reasons behind vaccine hesitancy or refusal range from religious objections to personal beliefs, safety concerns, a preference for "natural" immunity, and a lack of accurate information about vaccines from a trusted source.

In response to this problem, Medscape administered a survey to health care professionals. 1,551 physicians, nurse practitioners, and physician's assistants in pediatrics, family medicine, and public health who worked in a practice setting where vaccines were administered to patients younger than 18 years were surveyed. Wherever possible, Medscape compared its results to a similar survey it conducted in 2015 in order to identify trends in vaccine hesitancy, refusal, or acceptance. Of course, one problem with this survey is that it's just of health care professionals; in essence, it only tells one aspect of the story and relates the impressions that health care providers on the front line have regarding vaccine refusal. That means that the reasons for vaccine refusal that are related are only what parents tell health care practitioners, which might or might not be the real reasons behind vaccine hesitancy or refusal.

One piece of good news is that the clinicians surveyed don't perceive an increase in vaccine refusal and hesitancy. Between 44-46% of clinicians perceive more acceptance of children's vaccines in general, children's measles vaccines, and the recommended vaccine schedule, while 42%-47% perceived no change in these same metrics. Only 9-14% perceived that these metrics have gotten worse since last year. This is encouraging, but it is only a perception. Whether it is an accurate reflection of what is going on is impossible to say. Similarly, whether the respondents are correct in their perceptions as to why vaccine hesitancy has decreased is impossible to say, but majorities respondents perceived that there has been more concern about infectious disease and more fear of children contracting vaccine-preventable diseases. Minorities were concerned that their children were denied admission to school, day care, or camp because they weren't fully vaccinated.

Some of the comments by respondents to this question on the survey included attributing the perceived increasing acceptance of vaccines to:

Changing attitudes in the lay press—less glorifying and more scrutiny of vaccine refusers/press finally coming down negatively on vaccine refusers.
State laws removing philosophical exemptions for vaccines.
Taking more time to address all of the parents' concerns about vaccines.
A new policy to dismiss vaccine refusers from practice

I've discussed the first one before from time to time, as I, too, have perceived a change in the attitude of the lay press over the last five years or so. Back in the day, when I first started blogging and paying attention to the antivaccine movement, a staple of my blogging was the examination of news reports by clueless journalists who treated vaccine stories and the idea that vaccines cause autism like any other issue, in which there had to be (at least) two sides. So for every quote by a vaccine advocate or pro-science advocate like Paul Offit, there would almost always be a countering quote by someone on the "other" side like Jenny McCarthy, Barbara Loe Fisher, or even Andrew Wakefield. Indeed, from time to time there were even very flattering profiles of Andrew Wakefield in press. Unfortunately, back then, the material for this sort of post far exceeded even my ability to cover all the articles I came across every week showing false balance. It was false balance, too, because the two viewpoints are not even close when it comes to scientific evidence for them. Billions of doses of vaccines have been administered with very few serious adverse events, while a veritable mountain of scientific studies attest to the safety and efficacy of vaccines. On the antivaccine side, there are anecdotes, confusing correlation with causation, and crappy studies and case series by the likes of Andrew Wakefield, Mark and David Geier, Brian Hooker, Christopher Shaw, Stephanie Seneff, and other antivaccine physicians, scientists, and scientist wannabes.

Then, beginning around five or six years ago, I started to notice a change. Fewer and fewer articles in the mainstream press exhibited what I considered to be false balance. I can't quantify it, and maybe I'm suffering from confirmation bias, but it seems unmistakable to me. I also noticed a new shorthand for dismissing antivaccine views: Mentioning Andrew Wakefield, how he lost his UK medical license, and his fraudulent 1998 Lancet case series. Yes, it seems to me that the discrediting of Andrew Wakefield by the UK General Medical Council and by The Lancet's retraction of his 1998 case series did far more to reverse the sad state of affairs in health reporting about vaccines than all the studies finding no link between vaccines and autism. I wish that it weren't so, because I like to believe that people can be persuaded by scientific evidence, but we know that that's not the primary way minds are changed. Anecdotes, stories, and statements from trusted people are far more effective, which is why I've resigned myself to this development and even sometimes use Andrew Wakefield as shorthand for discredited antivaccine beliefs myself. I would prefer not to, but at least this shorthand, besides being effective, has the added bonus of being true.

In fact, the idea that disconfirming data can even backfire and harden positions has a name, disconfirmation bias, in which we humans tend to expend disproportionate energy trying to refute views and arguments with which we strongly disagree. There's a related phenomenon known as the backfire effect, in which challenging a person's deepest convictions with disconfirming evidence results not in the changing of that person's mind but the strengthening of those beliefs. The process through which people manifest the backfire effect is sometimes called motivated reasoning, in which we are very good at finding facts and evidence that support our preexisting point of view. The more educated a person is, the better he is at motivated reasoning, which is why the most vocal antivaccine activists are so frequently highly educated and affluent.

Of course, we're talking here about deeply held beliefs. This would describe what I like to call diehard antivaccinationists and the leaders of the antivaccine movement. They are notoriously difficult to persuade, and it's rare that any of them flips to accepting the safety and efficacy of vaccines. Most parents who express concerns about vaccines are much less certain. Antivaccine beliefs are not deeply held; so the potential to reach them with evidence is there. More importantly, from my perspective, it is critical to keep the antivaccine misinformation spewed by the diehards (who can't be persuaded) from influencing those susceptible to their message.

But what about vaccine refusers?

Vaccine refusal: The lay of the land

Medscape asked respondents who perceive that vaccine refusal is increasingly a problem what reasons they've heard from families. Here are the reasons, ranked from most common to least:

Fear of connection to autism spectrum disorder
Concerns about added ingredients in vaccines
Worry child will suffer other complications from vaccine
Worries about "overwhelming" infant's immune system
Distrust of pharmaceutical industry
Believe child will get illness from vaccine
Pain/stress of multiple injections for child
Believe naturally acquired immunity is preferable
Religious or political belief
Doubt about vaccine efficacy
Cost/lack of insurance coverage for vaccines

Note that the last concern was noted by only 8% of respondents.

Respondents also mentioned these reasons:

Vaccines are not safe
Worries about future repercussions of vaccines
Diseases to be prevented are not that bad (or, as I like to call it, the Brady Bunch fallacy)
Too many antigens given at once
Fear that vaccines are a government plot

You'll also note that every single one of the concerns that can be addressed with evidence has been discussed on this blog at one time or another. The evidence is clear: Vaccines do not contribute to autism. The concern about vaccine ingredients is one that I've dubbed the "toxins gambit" because, although there are chemicals such as formaldehyde in vaccines, they are present in such trace quantities as to be safe. Indeed, the amount of formaldehyde in infant vaccines is much smaller than the amount of formaldehyde circulating in the infant's bloodstream from normal metabolic processes that generate it. "Natural immunity" might be more long lasting for some vaccine-preventable diseases, but the huge downside to natural immunity is that the child has to suffer the disease, with all its attendant suffering, morbidity, and even potential risk of death to achieve it. Worse, in the case of measles, "natural immunity" involves a suppression of the immune system that leaves children more susceptible to other diseases and results in increased mortality in children who have had the measles, an effect lasting up to three years post-infection. In other words, in the case of measles, at least, the benefits of the vaccine go beyond measles.

One issue that we who advocate vaccines probably don't pay enough attention to is parental concern over the pain and stress of multiple vaccinations. That concern could be fairly easily overcome when it's just one shot at a visit, but when a child gets two, three, or even more shots in a single visit, it can trigger a very deep protective instinct in parents that can cause a great deal of distress and lead them to start to wonder if all these shots are really necessary. Alice Dreger, who is pro-vaccine (although she has an unfortunate and irritating penchant for portraying vaccine advocates as frenzied self-righteous zealots), was honest enough to talk about her experience with this instinct in herself:

My maternal instinct was riled with every new round of shots and cries and tears: I remembered one particular visit to our paediatrician when my gut instinct had a sharp argument with my brain. I can't even remember what the vaccine was; I just remember that Gut was yelling, "Enough already! Stand between our baby and that needle!" Trying to stay calm, Brain answered: "Vaccines are safe, and necessary not just for our baby's health but for the health of those around him, especially children more vulnerable than him . . ."

Vaccines aren't the only medical procedure performed on children that provokes this primal instinct, but it is by far the most common. Mild reactions after vaccinations, such as fever, are not uncommon, as well. Such reactions, when they happen, only serve to fire up parental instincts even more next time. How physicians, nurses, and medical assistants deal with this natural anxiety in a parent who might be predisposed to become vaccine-averse or even vaccine refusers can make the difference.

It's not all vaccines: HPV and flu vaccine resistance

Just as there are gradations of antivaccine views, from those who fervently believe that vaccines are ineffective and dangerous to those who have been influenced by antivaccine propaganda and fear that vaccines could harm their child, not all vaccines produce the same level of resistance. For instance, Medscape found that the vaccines most likely to be refused are the human papilloma virus (HPV) vaccine (Gardasil or Cervarix), the flu vaccine, and the MMR, while the least likely to be refused is the Haemophilus influenza type b (Hib) vaccine. It's not surprising that the Hib vaccine is an easier sell, given how deadly the disease was up until the early 1990s, which is when the vaccine basically eliminated the disease except for a handful of cases every year. It's also not surprising that resistance to the MMR vaccine remains high, given that even 18 years later Andrew Wakefield's fraudulent study still reverberates, nor is it particularly surprising that flu vaccine resistance would be high given that people still have the mistaken impression that the flu is not a serious disease coupled with the variable and less than optimal efficacy of the flu vaccine.

I'm, however, somewhat surprised that the hepatitis B vaccine didn't rank higher on this list, given the widespread perception of hepatitis B as a sexually transmitted disease and the frequent attacks of the birth dose of this vaccine by antivaccine zealots, but I'm not at all surprised that resistance to Gardasil is the highest because the HPV strains that cause cervical cancer are sexually transmitted. Not surprisingly, the reasons parents give are, in order of frequency from most frequent to least frequent:

Parents did not perceive their child to be at risk for acquiring a sexually transmitted infection
Parents have concerns about the potential side effects of the HPV infection
Parents voice concerns that the vaccine promotes sexual activity
Parents believe that not vaccinating their children doesn't harm anyone else.
I'm unconvinced that the benefits outweigh the risks, so don't promote as strongly as other vaccines

Fortunately, that last reason was only 7% of respondents, but that's still rather high. It's also very critical, as what this study probably didn't pick up is this factor discussed by Medscape:

Other research supports the finding that provider ambivalence plays a role in HPV vaccine acceptance. Although most providers reported in a recent study that they usually discuss the HPV vaccine at the 11- or 12-year visit, only about 60% of pediatricians and family practice physicians strongly recommend the vaccine to parents. Without a strong recommendation from clinicians, it is unlikely that parents will be able to overcome other reservations about the vaccine, such as the fear that it will encourage sexual activity, concerns about safety, or relative unconcern about HPV disease.

In other words, if clinicians don't, through action and word, let parents know that they consider the HPV vaccine to be very important, then why on earth would parents think it important enough to overcome their other concerns? These results also make it hard not to note that many US families are living in a fantasy world if they believe their teens are not at risk for acquiring a sexually transmitted disease, and it's a myth that the HPV vaccine promotes promiscuity. Yet these mistaken impressions leave HPV vaccine uptake far below what it should be.

Strategies to counter vaccine hesitancy

Medscape also asked the clinicians it surveyed what strategies they found most effective at encouraging vaccination in families who hesitate or refuse vaccines. They found these strategies mentioned, in decreasing order of frequency:

Providing evidence-based responses to concerns
Telling parents you would/do vaccinate your children on the recommended schedule
Providing info on potential morbidity/mortality of vaccine-preventable diseases
Offering an alternative schedule
Refusing to accept patients who won't adhere to the recommended schedule

I note that, even though it's the number one answer, "providing evidence-based responses to concerns" was only mentioned by 63%. Parents who are persuaded by evidence are almost certainly the ones least resistant to vaccines, given the backfire phenomenon. It's not part of their world view or a deeply held belief. Notice, however, number two: Telling parents you would vaccinate. This is similar to a question I not infrequently am asked by patients with breast cancer: If I were your mother/wife/sister, what operation would you recommend? Again, the human connection and personal anecdotes are often more powerful than data.

As Medscape puts it:

Rather than a lack of information about vaccines, there is information overload from countless disparate sources.[14] Providing accurate information about vaccines to correct misinformation and misunderstandings is one of the most common strategies used by clinicians to increase parents' confidence in vaccines. However, more than a few respondents were cynical about such strategies as sharing the science or telling "horror stories," which, as one respondent said, "work rarely. Most antivaxxers are not influenced in any way."

Again, just providing accurate information can be effective, but it is not enough, and it almost certainly won't work with antivaccine parents, as opposed to just vaccine-hesitant parents. Other examples cited by Medscape are in line with this:

Telling stories from early in my career when many current vaccines were not available and I watched children die from vaccine-preventable diseases
Reminding parents that providers, too, want what is best for their children
Explaining that healthy children must be vaccinated to protect more vulnerable children (kids with cancer, autoimmune diseases, transplant recipients, newborns) who can't be vaccinated

Other suggestions included:

Increase transparency about vaccines, better risk-benefit data, better tracking of adverse events
Public service announcements with personal stories from families whose children's lives have been affected by vaccine-preventable diseases
More flexibility in alternative vaccine schedules
Eliminate the vaccine court and restore the right of patients to sue vaccine manufacturers
More patience from providers. Parents may be frightened and need a little space and understanding. Most will come around.

The last one is probably the most useful and likely to be effective, while health authorities already do public service announcements with personal stories of children harmed by vaccine-preventable diseases. The rest of these ideas range from being truly bad (eliminate the vaccine court) to being based on a misconception (increase transparency; vaccine safety data are already pretty darned transparent), to being medically a bad idea (more flexibility in alternative schedules).

Remember, it's not just about vaccines

Overall, the 2016 Medscape survey probably does a decent job of capturing healthcare providers' attitudes and perceptions regarding vaccine hesitancy. It doesn't, however, look at the views of actual parents, and in my experience many providers are blissfully unaware of one thing: Whenever a parent refuses vaccines for her child, it's almost always about more than just vaccines. I like to cite as an example a post from an antivaccine blog entitled "Why don't you vaccinate?", in which a father named Matt tries to answer that very question. The various reasons he gives are, of course, easily refutable and in fact I refuted them when that article was first published, but it's worth looking at them anyway:

It's MY choice.
Many vaccines are designed using aborted fetal tissue as a growth medium.
Many vaccines contain foreign animal DNA.
The ingredients in vaccines scare the crap out of me.
Herd immunity does not exist.
We've traded disease epidemics and natural immunity for neurological and auto-immune epidemics and artificial, temporary immunity.
I don't believe that vaccines eliminated diseases.
The vaccines aren't as effective as you're led to believe.
Financial incentives and conflicts of interest turn me off.
Vaccine manufacturers are immune from any and all liability.

While it's easy to laugh at the utter ridiculousness and cluelessness of some of Matt's reasons, such as the claim that herd immunity doesn't exist (it most certainly does), vaccines cause neurologic and autoimmune diseases (they do not), and how Matt "doesn't believe" that vaccines eliminated any diseases (seriously, who cares what Matt "believes" about science, and I have two words for him: smallpox and, hopefully soon, polio), did you notice something about the reasons? Several of them have nothing to do with whether or not vaccines are safe and effective. For instance, the concern about whether vaccines are made in "aborted fetal tissue" is obviously incorrect, although 50 year old cell lines derived from aborted fetuses are used in the manufacture of some vaccines, which is a very different thing. However, concern about the source of cells used to make vaccines is not about whether these vaccines work or not; it's about moral values, a world view, and deeply held beliefs, about whether vaccines will somehow sap and impurify our precious bodily DNA. The same is true about financial incentives and the belief that vaccine manufacturers are immune from all liability (they aren't, of course). As exaggerated as these reasons are, they speak to a certain world view of which antivaccine beliefs are but a part. It’s also how “they” view “us” (i.e., scientists, physicians, and vaccine advocates), as I have discussed several times.

Perhaps most important is what Matt lists at #1: It's MY choice. Notice , in his original post, Matt starts with #10 and works his way to #1 in a countdown; so #1 is listed last. The buildup only emphasizes the importance of this reason, like a top 40 countdown does for the number one hit. Matt sees the requirement that he vaccinate his children if he wishes them to go to public school as an unacceptable affront to his own ability to choose. This is not surprising, given that Matt describes himself as a "a conservative millennial," which means that politically he is opposed to anything he views as overweening governmental power; e.g., school vaccine mandates. It's also a common reason among antivaccine activists and part of the reason that the appeal of the "health freedom" movement (which I like to characterize as the freedom of quacks to ply their quackery but its members see as the freedom to choose their own health care) is so potent. As you can see from his post, he's also not bad at motivated reasoning, able to marshal information supporting his point of view while dismissing the much more powerful evidence refuting it.

When trying to persuade parents who are merely vaccine-averse but for whom vaccine hesitancy or refusal is not part of an overall world view that is inherent in their core beliefs, traditional methods of persuasion using evidence, trust between physician and patients' parents, and anecdotes have a chance of working. When it comes to someone like Matt—or any of the bloggers at, for example Age of Autism or The Thinking Moms' Revolution—such methods will almost certainly fail or even backfire. They remain the last, most difficult challenges. I fear that the Medscape survey, while providing me hope that the prevalence of vaccine refusal is probably decreasing (or at least probably not increasing), it doesn't give me much confidence that most primary care physicians understand where antivaccine views come from.

oracknows Sun, 08/07/2016 - 21:45

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"3.Many vaccines contain foreign animal DNA."

And so does my steak.

"I have two words for him: smallpox and, hopefully soon, polio"
Don't forget Rinderpest! Less famous than smallpox was or polio hopefully will be, but it was a magnificent success regardless.

I'm always amazed at how people who should know better -- and claim to know better -- don't act like they know better. They don't even act like they know better when life and health are at stake. It's as if the brain has decided to do its own thing even when the stakes are high... Almost like a reflex and less like a reasoned (or reasonable) response.
That's what I get from most antivaxxers I interact with, just a knee-jerk reaction and little substance.

Ren@3: "That’s what I get from most antivaxxers I interact with, just a knee-jerk reaction and little substance."

As I've observed before, the True Woo is a paranoid narcissist, ignorant and impotent, raging against a world she does not understand and cannot control. Her ego, her social status, her entire identity and purpose in life; everything that she is hangs upon her unfaltering maintenance, propagation, and defense of those beliefs, for without them she has nothing; she is no-one.

By questioning or criticizing her beliefs in any way, you are personally perpetrating a direct and potentially deadly attack upon the person herself, and there is little most people will not do to protect themselves when their very lives are threatened—up to and including throwing others under the bus with zero consideration or remorse. Anyone can rationalize just about any belief or behavior when the rewards for doing so are sufficiently great, and/or the penalties unbearably awful should they not. It just comes a lot more easily to those who've never learned to count past One.

More patience from providers. Parents may be frightened and need a little space and understanding. Most will come around.

I must disagree with this part of the Medscape report, based on my own clinical experiences over the last 13 years and also this recent research finding showing that 72% of parents of newborns had already decided on whether/how they were going to vaccinate before their first doctor visit. ( https://aap.confex.com/aap/2015/webprogram/Paper32305.html )

It would have been more informative for Medscape to survey the practices that have expelled vaccine-refusing parents as to what finally drove them to do that. You know my reasons, and I suspect it is similar to other practices (ie. risk to newborns and immune susceptible patients, tired of battling the words of quack doctors who, unlike Wakefield have not been disciplined in the US, and the realization that no amount of time is going to change these folks' minds once they buy into all the nonsense in the AV echo chambers online.)

More flexibility in alternative vaccine schedules

This isn't the worst thing (please let me finish before heads explode) and can have a very positive effect on vaccine-hesitant parents. Back in my days on "Mommy Boards" I was able to get a lot of moms to start vaccinating their children by starting off slow e.g. "Hey why don't you start off with Pentacel and when you see everything is fine, do HepB the following month." This allowed them to do what they really wanted to do which was vaccinate but give them an out for their fear without validating it.

Parents who are vaccine hesitant (which are probably the vast majority) can be convinced with a bit more light-handed approach. They can easily be turned to a Bob Sears-type doctor (or even worse) if they are hammered over the head. That is not to say I don't understand and agree with some physicians who enact a blanket policy for a vaccination schedule who get inundated with anti-vaxx parents who are probably insufferable.

A number of years ago, I had a mother bring her son into my office to report a dog bite. The dog could not be found, so following standard procedures I was recommended the boy (8 or 9 years old) go through the rabies series. The boy was on a medical card, so there would have been no cost.

The mother refused even after having it explained that if the boy contracted rabies he would die. Her reason for refusing the vaccine for her boy: he is afraid of needles.

Luckily, he didn't contract rabies.

There is enough flexibility in the timeline to stagger the shots with certain combos and still maintain the schedule.

Maybe a good marker as to whether the primary care provider correctly applies Orac's as argument presented here would be to measure the community HPV vax compliance rate.

Something else not provided in the Medscape study is the idea of some sort of federal oversight and accountability in cases where states aren't willing or, it seems, able to enforce the evidence-basis on a practioner that willfully disregards it, and even capitalizes on it.

As a pediatric nurse I have struggled with families digging in against reason. Only this year with the rise of Trump I have learned to accept that for many people Feelings>Reason. Using reason with antivaxx parents only makes things worse, just as using reason with a Trump supporter is a waste of time.

I am at the point that I think schools need to exclude unvaccinated children, except those with a medical exemption. Religious or "philosophical" exemptions are too easily abused. If we cannot reason with such people then we have to go to ostracizing them from public benefits. You have the right to hurt yourself but not the rest of us.

There's quite a lot to digest on this topic. Not necessarily what the antivaxxer perceives or becomes misled about, but an argument more targeted toward what the professional primary care provider does, or may not be doing, and maybe a why on the provider.

You know, back in the 1800s, it made a bit more sense to be antivaccine, considering the state of medicine (and the level of medical ignorance among the general public). "You want to wound my child and infect him or her with disease so that they don't catch a worse version?"

Nowadays, of course, we have no such excuse.

I appreciated the story about the protective mom's inner dialogue, because I have the same reaction when my kids get shots. (Especially when they're young babies.) Everything in me is screaming "No! Stop hurting my babies!" My oldest daughter gets (mild) fevers after EVERY SINGLE SHOT, too. However, I dearly love the fact that my kids are unlikely to develop many serious infectious diseases, and that of course outweighs my gut distaste for the process.

@Heidi_storage: There's a great article on "Thinking Person's Guide to Autism" entitled My Baby Cried Louder than Science written by a pro-vax Mom who briefly panicked when her baby appeared to be having a vaccine reaction; I highly recommend it.

For the people that say measles is not a big deal:

Myanmar outbreak mystery solved: Measles behind deaths of 30 plus people in remote north

Generally speaking, it's hard to reason someone out of a position he didn't reason himself into. That's true of a lot of things in general, but it's especially true of hard-core anti-vaxers.

But there are many who can be reached: people who may have heard some of the anti-vax propaganda but are not committed to that position. These parents can be persuaded by pointing out that certain rumors they have heard are wrong, and explain why.

There is another category that deserves particular mention:

Cost/lack of insurance coverage for vaccines

It's an indictment of our medical system that there are parents in this situation, but if the choice is between "baby gets her vaccines this month" and "baby eats this month", the latter is actually the rational position. If the baby doesn't eat, her vaccination status is not going to matter. This situation most commonly arises in states which have not opted into Medicaid expansion, and is caused by irrational people of a different kind, namely certain politicians. All that doctors can do in this scenario is write to their state legislators recommending that they remedy this situation.

This situation most commonly arises in states which have not opted into Medicaid expansion

I think it's necessary to distinguish CHIP and ACA here, but I'm not in a position to do it right at the moment.

@Eric Lund: even before ACA, I expect the Vaccine For Children cost took care of most vaccines cost. That wouldn't change the problem of costs for doctors visits though, I think - though I'm not sure even of that - I don't know if VFC has any provision for that.

Of course, cost of vaccines is not the only access problem, nor even doctors' visit. Time to go to the doctor is also an issue, and a parent might fall behind when the choice is get the child vaccinated or get fired.

Yes, doctor visit costs may be an issue:
http://www.cdc.gov/vaccines/programs/vfc/providers/questions/qa-parents…
"Q: The vaccines are free, but what if I can't pay for the doctor visit or the vaccine administration fee?

A: Although the VFC vaccines your child may receive are absolutely free of cost, the doctor still has the right to charge a fee for an office visit.

If your child is on Medicaid, that office visit is paid for by Medicaid.
If your child is not on Medicaid, you are responsible for making appropriate payment arrangements with your doctor in relation to office visit charges.
Doctors participating in the VFC Program also have the right to charge an administrative fee for giving your child a shot. However, they are required by law to administer the vaccine even if a child cannot afford to pay the administrative fee. This means that the administrative fee, unlike the office visit fee, must be eliminated if you are unable to pay."

Why is Ilena Rosenthal shown snipping the syringes? I don't recall her beating the drum against vaccines.

Orac :
" It seems unmistakable to me"

I would agree: coverage of the anti-vaxxers DID change dramatically post- striking off of Andy.

@Sarah A. Yes, excellent article. None of my kids are (to my knowledge) autistic, but I can completely sympathize with the author's reaction. It is so nice that her pediatrician was kind and understanding; I remember a very sweet pediatric nurse calming me down one Sunday morning when I was convinced I'd given my one-month-old pneumonia.

@ Science Mom #8: My head didn't explode. My experience (before I expelled vaccine refusers) was that the parents I let delay/stagger vaccines almost always never caught their kids up on vaccines. I know there's a reference out there that supports this, too, but I can't find it. And tying into what Dorit says about the doctor visits--I didn't derive extra revenue from extra visits by parents who were spacing out vaccines as they wouldn't pay a nurse or doctor visit fee for those visits. Plans pay a fixed fee for each vaccines (typically about 10% over my cost--whoopee, Walmart would go out of business on that margin and so would I if I didn't see children for things other than vaccines) and a shot admin fee which didn't cover the other costs associated with vaccines. So letting parents space out vaccines tied up my exam rooms (I only have a finite number of them) with shot visits that then also kept me from seeing same day sick visits unless I wanted to tag a couple of more hours onto my clinic day (and then I have to convince staff to hang around and pay overtime as well). Plus you don't want to bring your kid into a pediatric office any more than is needed (and spacing out vaccines brings a lot more unneeded visits). because, yes, your kid can get sick in my waiting room.

Brought up to Mr Woo how relieved I was to see a picture of our two-month-old granddaughter at her shot visit. I mentioned he had said her parents delayed vaccinating. He then went on about the "thirty vaccines" they give to babies the day they are born. I suggested they only give the Hep B... he then goes on about that...

My son is watching, and I am behind Mr Woo. I mouth "science" to my son as Mr Woo says anyone believing statistics is only using faith.

Mr Woo is completely irrational about most scientific facts - vaccines, anthropogenic global warming... He is a Trump supporter and definitely not able to be persuaded on anything. Strangely, he is college educated. However, he is retired and white, so he still fits the typical profile, except for having a BS in sociology.

@Eric Lund-The Vaccines for Children program provides vaccines at no cost to the patient. Most health departments participate in VFC and do not charge a doctor's visit fee. Sometimes an administration fee is requested, but no one is turned away due to inability to pay.

I didn’t derive extra revenue from extra visits by parents who were spacing out vaccines as they wouldn’t pay a nurse or doctor visit fee for those visits.

Wait, what?

Narad@24: You know, selfish people.

Vaccination among healthcare workers in particular. I do not know vaccination rates among the nurses and what not, but I can think of two people off hand I work with in the cleaning department, who do not vaccinate. It is perplexing to me that they don't. Where I work has a program called the My Health Reward, it is an incentive program for employees to lead healthy life styles. If parameters are met (being current on vaccinations is one of them) then we get an extra $360 a year. If people opt not to vaccinate then they are supposed to wear a mask their entire shift. Unfortunately management is bad at enforcing this policy. The two I know who don't vaccinate, also don't wear the mask.

Sarah @26: A friend of mine who's a nurse posted some ridiculous thing on Facebook about how terrible flu shots are. Before I even had a chance to formulate a response her dad responded with a Snopes article refuting her article. Then my friend was "Oh, you're right!" and went off to get her flu shot (so she didn't have to wear a mask).

Some people do learn!

On the topic of Andrew Wakefield, the damning evidence that came out in his GMC fitness to practice earing that led tohim losing his licence and the full retraction of his paper have had a significant impact on the way the press has reported the anti-vaccine movement. It was one of those watershed moments when a lot of the press realised that the hero of the anti-vaccine movement was a fraud.

@ Narad #24: When you see a patient, you can often bill for a doctor or a nurse visit CPT code. However, for a shot-only visit, you cannot bill a doctor or nurse visit CPT code (if all you are seeing them for is vaccine(s), then you can only bill the CPT codes for (1) the vaccine(s) and (2) the administration of the vaccine. So if someone is coming to see me for one vaccine at a time, I billed for single shot/adminstration CPTs every visit, which brings in no more revenue then if the vaccines were given on schedule and not spaced out. Again, though, this spacing out of vaccines removes visit slots from my schedule that could be used for same-day sick patients--which are both critical for good patient care in pediatrics and also a source of revenue that made up for the abysmal payments I received for vaccines (and this is why pediatricians are the lowest paid of physicians--1/3 of my overhead was vaccines and the ROI financially was horrible). I've dropped insurance plans because they weren't even paying me cost on vaccines, which ought to be illegal.

#7 Rich Bly

The mother refused even after having it explained that if the boy contracted rabies he would die. Her reason for refusing the vaccine for her boy: he is afraid of needles.

Luckily, he didn’t contract rabies.

And it crosses my mind she may be lucky that he does not find out about this when he's 20.

But then I come from what used to proudly? call itself the rabies capital of the world and I am abslutely peranoid about rabies

@14 Eric Lund

There is another category that deserves particular mention:

Cost/lack of insurance coverage for vaccines

However that does not explain the low rates of vaccination take-up in other countries where they would be supplied routinely during a well-baby visit at no cost in countries with a more rational,(cough) medical care. Australia, Canada and the UK all seem to have this problem although I don't have figures on the relative rates.

I think while the Medscape study is interesting, I would not try to establish any kind of policy based on it (Sorry to the USians, I was thinking of provincial or federal health care policy) before doing a lot of in-depth interviewing & perhaps some focus groups with both non-vac and vac parents. The views of the care providers and receivers might be very different. Also I am I right that it is the mother who almost always takes the child to the doctor? If so Medscape has missed the other half of the family unit.

@Eric Lund-More about the false dichotomy between vaccine and eating-Most low income infants are eligible for both food stamps and WIC.

@Sarah-According to the CDC, the percentage of US nurses (RN) in all types of settings getting the flu vaccine was 90.5%. For non-clinical personnel it was 68.6%.

One of the ones who doesn't vaccinate seems to have mental health issues. She is very paranoid, loves conspiracy stuff, and one time came back to tell me about how her sister (who is a doctor in Mexico) told her that the priest who was poisoning her (this is part of her paranoia) must have been using this metal stuff, and that is why her chest pulls toward magnetic fields. I told her if she is having thoughts like this she needs to talk to a doctor at work, not her sister.

Most low income infants are eligible for both food stamps and WIC.

The whole WIC's-a-gonna make me vaccinate trip was a routine topic at MDC before I bailed quite a few years ago.

@Narad-That wasn't exactly what I meant, though that is a good point. I never worked for WIC, I worked on the immunization side of public health, until, like you, I "bailed" back in 2000. It's just a false dichotomy, though one that comes up often, to say that it's "vaccine or food".

@ Narad #24: When you see a patient, you can often bill for a doctor or a nurse visit CPT code.

My question was more whether you could charge cash on the barrelhead for the service.

Mark Thorsen @18, I think that's supposed to be Jenny McCarthy.

6. ...artificial, temporary immunity.

Yeah, there is indeed such a thing. The problem is, that isn't immunity from any vaccine, it's gamma globulin.

In a bit of genuine weirdness, Stagmom seems to be desirous of getting George Takei to come out against SB 277. I'm not really part of the Twattosphere, but I'm hoping against hope that some hilarity emerges.

Thanks a lot Narad; those comments are derpilicious.

I was wondering whether the "Joe" there is in fact Joe Harris/ccdaddy57, whose lips once fell off because of GMO corn triffids.

Hello all
I don't want to be a prophet of doom; but we need to plan for the worst, but hope for the best. If support against vaccination starts to rise in the general populous (from my understanding its isn't in general), we may likely be to be back to the "bad-old days" of preventable-disease outbreaks/pandemics. We need to plan for the sudden addition of very large numbers of patients (1000's) on a annual cyclic-basis (eg. like what I have read about Polio). It is unlikely to get to that, but we need to plan as though it is a certainty. We don't want to get caught unprepared.

Ooo Ooo, did you see this gem from that wordsmith Benedetta?

The sky is blue - science is clear - vaccines are safe; as a top scientist whistle blower sits ideally by for the past two years.

Oh and:

I believe American parents are far more curious about how Clinton's and Trump's grandchildren are being vaccinated then they are about their emails or tax returns.

What a sad little echo chamber they live in.

To increase vaccine compliancy, the CDC needs to tell all the vaccine-damaged people that they are actually suffering from a virus. This will have the positive side-effect of creating the need for more vaccines($), and also further increasing compliancy out of fear.

We just need to name a mythological virus.

Tenfold Shrew @44: If you stepped on a rusty nail in a horse barn, would you get a tetanus shot?

@Justatech

If you got buttraped by Tommy Lee would you get an HPV shot?

Hmmm, do I smell some old sock puppets?

@Chris, #47, that isn't old sock puppet smell, that's just the smell of bullshit. ;)

Ooo Ooo, did you see this gem from that wordsmith Benedetta?

I noted that she's recently stated that she's only 60 years old, which I found surprising given some of her other comments. I'm not going to bother collating them, but I got the impression from one recently that her husband was (or would have been) a centenarian and her father is Methuselah.

In any event, Flying Monkey Squadron Leader Maurine Meleck has relocated from South Carolina to Florida. I think that this entry is probably AoA's winner for today:

I'm 97 years old and on my last visit to the doctor, he recommended I take the HPV series. I asked him why and he told me it's a safety measure. I told him I haven't had sex since my husband died in 1991.

He told me then that one never knows when a proper suitor will appear. So I finally consented to the vaccine. After the first shot, I became a hoarder, collecting everything from old rags to lizards. He said "So what," to that so I took the second shot. I could only eat iceberg lettuce. He told me I'd have to take the third one or the others won't have any effect. So after that I'm confined to a wheel and am unable to move my arms or legs. When I told that to the doctor he said, Excellent and now you can find your
soul mate.

@ Narad, Good grief as if they couldn't become more unhinged and out of touch with the world.

Good grief as if they couldn’t become more unhinged and out of touch with the world.

I can only assume that this was an attempt at humor; Meleck was a rather prolific "contributor" to the Augusta Chronicle. But man, oh, man.

Stagmom seems to be desirous of getting George Takei to come out against SB 277

I think the odds of that happening are between slim & none. I don't recall Uncle George opining on SB277 when it was in the legislative process, but I do know the Opposition was courting quite a few celebrities.

BTW, there's a hearing on one of the suits against SB277 on Aug 12. The purpose of the hearing is to decide if there will be a stay on implementation of the law. I believe a certain prominent vaccine-advocate law professor will be attending the hearing. I look forward to her report.

Monica @46: What a perfectly nasty thing to say. And totally pointless: The HPV series (which I had years ago) works before infection. Some vaccines, like the tetanus shot, also work to prevent illness if given right after infection.

From your statement I can conclude that you are 1) very nasty and 2) not very informed about how various vaccines work.

BTW, there’s a hearing on one of the suits against SB277 on Aug 12.

Yah, I know. I also tried to update the docket and found that my RECAP is apparently not working, and I'm out of free PACER buxx for the quarter. As a result, I'm having trouble sorting out document 39, Plantiffs' objections to the Rich and Schechter declarations.

@Science Mom-Regarding post #6 (I know, I'm a little slow on the uptake) My best response to parents wanting to "go slow" is to tell them their kid is unprotected longer if they do that. Particularly, they should be protected against pertussis and Hib. While I would never recommend that anyone skip any vaccine, those are the two I'd prioritize if a parent insisted on a spread out schedule.

Wzrd1: "that isn’t old sock puppet smell, that’s just the smell of bullshit."

Well, a few minutes after I posted that I learned one was banned by Orac for being a sock puppet. The silly thing then stalked me a JustTheVax. Even while traveling on our lovely interstate highway system* six hours per day this week I seem to annoy the trolls.

* which seem to be under renovation. Great swaths of I-90, I-80 and I-84 are being replaced... not repaired but scraped away and being completely freshly built, which includes many bridges!

Hello to the US,

I'm every now and then right in the middle of a discussion with Anti-Vaxxers.

One Argument, I'm stumbling over and over again, every time I am quoting your blog to debunk a "study" or a belief, somebody is telling me that you are "big in circumcision" and hence "not scientifically trustworthy".

Search function in your blog didn't come up with "big in circ" - I could establish that you are rather indifferent about this seeing that you are an oncologist and it is highly likely that you have no "touching areas" here.

But I would like to hear from you firsthand if this is true? I would hate to jump to conclusions without evidence.
(my submitted email-adress is real and not made up, just in case).

@Tenfold Shrew
If you need to lie to make a point, the point is not worth making. It would be far more effective, although no doubt more difficult, to educate people to understand science.

Oh, dear, someone seems to have a really serious case of asshurt: Fendelsworth is now impersonating me on AoA. This almost makes having to survive the weather in a tattered slip all worthwhile.

@ Narad, wow that is really pathetic. Did you see this partial response to him? It's a keeper.

Yes, the "Spanish Flu" in 1918-1919 was indeed NOT caused by a "flu" virus, as virtually all fatalities were directly due to four, five, six vaccines for such as diphtheria, yellow fever, anti-pneumonia, tetanus, measles, etc., given to ALL the 4.7 million U.S. military recruits, that sparked the Panic. On top of that, scores of millions of civilians were panicked and also got several vaccines - all made from pus and toxic infections scraped from captive cow whose rotting belly tissue was used as the basis for all these insane "vaccines."

What a freaky little hive they have there.

Did you see this partial response to him?

The parenthesized exclamation point in the salutation is the best part.

Is it possible to hide oral vaccines in food? Like MMR popsicles and DTaP lollies?

We could put the swine flu vaccine in bacon.

If the vaccines could be administered orally, don't you think that that would already be done?
Or do you think that doctors greatest joy in life is sticking an inch of steel into children, when alternative and equally effective methods are available?

Oh, the last time I had bacon, (yesterday morning, to be precise), it has to be cooked. Even oral polio vaccine can't be cooked, as it's a live, attenuated vaccine. Cooking it would turn it into a dead, denatured nothing.

@Science Mom: I avoid AOA like I avoid fleas (and the plague). But they seriously went there? Measles vaccine in 1918? I guess history is something else they fail at - reading dates, I mean.

Well, really, name one conspiracy theory that doesn't, in the end, require a time machine to accomplish the "conspiracy"?
So, reading comprehension and temporal comprehension, or at least, an understanding of how causality works in this universe.

@Wzrd1 If the vaccines could be administered orally, don’t you think that that would already be done?

This is the efficiency fallacy.

Did you know that GE created an alloy for lightbulb filaments specifically to reduce it's longevity? Certain filiments can last decades.

Sometimes an industry creates a niche market and actively prevents technological or scientific progress in that area.

"This is the efficiency fallacy."

Erm, no. When you hit six sigma certainty of ineffectiveness, that isn't an efficiency fallacy at all, it's called cooking causing protein denaturing and digestion of proteins, plus no reasonable method for the vaccine components to magically cross into the blood stream or interstitial and provoke an immune response.
Orally delivered vaccines wouldn't even provoke diarrhea. Or a fart, for that matter.

Worse, to further undermine your notion, vaccines wouldn't really need to be anywhere near as sterile, if used rapidly, as sterility isn't required for oral consumption.
Yeah, you'd be amazed how many fungi, bacteria, protozoan cysts and viruses you ingest in your food, just from the time it leaves the pan until it reaches your mouth, to be further inoculated with oral flora and fauna.
Plus what was on the food before cooking, but denatured into their components, with anything nearly surviving intact, digested into base pairs at most.

Sometimes an industry creates a niche market and actively prevents technological or scientific progress in that area.

That would be monumentally self-defeating for pharmaceutical companies. Orally administered, efficacious vaccines would be a boon to the industry. Think about it, drink/eat your vaccine or get jabbed with it?

That we are seeing new delivery methods being tested - like vaccine "patches" speaks volumes to the industry drive to move away from needles and injections - if they prove to be as safe and have the same efficacy as current vaccines.

Alas, the influenza nasal spray vaccine method isn't recommended any longer, being largely ineffective. :/

MMR popsicles and DTaP lollies?

We could put the swine flu vaccine in bacon.

Is that you Fendelsworth?

MMR popsicles, DTaP lollies, swine flu vaccine in bacon.

Irony meter says this is not meant to be taken as a serious proposal. Methinks it's either just inserting an available off-tangent joke for the sake of some humor alone, or a light-hearted dig at fear-of-needles for 'wussyness'.

@sadmar #72, damn! I was holding out for my cholesterol pill coming in bacon!
And insulin coming in a sugar cube.*

*Yeah, yeah, I know, it isn't simply consumed sugar that's the problem, it's either insulin resistance, insufficient insulin secretion or no insulin secretion.
Really, the same is true for that bacon, as not a lot of cholesterol is absorbed intact, the liver manufacturers it.

@Wzrd1 If the vaccines could be administered orally, don’t you think that that would already be done?

You may have other arguments why oral vaccines are not more universal, but above is what I call the efficiency fallacy.

Another example would be: If they could make make cars that get 100 miles per gallon, don't you think that would be done already!

These naive arguments miss the mark because some companies simply care more about the status quo than they care about efficiency.

The oral polio vaccine is, well, oral. And there are rabies vaccines for animals that are delivered by food as well. And maybe a plague vaccine for prairie dogs?

But yes, generally oral vaccines are hard.

So how is an attenuated live vaccine attenuated?

How do they reduce the virulence without totally destroying the virus?

Michelle @76: Which live attenuated vaccine?

In the very earliest days (the first rabies vaccine) the attenuation was done by passing the virus through rabbits (I believe).

Now I imagine it's done through molecular methods.

There are programs in the US and Canada to control rabies by distributing oral vaccines in baits.
https://www.aphis.usda.gov/aphis/ourfocus/wildlifedamage/programs/nrmp/…

Success so far has been mixed, but research continues.

Irony meter says this is not meant to be taken as a serious proposal. Methinks it’s either just inserting an available off-tangent joke for the sake of some humor alone, or a light-hearted dig at fear-of-needles for ‘wussyness’.

Or more likely the most vile stench of socks.

Now I imagine it’s done through molecular methods.

The latest commercial rabies vaccine (for cats) is live, unadjuvanted, and canarypox-vectored. The human version is inactivated.

This, predictably, cluessly wanders back to Bruesewitz (boldface added):

"Comment k exempts from this strict-liability rule 'unavoidably unsafe products.' An unavoidably unsafe product is defined by a hodge-podge of criteria and a few examples, such as the Pasteur rabies vaccine and experimental pharmaceuticals."

Why doesn't inactivated vaccines work orally?

This stuff is interesting. Maybe I should buy a textbook.

Had anyone read History of Vaccine Development
by Stanley A. Plotkin?

Sometimes an industry creates a niche market and actively prevents technological or scientific progress in that area.

Needle-less jet injectors have been around since the 1960s, and in the 1970s they were going to Make Hypodermics Obsolete. Sounds like they have a built-in risk of cross-infection and so have been largely abandoned (though the Goofle informs me that the FDA has approved one such device for administering a flu vaccine).

But the Industry is going to suppress new technology, it is going to have to work harder.

I remember the needleless spray injectors. The US Armed Forces still use them for mass inoculations.
Injecting whatever is on one's skin past it never did sound like a grand idea, adding in cross contamination from other service members, plus whatever else gets picked up by liquid residue on the spray jet, yeah, a real niche market.

It didn't stop Star Trek from sticking with it though. ;)

That last one's probably your doom, Fendelsworth. If you don't remember SPEWS, I do.

Does anyone know why all vaccines don't have an oral variety?

Is there some kind of fundamental reason why intramuscular injections are more commonly used?

Unlike some people here, I don't like to be penetrated.

That's simple, Richard Clarke #85. Digestion.
As in, digesting the proteins, thereby rendering them useless for producing immunity. Add in, the difficulty in presenting those proteins (before they end up being digested) to the immune system so as to trigger an immune response.
Only some vaccines have a live, attenuated virus counterpart. Measles, mumps, rubella, tetanus aren't oral, as none of those infections are orally spread. It's conceivable that hepatitis A might be made into an oral form, just maybe, as we don't want to give the infection to someone that we're immunizing someone against.

And no, I'm not big on being penetrated, but I also loathe getting a disease that I could trivially avoid by taking a vaccine against it.
Indeed, the yellow fever vaccine makes me feel quite ill the very day that I receive it. But, nowhere as ill as yellow fever makes its sufferers.
Trust me, I've treated them.

Richard Clarke also has the distinct stench of socks. It boggles my mind how someone can spend so much time and effort to stay on sites dropping turds.

@Science Mom #87, perhaps, he has no personal life to speak of?
At least, my excuse is, I work at night and work's slow. :)

@ScienceMom

I boggles my mind how you can write for a site with virtually no readership and no original content.

It boggles the mind how you can know the full readership of a site that you do not own and hence, lack the statistics to.
Tell me my IP, since you know so much about other people's sites.

@Wzrd1 Add in, the difficulty in presenting those proteins (before they end up being digested) to the immune system so as to trigger an immune response.
Only some vaccines have a live, attenuated virus counterpart. Measles, mumps, rubella, tetanus aren’t oral, as none of those infections are orally spread

So how is measles spread? Can you introduce an attenuated virus through that same route?

Ah, so you want a spray attack of measles upon the population?
Or are you going to paint it on every available surface? How do you control the dosage of a virus that's attenuated to the point where it cannot reproduce and hence, must have a measured dosage?
Magic?

@Wzrd1

Measles, mumps, rubella, tetanus aren’t oral, as none of those infections are orally spread

How are they spread? Do you know?

Measles, mumps droplet and fomite spread. Rubella, mostly droplets from coughing.
Tetanus, spread from contaminated soil, dust and manure into a break in the skin. That doesn't mean a rusty nail, but a break in the skin, more commonly a puncture wound, such as a splinter.

Oh, got a meeting, once done, gotta take my wife to her surgeon for followup.

Measles: Airborne, spread through an infected person coughing and sneezing.
Mumps: Person-to-person through respiratory droplets, as well as through direct contact with saliva of an infected person. Airborne.
Rubella: Airborne. Transmitted by breathing in droplets that are sprayed into the air when an infected person sneezes, coughs or talks.
Tetanus: A person usually becomes infected with tetanus when dirt enters a wound or cut.

I boggles my mind how you can write for a site with virtually no readership and no original content.

Then why bother commenting under other peoples' 'nyms with your vile filth? Surely you can find healthier outlets for your teenage fantasies.

OK. Now what is preventing attenuated vaccines being atomized up the nose?

This is the natural route of entry, yes?

Is there some esoteric reason why this will not be effective?

So, does that mean that we should administer tetanus toxoid via railroad spike?
Maybe we'll get a vampire to deliver the rabies vaccine.

@Ms. Mia Wallace: The problem is that you need a much larger viral load for the nasal route. And you types are all "too many toxinzzzzz!" The MMR vaccine allows us to give a minimal viral load needed to induce antibodies. And, as we've found from the nasal flu vaccine, at this time, nasal vaccines aren't as effective as injected vaccines.

So would you prefer a much less effective vaccine but no injection? Or a much MORE effective vaccine via injection?

Déjà vu all over again, part deux: Yet another Internet survey on vaccinations

oracknows — Mon, 21 Dec 2015 05:30:42 +0000

Déjà vu all over again, part deux: Yet another Internet survey on vaccinations

One of the best things about blogging is that I don't feel obligated to cover a topic completely in one post because I know I can always write another one or revisit the topic later. It also allows me to look at what I like to call "variations on a theme" of various kinds of quackery (or anything else, for that matter). View this as a post looking at one such variation on a theme.

The theme this time is the tendency of antivaccine activists to demonstrate their utter cluelessness when it comes to designing clinical studies. This cluelessness virtually always manifests itself in the frequent call by antivaccine quacks for what they seem to view as the Holy Grail of evidence to "prove" that vaccines cause autism, other neurodevelopmental disorders, sudden infant death syndrome, asthma, diabetes, autoimmune diseases, and just about any other chronic condition you can think of, namely the so-called "vaxed/unvaxed" study. The reason they seek such a study is because it is an article of faith among the antivaccine movement that vaccines are degrading the health of our children, making them the "sickest generation ever" and causing all the aforementioned conditions.

As I mentioned the last time I discussed this, years ago (and sometimes even now) antivaccinations would call for an actual randomized, double-blind, placebo-controlled "vaxed versus unvaxed" clinical trial. Of course, as I mention every time this topic comes up, antivaccine activists appear to be completely ignorant of the concept of clinical equipoise, which renders such a trial completely unethical and therefore undoable, at least in developed countries with actual laws protecting the welfare of clinical trial subjects, particularly children. Remember: Clinical equipoise means that there must be genuine uncertainty over which group in a clinical trial is receiving the superior treatment, and there is no doubt that leaving one group of children unvaccinated leaves them susceptible to vaccine-preventable diseases and thus does them harm. That's why doing such a trial would be completely unethical and we have to rely on the accumulated knowledge from epidemiological studies to determine whether vaccines are causing adverse outcomes.

Some antivaccine activists have realized that there’s no way a randomized clinical “vaxed vs. unvaxed” trial will ever be done. Grudgingly (and I do mean grudgingly), they accept that virtually every other physician does; so they try to find evidence of vaccine harm that they so desperately seek in other ways. Most recently, it was a survey whose purpose was so incredibly obviously antivaccine that it was even more risibly pathetic than previous efforts, such as J.B. Handley's vaxed versus unvaxed phone survey and a hilariously incompetent survey by a German homeopath named Andreas Bachmair for VaccineInjury.info, both of which were presented as showing that unvaccinated children are healthier than vaccinated children and both of which showed nothing of the sort. This time around, it's a "study" being promoted by the surprisingly honestly named Vaccine Resistance Movement (VRM) called the VRM Autism Study. Not surprisingly, this new antivaccine "study" follows the long, dishonorable tradition of horribly designed and outright incompetent "studies" done by antivaccinationists since time immemorial (at least to me).

I'll show you what I mean.

Whenever a clinical trial is designed there are several important things that need to be prespecified. To put it simply, you need:

Hypothesis: What is the question being asked?
Inclusion criteria: What subjects will be included and why.
Exclusion criteria: Which subjects will be excluded and why.
Primary endpoints: What is/are the most important specific endpoint(s) you are comparing between the control group and the experimental group? How will it/they be measured and defined?
Secondary endpoints (optional): Additional things you want to compare.
Protocol: What specific treatments and procedures will subjects undergo? In the case of observational studies: What specific observations will be made on each group?
Sample size: How many subjects will you need in each group to have a reasonable chance of producing a statistically significant result?

Now, to be fair in the case of pilot observational studies, the need for a specific hypothesis can be somewhat less critical, as it can be quite possible to do such studies as a "hypothesis-generating" study. Even so, you have to have some. So does the VRM study specify these key variables? What do you think?

Let's take a look at the VRM announcement of its study on its Facebook page:

The purpose of this worldwide study is to determine the incidence/rate of autism amongst those unvaccinated children & adults surveyed. We are also concurrently tracking the incidence/rate of autism amongst those vaccinated children & adults surveyed; cross-referencing dietary factors, pre-existing medical conditions/allergies, family health/vaccine history (multiple generations), breast/bottle feeding, We hope to gain new insights into the causality & manifestations of autism with an exhaustive, scientific approach.

"Scientific approach." You keep using that term. I do not think it means what you think it means.

Elsewhere, VRM declares:

It is our goal, through this study, to determine an accurate percentage of those unvaccinated autistic children & adults vs. those unvaccinated children & adults who have not become autistic. Essentially what we are trying to identify is the healthy trend in unvaccinated children & adults.

OK, fair enough—on first glance. The devil, as always, is in the details. That's something that's true of any sort of science. How does VRM plan to measure these percentages? Well, that's where the big problem is. As was the case with all the previous studies I've discussed, apparently VRM thinks that an Internet survey is a valid way to collect data that can be used to up with accurate estimates of the prevalence of autism:

Just to clarify this study is open to EVERYONE. The absence of autism in your family/household or the fact you haven't vaccinated your children does not preclude you from taking part in the study. The control parameters are wide open this time. All the data we receive will be pertinent in determining the paths that lead to autism. VRM will be continuing to collect your invaluable data for as long as possible. That being said we still encourage everyone to enroll in the study while it's openly available.

And:

In order to guarantee accuracy of the data acquired study participants must allow for access to family medical records (*Note: only in cases where autism has occurred). This disclosure will be entirely confidential in nature and at the discretion of the study organizers. Any shared information will be used strictly to confirm an autism diagnosis. No data beyond that which the family agrees to disclose shall be included in the study results.

All participants in this study will be designated a number to assure complete anonymity. Any sensitive information including family names, personal references, e-mail addresses etc will be inaccessible to the public. Only study administrators will be privy to access. Contact will remain exclusively confidential between participants & VRM. At any time a participant may withdraw from the study group; whereupon their data will be returned to them and/or destroyed.

Out of curiosity, I took a look at the survey that VRM was using. As you can see if you take a look yourself, this "study" (such as it is), it's yet another example of bad experimental design coupled with bad survey design. Take a look:

Category of Participant (choose one selection):

Received standard vaccinations (full schedule of shots) between 0-7 years; also officially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (full schedule of shots) between 0-7 years; no official diagnosis of Autism Spectrum Disorder
Received standard vaccinations (partial schedule) between 0-7 years; also officially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (partial schedule of shots) between 0-7 years; no official diagnosis of Autism Spectrum Disorder
Received standard vaccinations (full schedule of shots); also officially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (full schedule of shots); no official diagnosis of Autism Spectrum Disorder occurring
Received standard vaccinations (partial schedule of shots); also officially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (partial schedule of shots): no official diagnosis of Autism Spectrum Disorder occurring
Received standard vaccinations (full schedule) between 0-7 years; also suspect/unofficially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (partial) between 0-7 years; also suspect/unofficially diagnosed with Autism Spectrum Disorder
Received standard vaccinations (full schedule of shots); also suspect/unofficially diagnosed with Autism Spectrum Disorder
Received no vaccinations whatsoever between 0-7 years; also officially diagnosed with Autism Spectrum Disorder
Received no vaccinations whatsoever between 0-7 years; no official diagnosis of Autism Spectrum Disorder occurring
Received no vaccinations whatsoever between 0-7 years; also suspect/unofficially diagnosed with Autism Spectrum Disorder
Received no vaccinations whatsoever; also officially diagnosed with Autism Spectrum Disorder
Received no vaccinations whatsoever; no official diagnosis of Autism Spectrum Disorder occurring
Received no vaccinations whatsoever; also suspect/unofficially diagnosed with Autism Spectrum Disorder

In clinical trials and observational studies, it is absolutely critical to define one's terms. What does VRM mean by "partial schedule of shots"? It's not defined. Then, later on, the survey lists the individual vaccines and when the person received them. Of course, anyone should be able to see another problem here. This survey includes "ALL AGES." The vaccine schedule has changed significantly over the years, as new vaccines were added and the recommended timing was changed over the years. So what it means to receive a "partial schedule of shots" will be very different depending upon how hold the subject is.

That's not all (of course). Later in the survey, the subjects are asked for "pre-existing medical conditions/genetic predisposition." The list includes a veritable laundry list of conditions that antivaccinationists consider to be "predisposing" to autism, including mercury amalgams, "medicated childbirth" (e.g., induced labor), antibiotics, and more. Elsewhere, under dietary history, the subjects are asked, for example, if they:

dairy-rich diet
use margarine regularly
use Crisco regularly
eat junk food regularly
eat fast food regularly
avoid junk food
avoid fast food
use corn syrup regularly
use fructose regularly
avoid fructose
meat-eater
vegan
vegetarian
semi-vegetarian
eat strictly organic food
eat non-organic food
eat soy products
regular alcohol user
recreational drug user
heavy drug user
regular caffeine user
drink pop regularly
consume Aspartame containing products
avoid Aspartame containing products
drink from plastic containers
avoid using microwave in cooking
avoid Genetically Modified Foods/GMO
do not avoid Genetically Modified Foods
Sodium Fluoride in toothpaste/drinking water
frequent cell phone user
work in front of computer

There are more—oh, so many more—examples listed. I simply chose some of the sillier ones. Let's just put it this way. The survey is so vague as to be meaningless. After all, most people don't even know what is and isn't a "genetically modified food," and there's no evidence that GMOs are associated with autism.

As with all these antivaccine vaccinated versus unvaccinated"studies," the key problem (besides the undefined hypothesis and endpoints) is that the subjects are self-selected. More than that, they're self-selected from people who tend to be antivaccine and learn about such surveys through antivaccine websites and Facebook pages. Add to that the multiple comparisons, and the "researchers" (and I do use that term very loosely) are virtually guaranteed to find all sorts of spurious associations. They'll be meaningless, of course, because the methodology is so poor, so utterly lacking in anything resembling valid methods. None of this stops antivaccine groups, though. They forge boldly ahead into the depths of pseudoscience in search of "evidence," no matter how risibly bad, that vaccines cause autism.

Seeing such perversions of science, I sometimes wonder if scientists should just do a large epidemiological study of vaccinated versus unvaccinated children, if only to shut antivaccinationists up and shut down studies like this, even though such a study would be expensive and require a lot of subjects. (Also, there are no compelling preliminary data to justify such a study.) Then I remember how antivaccine activists react to negative studies. They ignore them or attack them as fatally flawed, usually due to "bias" or—of course!—the influence of big pharma. Scientifically pandering to antivaccine loons achieves exactly nothing. Unfortunately, that means we're likely to continue to see such epically silly self-selected Internet polls masquerading as research.

And don't even get me started on where the Institutional Review Board approval is for this VRM "study," given that it says that participants are giving the VRM permission to examine their medical records.

oracknows Mon, 12/21/2015 - 00:30

Tags

autism

Vaccine Resistance Movement

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http://www.fda.gov/Radiation-EmittingProducts/ResourcesforYouRadiationE…

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Medicine

the “researchers” (and I do use that term very loosely) are virtually guaranteed to find all sorts of spurious associations

They are even more likely now. I appear to be the parent of a completely unvaccinated autstic child, but I have done everything right. I am a vegan meat eater who avoids GMO food, margarine and Crisco, doesn't cook food in a microwave. So what have I done wrong?

@Chris Preston,
Unless there is a medical contraindication to vaccination, the mistake you made would be not vaccinating the kid.

And, from the State of Montana, with the highest rate of pertussis per 100,000 in the US (per the CDC for 2014), comes this *lovely* abomination of a science fair project--the results of a horrible survey process and failure to disclose that at least one parent of the child is an anti-vaccine chiroquacktor: https://www.facebook.com/nicolebulick/posts/10153102601215728

@ Chris #3
Many moons ago, when I was in graduate school, I was asked to judge a 5th grade science fair. To my surprise, there was a shining example of a well-planned, hypothesis-based epidemiological survey study, including very basic statistics. Granted, the study group was too small, but that's a given considering the venue. The hypothesis was that babies who stayed home with mom (and had siblings in school) would have fewer ear infections requiring the use of antibiotics. She disproved her own hypothesis. I checked, and the parents were a banker and a stay-at-home mom who had been trained as an accountant. I always wondered what happened to that kid.

I participated in the survey. I told the truth. Family history of fully vaccinated, caffeine swilling, aluminum pot and microwave using (not together), take drugs as prescribed family of insanely healthy people. My parents lived to be 93 and 95 respectively. We do tend toward bad teeth despite fluoridated water so, yeah, lots of amalgam.

Orac mentions Handley's BS survey and the ((shudder)) German study but I think I have another anti-vaxxers' study which hasn't received insolence- respectful or not ( 'not' is probably more apropos)- as of yet and that is ( ahem!)-
TMR's Ion footbath de-tox study-
in which they compared pre- and post- footbath ATEC scores as rated by mothers or suchlike.
The TMs discussed results in their "recovery" panel at Autism One.
I can't seem to find ore about it at TMR- perhaps it's hiding itself in shame.

*Et voila!*
it's
The Thinking Moms' Revolution Study - IonCleanse by AMD Treatment Effectiveness for ASD
July 17, 3915.

As soon as I got to the "access medical records", my first thought was, "Okay, so did this get IRB approval?" Orac confirmed by thoughts: "IRB approval? We don't need no stinkin' IRB approval!"

@Denice: Oh, I remember that one. I thought about blogging it , but there were other things that interested me more, even though it would have been fun to take a look at.

Right.
I am trying to imagine by what mechanism they can so utterly *transforms* scores

Clean feet lead to self-control?
Less toxins lead to better communication?
Less metal leads to more rhythm?

-btw- please disregard the typos above .

I do wonder how they will get the medical records without IRB approved HIPPA waivers.

I've worked on projects that collected medical records and most places are really particular about those forms. We had a number of catch 22 scenarios that would have been funny if they weren't so painful. Too soon, too too soon, shudder.

work in front of computer

I work in front of a couple of different computer screens during the average day, with the computers themselves generally within 2-4 feet of me but facing either towards me or 90 degrees away from me (not that the survey suggests which direction might be the most risky). Actually, the majority of computers I work on are separated from me by either half a town or two brick walls and multiple sacks of mildly EM-absorbent meat (otherwise known as my colleagues), and some computers are ones I even work from behind rather than in front of.

It's almost like the questioner doesn't have a clue. What is the risk factor for computer work anyway? Bad posture?

It’s almost like the questioner doesn’t have a clue. What is the risk factor for computer work anyway? Bad posture?

Radiation, of course!

Actually, I never quite figured out why, when I was little, they used to tell us not to sit to close to the television. But, as it was the 60s, I'm going to stick with radiation.

@ Rich Woods:

Seriously. If the so-called risks cited by woo-meisters/ anti-vaxxers had any relation to reality, I'm sure that most of us would be long dead.

A case in point, we're always being told about how DEADLY dairy is- yet all of the long-lived members of my own families were dairy consumers as are the people who live in the Netherlands/ Norway who both seem to lack neither longevity nor height.

Most of the products they fear are signs of technology and affluence which do influence health and longevity.

But I believe that the major risk about computers is reading swill and crap about health risks.**

** although some of the loons I monitor go to great lengths to get their followers to avoid microwaved food, cell-phones, computer usage, wifi exposure, exposure to plugged in appliances during sleep etc etc etc.

As an epidemiologist just the description had me shaking in a froth of semi-coherent rage. Just the categorization of subjects alone was enough to make me break down. GIGO - garbage in garbage out. I'm going to drink my tea now and wait for cold medicine to kick in while pointedly not thinking about bad survey designs.

As an epidemiologist just the description had me shaking in a froth of semi-coherent rage.

Sorry about that... :-)

To be fair, the kind of undefined terms terms in this survey are typical of just about every survey I ever run across – mostly market research stuff, some public opinion.... 'Social science' surveys are only sometimes slightly better, often just as bad. The 'researchers' need to have response categories they can measure, and can only create these categories as abstractions that inevitably distort the complex nature of reality.

What strikes me about the survey items Orac included in the OP are the number of possible responses. If these are typical of the survey as a whole, that would make completing it a fair bit of a chore. Combine the effort involved, plus the need to disclose medical records, with the self-selection and the means by which the participants are being recruited, and imho that obviously skews the 'sample' big-time. Sample validity is not just a matter of size: even if a survey is presented to randomly selected subjects, and a 'statistically significant' number of responses are gathered, there's the possibility that the subjects who fail to complete the survey would have given very different responses from those that do. So who is going to have enough interest in vaccines-and-autism to bother with taking the the time to fill this out? Parents of unvaxed healthy kids, yes. Parents of vaxed ASD kids, yes. Everybody else, not so much. Obviously, I can't say the study designers had this in mind, but regardless of how the questions are phrased, it appears the very length of the thing all but guarantees the VRM of getting what they want – a much higher percentage of unvaxed 'healthy' vs. vaxed 'damaged'.

AntiVaxxers push for the usual fishing expedition, casting impossible wide nets. The results will predictably be other cases of insignificant correlations.
If I can dissent from Orac's opinion, I am sure that a well conducted survey will show that unvaxed children are healthier than vaxed ones. But not for the reasons Antivaxxers like to believe.
The real reasons are the social class differences : children of rich families are healthier than children belonging to poor families.
http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-prim…

And Antivaxxers concentrate in wealthy classes, as Orac showed some time ago. In USA as well as in Italy: a study in Verona area showed the same trend.
http://prevenzione.ulss20.verona.it/indagine_scelta_vaccinale.html

"Actually, I never quite figured out why, when I was little, they used to tell us not to sit to close to the television. But, as it was the 60s, I’m going to stick with radiation."

I was going to write a response to this, then decided to do a search first. It seems the FDA already answered the question, quite nicely IMO.

Hopefully that URL comes through okay.

I participated in the survey. I told the truth.

I considered doing that, but felt that including healthy, fully-vaccinated children in the survey was going to mess with their data less than a fictitious unvaccinated, autistic child.

This is a pre-emptive strike for when the results of the survey get touted around.

avoid microwaved food, cell-phones

I have never microwaved a cellphone but now I want to try.

"The control parameters are wide open"
Lol.

It is our goal, through this study, to determine an accurate percentage

Oh, my sainted aunt. This bunch wouldn't know accurate if it bit them in the assets.

does everyone get a gold star for participating?
it's usually a mandatory req for every chronic lyme fatigued soccer mom's little genetically predisposed but vaccine injured autistic superstar!

sorry...scotch on

RE: Chris @ #3

More proof that half vaccinated children are sicker than fully vaccinated.

It appears the child learned statistics and epidemiology the same way as his father the chiropractor (as in not at all). I want so badly to post on that facebook page. I stopped myself realizing it is pointless.

And in what town does someone actually know of 18 fully unvaccinated children who aren't infants...........wait a second! Where in the data is average age?

Capt

@Chris Preston
Have you heard anything from them asking about medical records? I'm super curious what their procedure is for confirming autism diagnoses through medical records.

This disclosure will be entirely confidential in nature and at the discretion of the study organizers. [emphasis mine]

What are the chances only unvaccinated autistic children need confirmation?

VRM's site is registered in the US. Depending on how disclosure is handled couldn't HIPAA violations make this whole thing quite illegal? Are there formal research ethics laws that require IRB oversight in the US and how would one report such misconduct?

No wonder these antivax people feel entitled to dismiss research that contradicts their position. They seem to think research means cooking the books.

Depending on how disclosure is handled couldn’t HIPAA violations make this whole thing quite illegal?

HIPAA prevents other people from disclosing one's information, not oneself. The question becomes who has the ability to disclose the records of one's child, but I'm going to go ahead and guess – without research – that there's no real legal issue regarding this specific link in the chain.

Of course, a parent would have to be out of his or her fυcking mind to hand over PHI to some random cranks, and there could be downstream legal consequences that may inure to the child, but that's rank speculation by comparison with the guess.

It does not change the fact that we will never ever have conclusive evidence on how the vaccines impact the human body.long term until it's actually done. It will always be a mystery. No matter how much you want to spin this. Epidemiological studies are weak.

That's not science based medicine. That's faith based

Sorry folks

THEO: "It does not change the fact that we will never ever have conclusive evidence on how the vaccines impact the human body.long term until it’s actually done."

So no one has figured out the detrimental affects after two hundred years of vaccine use? Wow, that is so horrible. It must be so terrible that so much fewer people do not get pneumonia, tetanus, diphtheria, measles and polio!

It is like someone has never looked into the changes during the twentieth century.

Epidemiological studies are weak.

That’s not science based medicine. That’s faith based

Sorry folks

This is quite ironic coming from a supplement peddler.

I vaguely recall that I was told not to sit too close to the TV to avoid eyestrain. How common that idea was, I don't know, but I had reading glasses when I was eight, so my parents may have been more worried about my eyes than the parents of children with better vision.

https://images.duckduckgo.com/iu/?u=http%3A%2F%2Ftse1.mm.bing.net%2Fth%…

"You've had your precious bodily fluids impurified as well? MY GOD!"

So no one has figured out the detrimental affects after two hundred years of vaccine use?
Chris

Of course we have thats why they are being rejected by a growing movement of people and physicians all around the world. Suspicion has been growing for a long time, now the science is proving they do harm.

Look no matter how you approach this issue there is no control group to compare too in the scientific literature anywhere!
How can science be conclusive without the placebo control?

It cant. for that reason it will always remains suspect. and to accept this as science is cognitive dissonance and intellectual cowardice.

http://ottawacitizen.com/news/local-news/vaccine-hesitancy-persists-amo…

Have you heard anything from them asking about medical records? I’m super curious what their procedure is for confirming autism diagnoses through medical records.

Well I don't know for sure, but the material on the website seemed to indicate that they will ask the parents to provide the records - by contacting them through e-mail.

No they don't have an IRB, which means that the data will be nonpunishable due to ethical reasons.

THEO, my JAMA article beats your newspaper online survey article. Your appeal to popularity fails because "one in four" is not a majority, especially when it is a specific demographic in one province of a developed country with a good public health system.

Please explain why an average lifespan of almost 80 years is worse that an average lifespan almost 50 years. Could you provide something a little more scientific than an online newspaper survey?

@rs #19

The link came through fine:

It should be emphasized that most TV sets have not been found to give off any measurable level of radiation, and there is no evidence that radiation from TV sets has resulted in human injury.

Narad@29

HIPAA prevents other people from disclosing one’s information, not oneself.

I thought HIPAA included requirements that organizations must meet (i.e. having a privacy officer). I was just looking at this HHS site though and it doesn't look like they would be a covered entity.

It should be emphasized that most TV sets have not been found to give off any measurable level of radiation, and there is no evidence that radiation from TV sets has resulted in human injury.

Part of this statement is false. Televisions give off very measurable amounts of radiation. It's called 'light'.

The part about no evidence of harm to humans is correct, as far as I know.

The part about no evidence of harm to humans is correct, as far as I know.

There is mental damage from that visible radiation, though.

The part about no evidence of harm to humans is correct, as far as I know.

That reminds me of a story. I think it was my third year in college, and I had a roommate in a two-room double. The front room contained an old console TV that basically required somebody to sit behind and adjust the gun controls on the fly if anybody else wanted to watch a movie.

At some point, I naively came up with the idea of turning it into a fish tank, which was met with general approval. This of course necessitated the removal of the CRT faceplate. Which, in retrospect, turned out to be bonded.

There were three of us – me, my roommate, and one decidedly amazing senior who was also a physics major.* So we pulled the tube and put it on a folding lawn recliner. In the same room.

The only obstacle seemed to be the metal band "holding on" the faceplate.** Slowly but surely, this was pried off. The tiny bits of glass occasionally coming with it seemed irrelevant to the goal of obtaining the front for the tank, because after all, they were coming from the side and it really was almost nothing. I was wielding the pliers.

It held until about a third of the way around. After the inevitable, my roommate was inexplicably found in the closet (I mean, implosions happen rather quickly), I was unharmed, and the senior only needed a butterfly on his right temple.

The only explanation I can come up with for the minimal injuries is that the thing was face-down. But it was in 1/16 inch pieces and under.

Good times.

* I'd give my bottom dollar for the pillowcase he decorated early on in a graduate GR class.
** Yes, the tension band.

Over at the other side (yes I have been slumming at AoA again), there is a mad, mad post about the so-called No jab, No pay laws in Australa. Apparently, these are all due to the fact that the Australian Technical Advisory Group on Immunisation did not front the Senate public hearings where their conflicts of interest could be exposed (never minding the fact that the conflict of interest declarations are on a public register).

Somehow this means the same laws are going to pass in the US.

For those still attempting to follow, Australia has a famiy tax rebate that is paid as an incentive to vaccinate. Those with medical exemptions to vaccination can get the rebate, but the new laws will forbid those with personal objections from receiving it if their children are not vaccinated. So far as I am aware, there is no comparable scheme in the US, so the Australian law cannot flow over to the US.

This demonstrates once again that logic has no place in the world of anti-vaxxers.

Orac writes,

I sometimes wonder if scientists should just do a large epidemiological study of vaccinated versus unvaccinated children...

MJD says,

More specific to regressive autism, a proteomic investigation of B-Lymphocytes in vaccinated verses unvaccinated children with an autism spectrum disorder.

We can seek funding through the Bill & Melinda Gates Foundation after forming a non-profit. organization named Caro.

You interested Orac?

@ Vicki #33

I vaguely recall that I was told not to sit too close to the TV to avoid eyestrain.

Me and my sister were told as much, and ditto we were both already wearing prescription glasses. The minimal distance was supposed to be about 3 times the screen's size.
We had the old type of low-res, cathodic TV screen by then; there may be some basis in the warning, but it may not hold true for modern plasma screens.

@ MJD,
Frankly I don't know why our esteemed blog host here continues to put up with your senseless drivel.All I can think of is that you amuse him.Much the same way a dead cockroach will amuse a cat for a few minutes.But it does get old and wear thin.I really need to learn how to use killfile here.

Antivaxers like MJD pretty much have built in firewalls that would make most computer security experts jealous.Firewalls that successfully filter out anything that contradicts their preconceived world view,and makes them incapable of learning anything new.I for one am sick of it.But I am going to make one last attempt with MJD,as he has brought up b-lymphocytes.Something I know a good bit about,having been diagnosed with a primary immune deficiency that involves both b and t-lymphocyte deficiency.

Regressive autism is usually either immune based, mitochondrial,or some of both,like I have.Meaning a primary immune disease,with secondary mitochondrial dysfunction.Or the other way around.Both types of diseases are inherited,specifically from the mother.I am not talking about a simple genetic predisposition here.I am talking about children who slide out of the womb already sick with serious diseases.Children who would suffer far more damage,or even death, from diseases like measles or chicken pox than they could from any vaccine.

I would not have even posted a reply to MJD,had I not just found this little blog.This is on the web site of a lab that is developing immunological screening tests for women who wish to become pregnant.It provides very straightforward,simplified explanations of how immune based forms of autism are passed from mother to baby during pregnancy.Please share.Note the entry on folate receptor autoantibodies,which I have lots of,and both kinds.Also note the post debunking Wakefield and vaccines.We are entering a real revolution as far as understanding inherited causes of syndromic and regressive autism.The last thing we need is a bunch of confused antivaxers spreading scientifically addled half-truths and outright lies.

Please explain why an average lifespan of almost 80 years is worse that an average lifespan almost 50 years. Could you provide something a little more scientific than an online newspaper survey?

Chris

I agree vaccines played a role in life extension. But not nearly as much has plumbing, sanitation, access to doctors, abundant food supply and refrigeration.

Do you really think Vaccines were the only reason? Not even close.

My question for you is how can you have so much confidence when there are no control groups ? Why is that unreasonable? and Why are 25% of canadiens still on the fence? Something is not right in the whole story. And if you cant see it thats your problem not OURS. Its called lack of judgement and enough information.

http://www.organiclifestylemagazine.com/how-plumbing-not-vaccines-eradi…

Do you really think Vaccines were the only reason? Not even close.

Ah, but plumbing and sanitation WERE the only reason, right? Not even close.

No amount of plumbing and sanitation can prevent measles, rubella (German measles), pertussis, etc. They're called airborne for a reason. Unless you're lumping air scrubbers and bio suits into "plumbing and sanitation," there's no way that those diseases would come under control without vaccines.
Or, what, you can wash the air? (Measles virus stay suspended in mid air for up to eight hours.)

How exactly does "plumbing" have any affect on airborne diseases?

Roger Kulp says (#45),

We are entering a real revolution as far as understanding inherited causes of syndromic and regressive autism.

MJD says,

A spectrum disorder such as autism may contain subgroups having dissimilar etiology.

In the absence of a definitive etiology based on genetics, environmental factors that may adversely affect the progression of regressive autism need to be researched. (e.g., forced immunity)

Do you really think Vaccines were the only reason? Not even close.

Where did anyone claim that vaccines are the only useful public health intervention? Of course they are not. Better sanitation (to large extent) reduced infant mortality from more than 30% before 1900 to 3% in 1950, better medical care, including vaccinations, reduced it further to 0.6% as it is today (in the developed world). Would you really be happy if 3 out of 100 children still died in infancy?

Yeah THEO I am calling BS. All of you anti-vax types seem to think you are so much healthier. I wonder how you explain countries like India where the sanitation is highly suspect but still they have seen many gains in life expectancy from vaccination. I want to know how these guys are counting 'healthier'. I imagine all of these parents are saying their snowflakes are definitely healthier, they eat all organic non-GMO food, no vaccines, no antibiotics, lots of exercise, boatloads of supplements, they are fantastic! I wonder what the kids will say. We just saw anti-vax mom who let all three of her kids suffer for 3-4 months with whooping cough (coughing until the vomited and turned blue, not sleeping through the night) while she forces them to continue their daily activities. But they got through with no evil medicines! Of course I wonder what these kids will think when they find out they didn't have to suffer like that. Or suffer through chickenpox. I've had it. Not fun. 2+ weeks of misery I spared my child from with the vaccine. Also had shingles. Not fun. Pain that I rank up there with childbirth which I've done twice. Something else I would spare my child from. We've seen kids raised anti-vax say the same thing over and over. How sick they were. How awful it was. But the parents would rate them as healthy. Wonder what the kids think about it. I for one will go on sparing my child pain, misery, and possible death thank you very much.

I couldn't resist answering the study although I was honest. I have a digustingly healthy kid who received all his vaccinations as did his parents and none of us have any serious health problems. We live where there is not flouridation and we couldn't afford a microwave when he was young. I concur that the study is meaningless. Not to mention no informed consent, no purpose except for the pretty obvious one of "proving" that vaccines are wrong/unnecessary. I sit on an IRB. This would never get through, which of course is the point. Not to mention that a self-reported, non purposive sampling would never provide accurate results.

I thought HIPAA included requirements that organizations must meet

Based on recent experience, no IRB* will green-light human subject research that is not able to demonstrate a couple of layers of data protection, starting with CITI training for everyone involved in conducting the study.

*no IRB that's at all interested in doing it's job properly, that is.

I've decided I agree with THEO. If more than 20% of Canadians are uneasy about any statement (as measured by a poll), then that statement is necessarily false. Anyone who says otherwise suffers from lack of judgement and enough information.

THEO@46

But not nearly as much has plumbing, sanitation, access to doctors, abundant food supply and refrigeration.

Because in the fifties people ate rocks and drank mud and emptied their bedpans right onto the dirt streets? This always struck me as either one of the dumbest or most dishonest antivax arguments. Then again, most antivax strike me as the dumbest or most dishonest so...

I’ve decided I agree with THEO. If more than 20% of Canadians are uneasy about any statement (as measured by a poll), then that statement is necessarily false. Anyone who says otherwise suffers from lack of judgement and enough information.

In addition, articles in Organic Lifestyle Magazine written by college students are more accurate than the academic medical literature with regard to the causes of infectious diseases.

THEO: "Do you really think Vaccines were the only reason? Not even close."

Where did I say that? Perhaps you should try getting someone to explain the article I posted to you. Perhaps they can explain to you words like "dysentery" and "syphilis."

"My question for you is how can you have so much confidence when there are no control groups ?"

Control groups for what? Like the ones they used for vaccine studies at institutions like Willowbrook?

"Why is that unreasonable? and Why are 25% of canadiens still on the fence? Something is not right in the whole story."

R..i..g...h...t. Here is what is not right about that whole story, it is in the paragraph of that article you posted: "Results of the online randomized survey of 1,000 Canadian parents of children under five..."

Wow, a thousand people that speak for all of Canada. And it was an online survey.

Then there is some clarification later: "The survey was led by Josh Greenberg, director of Carleton University’s school of journalism and communications."

So the problem that is being identified is one of communication. Unfortunately a minority of parents seem to be confused when reading idiocy like the stuff you post.

"And if you cant see it thats your problem not OURS. Its called lack of judgement and enough information."

Oh, the irony. You clearly could not read the JAMA article I posted with any kind of comprehension, and throw out credulous news articles like they actually reflect reality.

The thrust of the argument is that vaccines are only compared to themselves in scientific studies. Only this medical procedure gets a pass? Becuae its child abuse and immoral to not vaccinate? That is not science that's bullshit and all of you know it no matter how much spinning you want to do. You will never know what the real side effects were. Which kids were sensitive and which ones were not. Seriously what a crap shoot playing with people's children like that. Of course we have a good idea and plenty of science to back us up and we will gladly band together and refuse your needles. And spread the message you don't need to polute your kids with this crap. Trust your innate immune system its superior to pharmaceutical mysticism. Just think about it for a second exactly how is your delicate immune system system being reprogrammed from infancy with this onslaught? I said it here before sure a few vaccines I would be ok with but this schedule is ludacris and we don't understand poly pharmacy or polyvaccine. Ina world where we are trying to avoid toxins the medical authority is happy to pump you up as soon as you get out of the womb. It's disgusting. Proud anti vaxxer

THEO: "The thrust of the argument is that vaccines are only compared to themselves in scientific studies"

Well then, if you don't like the studies that have been done, including the massively huge one done with placebos for polio in the 1950s, then do it yourself.

Sit yourself down and design the vaccine study to end all vaccine studies. Make sure it complies with the Belmont Report and gets approved by an IRB. Then write a grant to submit to SafeMinds, the Dwoskin Family Foundation, Generation Rescue, Autism Speaks, etc. Then go do it!

"Trust your innate immune system its superior to pharmaceutical mysticism."

Oh, do tell us your proven method of avoiding the assault to the immune system by measles. An article a while ago on this blog discussed how a measles infection suppresses the immune system for years, making it more probable that a child will succumb to some other infection.

"Just think about it for a second exactly how is your delicate immune system system being reprogrammed from infancy with this onslaught?"

Do you children live in a sterile bubble? How do the small number of antigens in the vaccines compare to the cloud of microbes you encounter every moment of every day? That argument is just about as bad as thinking "one in four" is a good argument from popularity.

Trust your innate immune system its superior to pharmaceutical mysticism.

But only in the presence of adequate plumbing, apparently...

@theo

Why should we believe a known liar and someone with a clear COI like you? You'd profit from peddling your worthless cures to sick children, why should anyone believe you?

Also, how'd that innate immune system work for the native Americans when the European explorers got here?

THEO@58
Backing off from the vaccines didn't save us lie, are you?

The thrust of the argument is that vaccines are only compared to themselves in scientific studies.

Untrue. Heck, even the Francis Field Trial of the Salk vaccine was placebo controlled. Despite what you hear in your echo chambers, vaccines go through the same approval process as other drugs.

Trust your innate immune system its superior to pharmaceutical mysticism.

No no no. No. What is so magical about natural immunity? There's not seperate immune systems for vaccines and diseases. You mount the same response for both. That's kind of the point.

Plus natural immunity doesn't help much if the disease kills you. You want to talk about delicate immune systems? Measels does a much better job wreaking havoc on them than MMR.

Trust your innate immune system its superior to pharmaceutical mysticism.

Tossing aside the adaptive immune system, eh? Shades of Phildo.

Just think about it for a second exactly how is your delicate immune system system being reprogrammed from infancy with this onslaught?

"Delicate"? Do go on.

Narad@63

Shades of Phildo.

IIRC, THEO is something of a Phillip Hills fanboy, no?

To THEO's credit, he seems to have fixed the problem with the capslock key his computer was having a while back. Maybe next he can get the Enter key fixed and give paragraphs a try.

THEO- If we didn't trust our innate immune system, we wouldn't use vaccines. Learn what vaccines are before you comment on them.

Lawrence says (#48),

How exactly does “plumbing” have any affect on airborne diseases?

MJD says,

If you have flatulence keep your pants on. :-)

http://blogs.discovermagazine.com/seriouslyscience/2014/08/27/farts-car…

Trust your innate immune system its superior to pharmaceutical mysticism

Gee, our inferior immune systems must have been the reason why, in a clean, prosperous, white collar suburb of Detroit in the 1950's and 1960's, my family of well-nourished, active brothers and sisters -- not to mention all of their friends and classmates -- came down with measles, mumps, and chicken pox.

Unfortunately, Theo's SWAG doesn't explain why none of their children, all of whom are fully vaccinated, ever suffered from the same diseases.

(possibly because three of the seven of us siblings are healthcare professionals, or maybe because none of us are kooks, all of my nieces and nephews are vaccinated).

Déjà vu all over again: Another Internet survey on vaccinations

oracknows — Tue, 24 Nov 2015 08:00:08 +0000

Déjà vu all over again: Another Internet survey on vaccinations

It is an article of faith among the antivaccine movement that vaccines are degrading the health of our children, such that vaccines cause autism, asthma, diabetes, and a number of other chronic diseases. You won't have to look far on most antivaccine websites to find claims that today's children are the sickest in history and insinuations, if not outright statements, that vaccines are at least part ofthe cause. If you've been following the antivaccine movement as long as I have (more than a decade) or even if you've only been following it one tenth as long, you are probably aware that one of the most common arguments trotted out by antivaccine activists is that there has never been a true study of vaccinated versus unvaccinated study, or "vaxed vs. unvaxed" for short. Early on, when I was writing about antivaccine activists, I would see calls for an actual randomized clinical trial of "vaxed vs. unvaxed." Indeed, three years ago, no less a crank luminary than Vox Day himself blamed vaccines for sudden infant death syndrome, and castigated the lack of such a randomized trial, producing rich fodder for an epic (and much-deserved) ranty takedown by yours truly.

Of course, the concept of clinical equipoise renders such a randomized clinical trial of vaxed vs. unvaxed hopelessly unethical right from the get-go. Basically, in clinical trials clinical equipoise demands that there be state of genuine scientific uncertainty in the medical community over which of the drugs or treatments being tested is more efficacious and safer or whether a drug being tested with placebo is better or worse than doing nothing. Without that genuine scientific uncertainty over which option being tested in a clinical trial is better (or at least less harmful), the trial cannot be ethical because investigators would then be knowingly assigning one group of subjects to a treatment known to be inferior, or at least strongly suspected to be inferior. One reason (among many) why a prospective randomized, clinical trial that intentionally leaves one group unvaccinated to determine whether vaccines cause autism (or whatever condition or disease the investigator suspects to be associated with vaccines) would be completely unethical is that it egregiously violates the principle of clinical equipoise. The unvaccinated group would be left unprotected against potentially life-threatening vaccine-preventable diseases, and that is completely unacceptable from an ethical perspective. Consequently, when it comes to studies of this type, we have had to rely on less rigorous trial designs to ask the question of whether vaccines cause various problems. While each individual trial of such types is less powerful and convincing than randomized clinical trials, the accumulated weight of such evidence can (and is) often enough. In the case of vaccines, it’s more than enough.

Some antivaccine activists have realized that there's no way a randomized clinical "vaxed vs. unvaxed" trial will ever be done. Many do not truly accept or believe that such a trial would be unethical, but they grudgingly accept that virtually every other physician does; so they try to find evidence of vaccine harm in other ways. For example, way back in the day, J.B. Handley and Generation Rescue did what was in essence a vaxed vs. unvaxed phone survey. Let's just say that it didn't show what J.B. Handley thought it showed, and, even if it had, its methodology was so poor that it was a meaningless study anyway. A few years later, a German homeopath named Andreas Bachmair conducted a hilariously incompetent survey that purported to find that vaccinated children are unhealthier than unvaccinated children. It didn't.

Yes, I've seen several epically incompetent attempts at "vaxed vs. unvaxed" surveys by antivaccine activists over the years. Yesterday, I might just have seen the most incompetent one of all, courtesy of Rashid Buttar (yes, that Rashid Buttar). who is promoting this survey:

The splash page of the website features a large photo of a girl being vaccinated, her mother holding her hand for support, emblazoned with the question, "Do vaccinations help or hurt my child?" Whenever you see a question like that on a website, a good rule of thumb is that you're probably on an antivaccine website, but let's take a look at how the survey is described:

One of the most controversial issues in society today is the issue of vaccinations. Evoking intense feelings, both sides of the debate are very passionate. Studies have shown evidence to support both sides of the debate. Each alleges the other side skewed the data or altered the results to show desired outcome. So what is the truth? Maybe YOU can help us in less than 2 minutes to find the truth for the benefit of all children on the planet!

Nope. Vaccinations are not "one of the most controversial issues in society today." Not even close. To the small cadre of dedicated antivaccine activists who fervently believe that vaccines are toxic and deadly, the equivalent of injecting toxic waste into children, maybe they're "controversial." To the scientific community, not so much. The overwhelming scientific consensus is that vaccines are both effective and safe, a consensus built upon considerable evidence.

Of course, it's incredibly silly to think that an uncontrolled Internet survey can reveal much about the state of health of vaccinated and unvaccinated children, but that doesn't stop whoever made up this site:

The following survey is a simple 11 question survey that will take you only 1 minute to complete (2 minutes if you read all the quotes, which we hope you do). Your information will be added to the data being collected and once submitted, you will be able to immediately see the results on a global scale, or just by your country if that is what you choose to view. Even better, you will be able to filter the data for specific criteria and see the results in real time.
Please remember, this is a world community project and we are dedicated to empowering the world, so that all of us can benefit from the truth and our future generations are provided with the maximum level of protection. Our promise to you is the following:

You will never have to pay a single penny at this site. This site is 100% FREE...no secret agendas!

You will never have to worry about your information being sold to anyone. Everything is strictly confidential!

You can be assured that the data you see at the end will be completely unbiased, with the sole agenda of discovering the truth!

It's that last statement that reveals a well of scientific ignorance so deep that I fear it might hit magma made of burning stupid. "Unbiased"? Seriously? By its very nature this survey will be biased. It's an Internet survey! At the very least, only people with access to the Internet, either by smartphone or computer, can take this survey, which introduces a huge bias right there. Worse, there's no effort whatsoever to make sure the sample is representative of the general population. In fact, given that I've seen links to this survey being passed around by antivaccine practitioners and activists like Rashid Buttar, it's a virtual guarantee that this survey massively overrepresents parents who believe that vaccines cause autism and other health issues, which means it also massively overrepresents children with autism or chronic health problems. It even has a "Tell A Friend" page that tries to encourage people taking the survey to "spread the word" to at least five friends and to "help us discover the truth once and for all!"

No, there's no way this survey can be anything near representative of anything.

This is even more so given the sorts of questions it asks. For instance, the very first question is: "Has your child received any vaccinations since being born?" The possible choices in the dropdown menu include:

No vaccinations
1-5
6-10
11-15
16-20
21-30
30+

The very nature of this question buys into the "too many too soon" antivaccine trope, along with the way antivaccine activists try to make the number of vaccines sound really huge by counting combination vaccines not as one vaccine but as the number of vaccines included in them; e.g., MMR counts as not one but three vaccines.

Next up is this question: "Where would you place your child on their developmental milestones?" Possible answers include:

They were way ahead of their peer group
They were with their peer group
They were behind their peer group

No medical verification needed, this is just a survey asking parents.

Tags

autism

Progressive Health Consortium

antivaccine

Jason Yensid

pseudoscience

quackery

survey

Vaccinated and Non-Vaccinated Children's Data

vaccines