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autism-vaccine link?

JoeTheJuggler

Penultimate Amazing
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So I've just read a singularly uninformative CNN article with the title "Case renews debate on vaccine-autism link".

http://www.cnn.com/2008/HEALTH/03/05/autism.vaccines.ap/index.html

Best I can tell the article contradicts the headline.

Apparently several vaccines administered in one day are suspected of aggravating a pre-existing mitochondrial disorder in a child.

And 7% of autistic children also have that mitochondrial disorder (compared to 0.2% in the general population).

Otherwise, the most interesting thing in the article is John McCain's take on the subject.

Anyone with real information care to enlighten me? Am I misreading this?
 
I agree with you about those things you pulled from it.

Here are the things I don't like about this article:

"The cases are before a special "vaccine court" that doles out cash from a fund Congress set up to pay people injured by vaccines and to protect makers from damages as a way to help ensure an adequate vaccine supply. The burden of proof is lighter than in a traditional court, and is based on a preponderance of evidence."

That doesn't sit too well with me. Sounds like it's just a way to make people shut up and go away.

"Federal officials say the law bars them from discussing the case or releasing documents without the family's permission. However, The Associated Press obtained a copy of the concession by U.S. Department of Health and Human Services officials."

So they didn't actually see the evidence, if there even was any.

Re: John McCain... Awwww, you guys don't have any decent people to vote for, do you? I thought he seemed like a good candidate until I read that. But then...who knows - maybe he was misquoted or something. Also, maybe he can learn. (I'm not usually a big fan of politicians, though...)
 
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Even though this was a specific situation where the kid had a condition which put them in danger, you can bet that the anti-vaxers will make much ado about nothing concerning this story.

In addition, this is another great example of both the media and government screwing up the science on an important topic :rolleyes:
 
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This ruling was very unfortunate. The decision was a matter of not proving the negative rather than anyone proving a link. I doubt the multiple vaccines in this case even really contributed. While the information has not been released, I'm speculating the parents merely swore to a temporal connection and got their doctor or even several doctors to say they could not rule the connection out.

I've seen this time and time again with doctors supporting worker's comp claims. Plenty of doctors are reluctant to deny a patient compensation in these cases. And sometimes its because one doc won't go against what another has said.

Now we'll have even more work fighting the anti-vaxers. I'll bet the doctors giving this family the benefit of the doubt haven't got a clue how many kids will get a vaccine preventable disease as a direct result of these doctors' (or judges') empathy for this family.

And if there was some fever problem, then it was a matter of not giving Tylenol or some other antipyritic. What child could possibly get through childhood without a fever unless you made them a "bubble kid" or something.
 
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So I've just read a singularly uninformative CNN article with the title "Case renews debate on vaccine-autism link".

http://www.cnn.com/2008/HEALTH/03/05/autism.vaccines.ap/index.html

...And 7% of autistic children also have that mitochondrial disorder (compared to 0.2% in the general population).

...Am I misreading this?

Yes, you are misreading it... a more full quote on the 7% number would include:
Portuguese study suggested that 7 percent of autistic children might also have the mitochondrial disorder, versus one in 5,000 people -- or 0.02 percent -- in the general population, said Dr. Marvin Natowicz, a Cleveland Clinic geneticist.

"Even if they're off by a factor of seven" and only 1 percent are afflicted, "it's still a striking statistic," he said.

Others said they doubt the Georgia case will have much effect.

"No link between mitochondrial disorders and autism spectrum disorder has been made in mainstream medicine," said Dr. Michael Pichichero of the University of Rochester in Rochester, New York, who has consulted for the government on vaccines and has received speaking fees from vaccine makers.

The 7% number comes from one study, and may not reflect the total population. I would suggest you read Snake Oil Science. This is the abstract from that paper:
A minority of cases of autism has been associated with several different organic conditions, including bioenergetic metabolism deficiency. In a population-based study, we screened associated medical conditions in a group of 120 children with autism (current age range 11y 5mo to 14y 4mo, mean age 12y 11mo [SD 9.6mo], male:female ratio 2.9:1). Children were diagnosed using Diagnostic and Statistical Manual of Mental Disorders criteria, the Autism Diagnostic Interview--Revised, and the Childhood Autism Rating Scale; 76% were diagnosed with typical autism and 24% with atypical autism. Cognitive functional level was assessed with the Griffiths scale and the Wechsler Intelligence Scale for Children and was in the normal range in 17%. Epilepsy was present in 19 patients. Plasma lactate levels were measured in 69 patients, and in 14 we found hyperlactacidemia. Five of 11 patients studied were classified with definite mitochondrial respiratory chain disorder, suggesting that this might be one of the most common disorders associated with autism (5 of 69; 7.2%) and warranting further investigation.

The 7% were a total for 5 out of 69 children, which were a subset of 120 children. So that percentage is a case of Lying with Statistics.

Also a check on www.pubmed.gov for "mitochondrial autism" brings up a total of 37 papers. I would ignore the one from "Medical Hypothesis", if you wonder why, look up "hypothesis".

There seems to be some research with conflicting results going on, if you go by some of the titles on the first page:
SLC25A12 expression is associated with neurite outgrowth and is upregulated in the prefrontal cortex of autistic subjects

Autism-related routines and rituals associated with a mitochondrial aspartate/glutamate carrier SLC25A12 polymorphism

Lack of association between autism and SLC25A12

Confirmation of association between autism and the mitochondrial aspartate/glutamate carrier SLC25A12 gene on chromosome 2q31.

SLC25A12 and CMYA3 gene variants are not associated with autism in the IMGSAC multiplex family sample.


Anyway more reading about the case:
http://scienceblogs.com/insolence/2008/02/incredible_shrinking_causation_claim.php
 
This ruling was very unfortunate.
It is unfortunate that there are those who will attempt to present this as "the government conceding a causal link between vaccination and autism", and unfortunate that many will swallow this drek, but the ruling itself was consistent with VICP rules; the child was documented as having recieved covered vaccines, and of having experienced a condition (encephalopathy) which is listed on its vaccine injury table.

The decision was a matter of not proving the negative rather than anyone proving a link.
That's the way the VICP works. The idea is to provide health care providers and pharmaceutical companies (upon whom vaccine supplies depend) some relief from expensive litigation by creating a system under which a claimant need not meet a strict standard of proof.
 
I've been reading all the links in this thread, and I've generated one possibly dumb question:

Was the award give based on the fact that the Georgia girl in question had the mito disorder? That's the best conclusion I can get to from the CNN link in the OP. If so, how can antivaxers really claim this is any sort of victory? The mechanism for causing problems associated with the mitochondrial issues in the Georgia child in question does not necessarily reflect any proposed (emphasis on "proposed", i.e. not proven or even hypothesized, but merely speculated towards) mechanisms trying to link vaccines, and the thimerosal contained within, with autism. This only seems to be as "strong" (yes, scare quotes) as the Wakefield "association" (ditto) of MMR -> lower digestive tract disorders -> autism. Which is to say, the association isn't very strong at all. Or at least that's the way it all comes off to me.

So anyway, how is this judgement supposed to strengthen any vaccines-lead-to-autism argument? I don't see it.

ETA: Oh, okay, that's two questions. Sorry. :o
 
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Was the award give based on the fact that the Georgia girl in question had the mito disorder?
No. It was the encephalopathy.

If so, how can antivaxers really claim this is any sort of victory?
Because they know that since the people most likely to be swayed are those who have neither the time nor the inclination to investigate beyond headlines that read "Government Concedes Vaccine-Autism Link", all they have to do to achieve victory is to claim it.
 
Apparently the father of the child wrote the paper about her disorder. The parents (Mum is a lawyer) are due to be interviewed on Larry King Live today.

The CNN Larry King site has a poll on it with the question:
"Do you believe vaccines cause or contribute to autism?"

The answer? 79% of 1500 respondents say yes, depressingly.

Orac has a piece up with the latest news about the case.
 
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So anyway, how is this judgement supposed to strengthen any vaccines-lead-to-autism argument?

As Dynamic said, just by anti-vaxxers saying it and pseudo-jounalists passing the information along in bold headlines. The headline from the Atlanta paper reads "Georgia Girl Helps Link Autism to Childhood Vaccines", and although the article does state that

The language in the document does not establish a clear-cut vaccine-autism link. But it does say the government concluded that vaccines aggravated a rare underlying metabolic condition that resulted in a brain disorder "with features of autism spectrum disorder."

this is only after it poisons the water by saying

While government officials continue to maintain that vaccines don't cause autism, advocates say the recent settlement of the girl's injury case in a secretive federal vaccine court shows otherwise.

The headline has nothing to do with the facts of the case. But that's all that most will remember - that a link has been established. It's patently wrong, but it's too late now. Even if you could get a correction published, it will be buried and unread.
 
The media is totally irresponsible in how they are covering this, and we as the medical profession are just invisible!

This is so unfortunate.
 
Here's what I wrote in Orac's blog comments:

First it was MMR that supposedly caused autism. Research ruled that out. Then it was thimerosal. That was ruled out when the rates of autism went up rather than down as thimerosal was removed from most childhood vaccines. As evidence accumulated against these hypotheses, yet another emerged. Now it is giving too many vaccines at the same time.

All the while real research, (as opposed to parental speculation), has improved our ability to diagnose autism at younger and younger ages which completely negates the significance of the correlation between 15-18 month vaccines. But there is no news commodity to be sold with that story.

Do you suppose anyone in the news media will ever report on the unvaccinated child who dies as a direct result of the irresponsible choice to sell the news rather than report the actual facts? Or will we ever see a story about the delay in finding the real cause of autism as we waste our limited research resources chasing parental convictions rather than the actual evidence?

Science needs a voice that is as loud as a heartbroken and/or angry parent. We need a story that is as marketable as perseverance prevailing over the establishment. Until we find that voice or that story, it's going to be a long struggle with these issues.
 
I added this:

How does the this fund work?
Posted by: Rjaye

The National Vaccine Injury Compensation Program is described here:
http://www.usdoj.gov/civil/torts/const/vicp/about.htm

"Individuals who believe they have been injured by a covered vaccine can file a claim against the Department of Health and Human Services (HHS) in the U.S. Court of Federal Claims seeking compensation from the Vaccine Trust Fund. The Department of Justice (DOJ), which represents HHS, consistently works to ensure that fair compensation is awarded in every case that meets the eligibility criteria. If found eligible, claimants can recover compensation for related medical and rehabilitative expenses, and in certain cases, may be awarded funds for pain and suffering and future lost earnings. Often, an award is more than $1 million. By protecting the Trust Fund against claims by those who have not suffered a vaccine-related injury, DOJ helps to preserve the Fund for future deserving claimants. Regardless of a claimant’s success under the Program, reasonable attorneys’ fees and costs are paid."

Among the reasons the fund was established was to remove the disincentive drug manufacturers had from entering the vaccine market. In addition, just as many worker's compensation programs do, it removes the claims from the tort system. In doing so, the vaccine manufacturer and health care providers do not have to fight frivolous lawsuits and the claimants do not have to prove the facts of their case in they same way they might have to in a tort case.

The real tragedy here is the incompetent way the news media is reporting on this case. And I doubt that damage will be undone even if Larry King has someone on with this family to talk about the scientific evidence regarding vaccine risks and benefits.
 
And this:

Did any of you antivaxers consider the fact that because autism rates increased when thimerosal was removed from most childhood vaccines, it actually suggests thimerosal may have had a protective effect against autism.
 
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Yes, you are misreading it... a more full quote on the 7% number would include:
I guess I meant am I misreading it that the case really had nothing to do with autism (the girl had a disorder that might be higher among those with autism--but as you point out, might not--and not autism) at all, and the headline of the article is completely wrong?

I mean, even if that 7% figure were true, and even if the vaccines somehow caused the worsening in her condition, it would still not have anything to do with a vaccine-autism link, right? (I realize that those two "even ifs" are big--and they're both almost certainly not so.)

The girl did not and does not have autism. Or did I miss something?
 
Science needs a voice that is as loud as a heartbroken and/or angry parent.
That's not going to happen, and I can't agree that it would be a good thing if it did. The science proceeds cautiously, and while it ultimately speaks for itself, it tends to do so in reserved tones. Since those who refuse to listen are going to refuse to listen regardless of the tone or the volume at which the message is delivered anyway, it seems appropriate for those delivering it to maintain some modicum of dignity while doing so -- regardless of (perhaps even because of) the shrillness of the opposing voices.

Sometimes the only real option is to keep plodding forward like a mule in a hailstorm.

JoeTheJuggler said:
The girl did not and does not have autism. Or did I miss something?
I don't think even that much is entirely clear. She developed several symptoms consistent with ASD, enough to meet the official diagnostic criteria. What is autism, other than the manifestation of those symptoms? I don't think there are any good answers to that as yet -- but if it's a mitochondrial disorder, then it's way overdiagnosed.
 
And this:

Question: Is there a big problem with waiting until children are older to vaccinate? If all older children and adults are vaccinated there should still be herd immunity, and presumably difficulty for any epidemic to gain hold. The benefit would be that it would make it clear that there isn't a connection, as the problem now is that autism symptoms show up at approximately the same age as the vaccines are given.
Posted by: Carlie


First, autism is diagnosed before these vaccines are given. Some very clever research was undertaken looking at the abundant videotapes of children's first birthday parties. Researchers identified behaviors that were diagnostic of autism. Prior to that, the diagnosis was most often made when toddlers reached a stage of more social interaction after 12 months of age. The original suggestion vaccines were related to autism had to do with the coincidence vaccines are given at the same age socialization increases. The original research has been discredited, by the way.

Now autism can be diagnosed even younger than one year. It's pretty apparent that the root of autism is either in utero, perinatal, or genetic. The medical community has been unable to get the news media as excited about those discoveries as they have been about the vaccine misinformation.

As for the ideal age for vaccinations and the reasoning and safety of administering them together, in the US that is determined after very careful review and continual monitoring undertaken by the public health service's Advisory Committee for Immunization Practices (ACIP). They meet twice a year to review the research and the Vaccine Adverse Event Reporting System (VAERS) data. Their findings are public as well as the documentation of their rationale and the hundreds of citations they based their decisions on.

They also alert providers to any problems with vaccines that show up in between the April and October meetings.

Criticism the ACIP is simply an extension of the pharmaceutical companies couldn't be more ignorant. Their decisions are completely transparent, and contrary to the big pharma conspiracy theorists, there is abundant research out there which is not funded by drug companies. There is also a very large and very diverse medical community out there who are capable of and do read the research for themselves, and who are capable of and do evaluate the bias of the source or funding of the research. In fact, it should be rather obvious the medical community is by far better at evaluating the bias and significance of medical research than any layperson conspiracy theorist.

Vaccine age recommendations are based on actual data as to the risk of the specific infections. The earliest given, hepatitis B vaccine, is given just after birth because there are cases of infants contracting hepatitis B at that age. Pertussis and tetanus are risks to infants. It would be dangerous to delay those vaccines. Herd immunity is irrelevant when it comes to tetanus, the bacteria come from dirt not other people. And you need both herd immunity and individual vaccinations to protect infants from pertussis because the vaccine is not good enough without both.

Also, you cannot usually achieve sufficient herd immunity in older populations to protect younger populations because the pool of unvaccinated younger kids would be too large.

Vaccines are given in combinations, one, to decrease the discomfort in giving a child numerous injections, and two, because the data shows if you can give them all together, kids are more likely to get them. If you spread vaccines out, they inevitably get delayed, duplicated (when records of past shots cannot be found) and sometimes missed altogether. Again, we know this from experience, not from guessing or assuming.

Other countries have similar public health systems to evaluate and make vaccine recommendations. There is more consistency in the recommendations between countries than there are discrepancies. Again, for vaccine recommendations to be a big pharma conspiracy it would have to involve the majority of researchers and scientists all over the world, the majority of health care providers all over the world, and all the world's public health systems. Either the entire medical community is in on the scheme or they are a bunch of dupes. You trust them to perform neurosurgery but not to figure out if a vaccine is safe?

There is one more typical antivaxer misinformation I haven't addressed here. That is the notion that 'herd immunity' is somehow the sole objective of the public health system. Nonsense! The objective of this country's public health system and the world's public health systems is to decrease disease burden. The idea herd immunity trumps individual risk is a contradiction in logic. If individuals were somehow sacrificed for herd immunity, you would have by simple analysis, a vaccine risk greater than vaccine benefit.
 
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That's not going to happen, and I can't agree that it would be a good thing if it did. The science proceeds cautiously, and while it ultimately speaks for itself, it tends to do so in reserved tones. Since those who refuse to listen are going to refuse to listen regardless of the tone or the volume at which the message is delivered anyway, it seems appropriate for those delivering it to maintain some modicum of dignity while doing so -- regardless of (perhaps even because of) the shrillness of the opposing voices....
I am always flabbergasted with a response like this. What misconception do you have about what I am suggesting that would make you reply like this?

Is not the whole purpose of JREF ultimately to increase critical thinking skills in the world and decrease false beliefs people have because they don't think critically?

Why should we ignore the science of communication in this endeavor?

That would be, collect the evidence: Why/how is the medical and scientific community failing to educate the public about the vaccine evidence? How do we correct it? Implement the correction. Evaluate the correction. And so on.

What do you think I am suggesting? That we take a Bill Nye the Science Guy approach to vaccine information dissemination?
 
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