Today the U.S. Court of Appeals for the Federal Circuit affirmed the Special Master’s finding that plaintiffs had failed to demonstrate any link between childhood vaccines and autism or autism spectrum disorders. More from BLT here.
I’ve previously blogged on the efforts to link autism and vaccines here, here, here, and here.
Roger the Shrubber says:
Not to worry, the plaintiffs’ lawyers will just move on to the next bogus theory.
August 27, 2010, 8:39 pmDave Ruddell says:
Clearly this court has been bought by Big Pharma.
August 27, 2010, 8:42 pmOwen H. says:
In a related note, in PA whooping cough is rising. Good going, anti-vaccine nuts!
August 27, 2010, 9:24 pmJohn Skookum says:
In my experience, most of the nincompoops who trust the wild accusations and speculations of Jenny McCarthy and the plaintiff’s bar more than the American Academy of Pediatrics are hairy-legged left wingers who can’t stop talking about how stupid Republicans are.
August 28, 2010, 12:16 amGil says:
My hypothesis as to why vaccination of a toddler seems to cause autism in some is that the unpleasant process of getting jabbed is one of the first major external emotional events which tests a child’s respsonse and exposes a child’s autism. Since no parent wants to believe their child is a born with a disorder they would prefer to believe the child was normal until the vaccination.
August 28, 2010, 1:06 amDG says:
Paging Jenny McCarthy….
August 28, 2010, 10:22 amA. Criminal says:
FWIW: the National Vaccine Injury Compensation Program.
Vaccine Injury Table:
http://www.hrsa.gov/vaccinecompensation/table.htm
Bean counting:
August 28, 2010, 10:23 amhttp://www.hrsa.gov/vaccinecompensation/statistics_report.htm
About $2 billion paid out over 20-some years, about 100 cases filed per year, all autism cases denied.
Koolaid is fun says:
But oddly, enough left wingers like big government and trust big government to make decisions for the people.
http://www.huffingtonpost.com/david-kirby/new-study-hepatitis-b-vac_b_289288.html Hep B vaccine triples risk of autism in infant boys. INteresting article.
August 28, 2010, 11:55 amOwen H. says:
Study doesn’t say that. And in using self-reporting, it tends to under-report earlier cohorts.
It is also ludicrous to deny the validity of multiple studies, while relying on a single one to make your case. The author also declares that only thimerisol has been examined (not true), but then goes on to connect thimerisol to this study’s findings.
August 28, 2010, 12:25 pmOwen H. says:
I am a hairy-legged left-winger, and I fully suport vaccinations. Meanwhile, the few aquaintances I have that are anti-vaccine are quite right-wing. Their claim is that we lefties support vaccinations because of the “nanny state” desires we all have.
August 28, 2010, 12:26 pmNickM says:
I’m hoping that the original commenter was referring to hairy-legged women. If he knows lots of non-hairy-legged men and he’s not involved in competitive cycling or swimming, I’d be worried about him.
For whatever reason, “vaccines cause autism” believers are normally female IME. Most of the ones I have run across where I was able to discern their ideology were fervent environmentalist lefties – anti-vaccine and vegan proselytizing seem to go together often.
Nick
August 28, 2010, 2:18 pmmatthew says:
John Skookum, the ‘left-wingers’ certainly don’t have a monopoly on junk medical science. Try googling ‘abortion breast cancer link’ for quackery that has a distinctively ‘right-wing’ tilt.
August 28, 2010, 2:54 pmWfjag says:
Kookaid Is Fun – I hope that linking to a “science” article in HuffPo and an autism article by David Kirby was sarcasm.
August 28, 2010, 2:56 pmOwen H. says:
NickM- and most of the ones I’ve met are anti-government types. YMMV.
August 28, 2010, 3:27 pmChris Travers says:
It’s one thing to support mandatory vaccination for polio and measles. It’s another to support mandatory vaccination of school kids against Influenza (as some states are doing), chicken pox (as my state does) and the like.
Yes, some of this is nanny-statism. Some of it is a response to a legitimate public health risk. There is a difference.
August 28, 2010, 4:30 pmBrooks Lyman says:
There does seem to be a rather dramatic increase in autism (unless in the “good old days” people simply ignored most autistic kids as being “a bit slow, but OK” or whatever, and now they are diagnosing it more accurately).
There’s also a great increase in mandated (or strongly encouraged, anyway) kid’s vaccination for all sorts of things that we used to ignore. Influenza particularly comes to mind.
I think that we need some really serious research on what’s causing the autism increase, and I think that it’s a mistake to totally rule out vaccines as a possible cause. Obviously, since the vast majority of children vaccinated don’t become autistic, it’s not so simple as “vaccines cause autism.” But the medical profession doesn’t deny that there are sometimes side effects to many of the child vaccines, so it’s a fair question whether autism might be one of them, directly or indirectly.
(And no, I am not a lawyer – or a doctor…)
August 28, 2010, 6:18 pmjoe says:
“In my experience, most of the nincompoops who trust the wild accusations and speculations of Jenny McCarthy and the plaintiff’s bar more than the American Academy of Pediatrics are hairy-legged left wingers who can’t stop talking about how stupid Republicans are.”
John your spending too much time reading the huffington post
August 28, 2010, 7:15 pmjoe says:
My experience indicates a very high correlation with both autism and down’s syndrome with age of the mother and the time of birth of the child, the older the mother, the greater chance of autism. I know several people who work in the field, and they all tell me that there are very few children with autism when the mother is less than 30 at time of birth. (not saying it doesnt happen, just that the vast majority are from older mom’s)
August 28, 2010, 7:20 pmAnatid says:
IANAE, but the large majority of this increase, if not all, is due to a reduction of diagnosis of general mental retardation and an increase in diagnosis of autism.
August 28, 2010, 7:55 pmChris Travers says:
*shrugs* If it was a vaccine that gave long-term immunity it wouldn’t be a problem. As it is you need a booster shot ever 10 years. How many adults do you know who get a DTaP vaccine every 10 years? I don’t.
Same reason my kids don’t get flu shots (they do get required DTaP vaccines, but once they are adolescents, I figure that’s their choice.
August 28, 2010, 8:19 pmleo marvin says:
I wouldn’t rule it out either, but my understanding (and IANA[whatever's relevant]) is that there’s been a fair amount of research into the alleged causal connection between vaccines and autism, and it’s come up negative. Among other possible causes, I also wouldn’t rule out reality television and the designated hitter, both of which have also become prevalent in the era of perceived higher autism rates. Snark aside, I’m all for more testing of vaccine safety, and research into what causes autism. What I’m not for is anecdote driven hysteria and its potentially dangerous backlash against important vaccines, especially when, as anatid pointed out, it isn’t even clear there’s actually been an increase in the autism rate.
August 28, 2010, 9:40 pmGil says:
I would support the notion that autism is being better recognised than there being more incidences of it over time. Considering most work in the old days was repetitive manual labor not to mention adults had a “children are to be seen not heard” policy then most people wouldn’t have picked up many autistics. If anything autistics were probably considered as the good workers who do their jobs without intefering with others. Nowadays people skills is becoming ever more vital to the modern job market as well as children are expected to speak up to adults so this is why I believe autism is being recognised more.
August 29, 2010, 12:15 amOwen H. says:
Actually, that’s the problem. Adults don’t need boosters, as long as most kids get the vaccine. And the rise in in children.
August 29, 2010, 8:55 amChris Travers says:
Hmmm on further reading I was wrong about adults getting the vaccine. I stand corrected on this.
However, whooping cough vaccine is about harm reduction, not epidemic prevention. We don’t give it to adults because the disease is nearly always minor in adults. The possibility of side effects (including serious allergic reactions) simply means the harm for this group far outweighs the benefits to giving this vaccine.
In fact, if I understand these vaccines correctly, they don’t even stimulate the immune system to directly fight off the germs themselves but simply stimulate harm reduction (in the sense of producing antibodies to exotoxins only) in the case where one is infected. IOW, it seems likely that all components of the DTaP vaccine do not produce herd immunity against the diseases for epidemiological purposes at all.
I doubt an adult with pertussis would even go to the doctor. That’s why the vaccine isn’t administered. It has nothing to do with epidemiology in this case.
August 29, 2010, 12:32 pmSammy Finkelman says:
The problem here is that the lawyers can only make real money if the vaccine caused the disease because of an IMPURITY, not an essential part of the vaccine; but not if the vaccine caused it by its very own nature (with autism being an auto-immunity disease) because Congress gave the vaccine makers very limited liability in that case.
So if the vaccine caused it, they would attempt to say it caused it by an untrue method.
August 29, 2010, 12:42 pmSammy Finkelman says:
What’s been researched is various ways in which vaccines could have caused autism but not the very idea itself.
Proving, for instance, that adding thiomersal doesn’t cause autism, doesn’t mean that *nothing* about being vaccinated causes or increases the liklihood of autism.
So we don’t get statistical tests comparing children who received vaccines with those who did not, perhaps children who spent their first few years in other countries.
Of course then there would be compounding factors anyway, most likely the particular genetic heritage of the children, and exposure or no exposure to bacteria.
The plaintiff lawyers cannot make any real money if any vaccine is inherently at fault, since Congress has strictly limited liability for any FDA approved vaccines. But the pharmaceutical companies have an incentive to deny it or hide it. Although the lawyers can’t win if that’s true, they can still lose because Congress might, at least for the future, impose some liability or the FDA might approve vaccines even slower, and there could be all sorts of spillover effects on a lot of things.
And then maybe they also could lose if fraud was involved but lawyers wouldn’t rest their hopes on that. Rather they’d rest their hopes on proving a vaccine-autism connection without trying to prove especially how, and if to win with the truth they’d have to select a method that normally gave no real money and also prove fraud, they’d stay far away from that. Anyway the lawyers really want to get a settlement.
August 29, 2010, 12:58 pmChris Travers says:
Further reading confirms that toxoid vaccines don’t prevent infection or carrier states but only prevent serious infection and certain complications, meaning that the whooping cough vaccine is not one which affects herd immunity per se. The Diphtheria vaccine which works on the same principle (i.e. stimulating antibodies against exotoxins rather than against antigens like traditional vaccines do) does not provide such protection:
Basically this is because the vaccine is not against the germ but against the toxin that causes serious complications. One can still get sick and pass the bug on to others. One just can’t get the full-blown, life-threatening version of the illness. The same thing presumably occurs with whooping cough. Once vaccinated, one can still get, carry, and pass on the illness, but it becomes a minor illness even for a child compared to a major illness.
Interestingly, the current whooping cough epidemic in California doesn’t appear to be due solely to a lack of vaccination, and the CDC is currently investigating.
What has me confused about this is the concern by some that infants born into houses where an adult has the disease and later gets a potentially fatal infection could be saved by better immunization. This vaccine isn’t given to adults (and note it doesn’t prevent infection either), and it isn’t given to children under 2 months old.
Epidemiological evidence from the UK also suggests that insufficient herd immunity occurs with this vaccine, although I have serious doubts as to whether a toxoid vaccine of any sort will ever provide herd immunity.
There are recent attempts to use genetic engineering to produce live bacteria vaccinations, but it’s not entirely clear to me how effective these are likely to be long-term, esp. since they provide no protection against the exotoxins.
August 29, 2010, 2:54 pmMac says:
On the subject of the increase in autism. I am not at all sure that autism has increased. What has changed is the definition of autism which has been so greatly expanded that it is hard to see how any child, if a parent so desired, could avoid that diagnosis. Either that or both of my children were autistic as the behaviors, as currently defined, certainly were exhibited by my kids and myself as a child as well and most other kids I have ever known.
I hate to be a cynic, but there has been quite an industry built up around treating autism. It is in this industry’s best interest to have as many clients as possible, ergo expand the definition of what was normal behaviors and redefine them as autism and you suddenly have a whole lot more clients.
August 29, 2010, 3:30 pmMac says:
Kudos to you, Chris. All too few people these days are willing to question and further research their own beliefs and to then admit they were wrong. It would be a better world if everyone followed your example.
August 29, 2010, 3:34 pmChris Travers says:
Hmmm… Reading even more I was wrong again.
The CDC recommends occasional vaccination against pertussus even for adults. However, I have been unable to locate any data showing epidemiological benefits for this. Presumably, since it is a toxoid vaccine, the benefits would seem to me to be limited to reduced severity and duration of the disease, making transmission somewhat less likely. The CDC notes:
The CDC further notes:
In other words, the vaccine may have some epidemiological benefits, but it doesn’t, strictly speaking, protect against infection (the same would hold true for all toxoid vaccinations since one isn’t vaccinating against the disease-causing organism per se).
August 29, 2010, 5:25 pmChris Travers says:
(It seems giving adults whooping cough shots is a new thing, fwiw.)
August 29, 2010, 5:32 pmAnatid says:
To be fair, if a substantial portion of certain demographics does experiences high rates of autism spectrum symptoms, then making treatment widely available is the right way to go. One doesn’t have to have full-blown, severe, utterly debilitating autism in order to experience difficulties from much milder symptoms – and both can benefit from help.
As a crude analogy, think of it this way. Instead of just amputating gangrenous limbs, we’re also putting broken bones in casts, wrapping sprains, and stitching deep surface cuts.
August 29, 2010, 6:11 pmMac says:
Granted. I wholeheartedly agree. But, if you look at autism symptoms, I don’t feel they are analogous to putting broken bones in casts, etc. Broken bones are, after all, broken. However, I think what we are doing is treating a scrapped knee, quite common in childhood after all, not with the old bandaid and a kiss, but with a trauma room Doctor. Hardly necessary. Of course, I could be wrong, but it does seem rather odd that the definition has been greatly expanded and ever so many more kids now are diagnosed with autism. That, in and of itself, certainly could explain the “epidemic” especially when perfectly normal behavior is now abnormal and called autism.
Correct me if I am wrong, but I don’t think the autism epidemic is showing itself in other countries which is pretty odd as well.
There is a case to be made for mass hysteria rather than an autism epidemic.
August 29, 2010, 8:10 pmChris Travers says:
I would generally agree with this. Also the fact is that there is a danger of over-diagnosis as the symptoms become less defined and the criteria less strict.
August 29, 2010, 11:34 pmBingoNameO says:
I’m glad the supreme court finally came out with this ruling. Maybe it’ll finally shut up all those crazy celebrities and they’ll succeed where previous court rulings have failed: http://lawblog.legalmatch.com/2009/08/26/yet-another-court-agrees-vaccines-do-not-cause-autism/
August 30, 2010, 12:15 amAnatid says:
Keep in mind that autism spectrum disorder is one of the more-recently reclassified disorders that views mental illness from a dimensional rather than categorical perspective.
Say that autism symptoms (which is itself misleading, since “autism” refers to several different overlapping symptom clusters that can exist independently of one another) exist on a spectrum from 0 to 100. Used to be, we only diagnosed 80-100 as autism. Now, we’re diagnosing autism spectrum anywhere from 20 to 100, with the understanding that a 20 may be quite high-functioning and really only needs a little extra guidance for a few years during development, while a 100 will need intensive lifelong treatment.
For example, if you examine high-functioning individuals with very mild autism symptoms, you tend to find that they are socially awkward as children and adolescents. As they grow to adulthood, they learn to apply their intellect to compensate for deficiencies in social processing, producing a socially graceful end result similar to non-ASD even though the resources recruited to get there are quite different. By identifying these children at a young age, perhaps we could offer guidance in this process, allowing high-functioning ASD kids to learn to master their social environment years earlier, saving them years of embarrassment, social ostracism, and loneliness. Some might call that character-building; I call it unnecessary suffering and impairment that hampers the ability of the child to develop socially at a normal rate.
The question isn’t “Are you or are you not autistic.” It’s “How autistic are you” and “Past which point is it appropriate to begin treatment.” Kind of like depression isn’t a binary state, and even the stablest of individuals will still experience depression symptoms when in a severe enough situation, such as the death of their spouse. If we labeled everyone who was 1-100 as having ASD, it might not be an incorrect label. Whether it would be an appropriate label hinges on the second question, of when it becomes beneficial to apply such a label. Although a 2 might have measurable symptoms, they are so slight that the individual might not benefit measurably from the treatments that would be beneficial to a 15.
The United States, the United Kingdom, Switzerland, and a few other countries are juuuuust starting to take the dimensional approach to mental illness, and for the most part the categorical approach is still strong everywhere. I don’t know what the actual data are, but I would not be surprised if the increase in ASD diagnosis correlates with the extent to which dimensionality has pervaded the fields of psychology and psychiatry in that country or region.
August 30, 2010, 12:24 amChris Travers says:
One real danger of a dimensional perspective however is that it’s quite possible to misdiagnose other illnesses as ASD. For example, how do you determine if a very introverted, individual who is struggling socially or otherwise has ASD or some sort of attention deficit disorder?
I’ve noticed an increasing trend for people to receive a melting pot of medications and therapy for a salad bowl of disorders. That doesn’t seem very healthy to me. All to often it turns out after years of all of this that the root cause is discovered and is something else entirely. For example, I have a relative who was being treated for bipolar disorder, various anxiety disorders, attention deficit disorder, and more, only to discover that none of that was the problem— he had a complex form of epilepsy and once that was diagnosed and treated all the rest of it went away.
That can’t be healthy.
August 30, 2010, 12:37 amAnatid says:
You present a very real concern – mistreatment from misdiagnosis can cause more harm than no diagnosis at all.
Hopefully, as this paradigm shifts continues, it will create greater pressure to improve testing and measurement techniques to be able to successfully discriminate between conditions that can superficially appear to have similar symptoms. Of course, the human error will always be in place – an incompetent psychiatrist will make poor diagnoses no matter what tools are available.
August 30, 2010, 12:52 amsardonic_sob says:
Actually the high-functioning ones were just regarded as crazy, and the low-functioning ones were regarded as retarded (which, technically, they are.)
The diagnosis is way up, both because of better diagnostic tools and broadening of the “spectrum” of behaviors which are regarded as autistic.
As for the rest of your assertions, I respectfully assert that you don’t know what you’re talking about and should ponder the ancient psychiatric dictum, “Wovon man nicht sprechen kann, daruber muss man schweigen.”
August 30, 2010, 9:34 amsardonic_sob says:
This is like saying we need a cure for “cancer.” There is no such thing as a generic vaccine. Other than the fact that MOST of them contain a certain amount of water as a carrier medium, there is no factor that “vaccines” have in common. You cannot research an “idea” (just like you can’t patent one. :) ) I suppose you could research the question of whether injecting children with anything at a given age causes autism… whoops, no, we tried that and there’s no correlation. (Correlation does not imply causation but lack of correlation implies lack of causation. The Universe is funny that way.) We already looked at most of the somewhat common elements (thimerosal being the most famous but far from the only one) and none of them show correlation either. Find one. Point them at it. Succeed and you will be rich and famous. Until then, hush.
You cannot point to “vaccines” as a villain, any more than you can point to “Jews and speculators” as a villain. The next person who says “Too much too soon!” to me is going to be asked, “Too much what?” and if they have no answer I will pass them a duncecap and laugh disparagingly at them. And when I laugh disparagingly at you, you stay disparaged.
FOREVER.
August 30, 2010, 9:55 amAnthony says:
Nope, they’ve researched the idea itself. Autism is ordinarily diagnosed at around the age of 2, because it’s not very visible until the child would ordinarily start speaking (newer techniques have identified autism in much younger children). This results in a cluster of autism diagnoses at about the same time as MMR vaccination occurs. However, it turns out that autism is frequently diagnosed before MMR vaccination, and that there isn’t the spike you’d expect after vaccination if in fact there were a causal link.
August 30, 2010, 1:07 pmDan Weber says:
Yes, but what about the idea? Has anyone ever done a double-blind test where your doctor doesn’t even know about vaccines sees your baby, versus one who has had that idea put in his head?
Until this is done, I won’t be convinced!
And if it is done, I’ll move the goalposts!
August 30, 2010, 1:31 pmwfjag says:
Like a Tuskegee Experiment using Pre-K kids? Wouldn’t that make a wonderful comment in next year’s apology by the State Dept to the UN Human Rights Comm.
August 30, 2010, 1:48 pmDan Weber says:
Have scientists 100% proven that Boutros Boutros-Ghali doesn’t cause autism?
August 30, 2010, 1:56 pmsardonic_sob says:
NO!
Why that… I’ll… OOOOOOOH!
I’ll give him SUCH A PINCH!
August 31, 2010, 10:57 amStephen Lathrop says:
This comes up from time to time, and it’s always a little on the ugly side. Does it even make sense? How do you convince a parent that it’s a good idea to impose a false diagnosis of autism on their kid?
There’s also a tacit notion there that real autism is serious, but these more recently recognized manifestations are just trivial. You hear stuff like, “Asperger’s syndrome, which is a mild form of autism…” I don’t know what to make of that “mild.” Asperger’s can ruin your life.
As for the vast industry built on “treating autism,” you might do well to point that out to the parent of an autistic child, because I’m sure many of them remain desperate to find it.
September 1, 2010, 6:41 am