Today's NYT profiles Dr. Paul Offit, author of Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. His book is a fervent and detailed defense of childhood vaccination. For daring to challenge the "vaccines cause autism" crowd, he's been tarred a a "terrorist" and labeled "Dr. Proffit," which only shows how urgently his message was needed.
Dr. Offit’s book, published in September by Columbia University Press, has been widely endorsed by pediatricians, autism researchers, vaccine companies and medical journalists who say it sums up, in layman’s language, the scientific evidence for vaccines and forcefully argues that vulnerable parents are being manipulated by doctors promoting false cures and lawyers filing class-action suits.
“Opponents of vaccines have taken the autism story hostage,” Dr. Offit said. “They don’t speak for all parents of autistic kids, they use fringe scientists and celebrities, they’ve set up cottage industries of false hope, and they’re hurting kids. Parents pay out of their pockets for dangerous treatments, they take out second mortgages to buy hyperbaric oxygen chambers. It’s just unconscionable.”
In addition to providing intellectual ammunition for vaccination advocates, Dr. Offit has also helped recruit celebrities to the cause. According to the NYT article, he helped convert actress Amanda Peet to the cause. (Take that, Jenny McCarthy!)
That was an irritating feature of the 2008 Presidential election, hearing all the politicos giving credence to the vaccines cause autism meme. IIRC, all the major candidates did this to some degree (McCain was the worst, but I think Hillary and Obama did it too).
movie "Digby Goes Down." I'd take her over Jenny McCarthy any day.
Anyone who was a kid when the Salk vaccine came out, as I was, will find the book fascinating, whether he cares about vaccine controversies or not.
Damn right. We need more Dr. Offits.
I almost fell over when McCain started talking about the "strong evidence" linking vaccines to autism.
Ill go re-cloak back into lurk mode now
In Ms. Peet's case I believe the exact moment was the window scene in The Whole Nine Yards.
The reason for this is that there is a very small but fierce contingent who are utterly convinced that vaccines cause autism (despite no credible scientific evidence to support it). Many are such "true believers" that they in effect become single-issue voters. Meanwhile, the issue passes right over the heads of 99.9% of the rest of the voting public.
So there's nothing to gain by opposing them, but a candidate might just pick up their votes by pandering to them. So, pander it is.
My recollection is that Obama and HRC made mostly non-commital equivocations and tried to change the subject when the issue came up; McCain used it as a talking point in one of the debates.
There is even a strong marketing attempt to ensure that most kids get a flu shot every year. Fortunately, the physicians I know don't drink that koolaid (flu shots still contain mercury preservatives too, unlike the other routine vaccines).
IMO, the general rule should be that the big vaccines should be given, and that other vaccines, should be given where unusually high risk conditions exist (medical or environmental). I don't think every kid needs a Hep A vaccine in the US. However, my kids will get it because of the amount of foreign travel they do.
Note I don't think that autism and vaccines are connected, but I don't think that more vaccines are necessarily better.
BTW while Hilleman probably did more to promote human health than any other scientist, he never got a Nobel Prize. It seems the Swedish Academy did not want to give the prize to anyone who worked for a pharmaceutical company. In their mind it automatically makes someone suspect.
I am as skeptical of a pro-vaccine book written by a vaccine inventor as I am of pro-oil drilling studies done by the Petroleum industry.
I'll read the book, but I won't hold my breath that it's anything more than a couple hundred pages of "Those people are crazy!"
There, fixed it for ya. There's nothing "almost" about death threats.
Since there is no more evidence that thimerosal causes autism than that vaccines in general cause autism, this is kind of irrelevant. Flu is no laughing matter and I favor widespread vaccination against it.
It hurts medicine’s cause and creates a perception of bias because he gets vaccine royalties, and boasts “it's like winning the lottery”.
It hurts medicine’s cause when Offit says babies can ‘handle as many as 10,000 vaccines . . . probably closer to 100,000’ vaccinations. Parents remember the three days of fever and reaction after just a couple of vaccines, and Offit’s hyperbole doesn’t help.
Offit was right when he said the wackos have “set up cottage industries of false hope”, but he offers nothing in its place, ignoring it is that magic of hope letting (otherwise rational) parents accept voodoo and worldwide conspiracies. He offers no future for autism beyond what exists in the here and now.
While I disagree with anti-vaccinism, Offit ups the ante by backing compulsory flu vaccination . . . just about the time researchers find them to be worthless.
One of modern medicine’s problem is public health dogma, and Offit is a prime example. I appreciate any reduction in shamanism he may have done, but suspect he is preaching to his choir.
In a word, "Yes."
Hannah Poling's diagnosis is encephalopathy caused by a mitochondrial enzyme deficit, not autism. The onset was at age 19 months, after she'd received five vaccines — diphtheria–tetanus–acellular pertussis, Haemophilus influenzae type b (Hib), measles–mumps–rubella (MMR), varicella, and inactivated polio. Up until then she appeared to have had a normal development. Two days later, she was lethargic, irritable, and febrile. Ten days after vaccination, she developed a rash consistent with vaccine-induced varicella.
You can read Dr. Offitt's article in NEJM, Vaccines and Autism Revisited — The Hannah Poling Case by Paul A. Offit, M.D, Volume 358:2089-2091 The New England Journal of Medicine (May 15, 2008) online at http://content.nejm.org/cgi/content/full/358/20/2089
and the response letter of Dr. Poling (Hannah's father), Vaccines and Autism Revisited, Volume 359:655-656The New England Journal of Medicine (Aug. 7, 2008) online at http://content.nejm.org/cgi/content/full/359/6/655
No mention, of course, of the son's age or that generally in the teen years - as maturity sets in - and sometimes even earlier, the symptoms of Autism fade away. We believe what we want to believe.
If interested in the subject of "belief" start with this first post of an intended statistically accurate test of ESP attributed to a belief system. Then follow the three or so linked subsequent posts in the series for an illuminating read.
Great. Exactly as I suspected. She doesn't have Autism, just a mitochondrial disorder whose symptoms exactly mimic Autism.
Whew! Dodged that one.
Incidentally, you posted an article by Offit as support for Offit's assertions? Nice.
Overall, I thought Dr. Poling did a fine job of showing that Offit is just as susceptible to a good case of the could've-been-caused-bys as anyone else.
I'd like to see the evidence for that.
Autism Spectrum Disorder is a clinical diagnosis -- meaning it is based on behavior, there is no diagnostic test. If there is another diagnosis -- such as mitochondrial enzyme deficit, an ASD diagnosis is not appropriate. Using an example that people generally are more familiar with, if the proper diagnosis is MR, then ASD is not the proper diagnosis -- although many of the same behaviors may be present for MR of various degrees and various types of ASD.
Yes, I did provide links to both Dr. Offitt's article and Dr. Poling's response letter in NEJM, since for those who haven't made up their minds in advance, they can read both.
If you want additional information about the relationship between mitochondrial defects and autism (essentially, no relationship is known to exist), see Mitochondrial Mutations and Autism (Aug. 18, 2008) online at
http://photoninthedarkness.com/?p=149 , The Nature of Neurological Diagnosis by Dr. Steven Novella (July 24, 2008) online at http://www.theness.com/neurologicablog/?p=342 , Autism and Vaccines: Responding to Poling and Kirby by Dr. Novella (July 23, 2008) online at http://www.theness.com/neurologicablog/?p=341 , Dr. Offit Article on Vaccines and Autism in the NEJM by Dr. Novella (June 4, 2008) online at http://www.theness.com/neurologicablog/?p=303 , and New Scientist Article on Autism by Dr. Novella (Mar. 6, 2008) online at http://www.theness.com/neurologicablog/?p=205 , and the comments and responses and links to the various articles in those articles.
As far as what causes ASD -- no one knows. The contentions that vaccines, or particular vaccines, or components or preservatives in vaccines cause ASD have been shown to have no scientifically based support. Now the allegations are vaccine frequency or contaminants (rarely if ever) found in vaccines.
Poling is supposedly the poster child for the vaccine frequency and ASD association. The problem with that is that her mitochondrial enzyme deficit when faced with a sufficient environmental stress would have caused the same outcome. The standards for recovery in the Vaccine Court are very liberal, and a temporial association is usually sufficient. So, that there was onset within a few days of receiving several vaccines would likely have supported a verdict in her favor, so that settlement was warranted. However, I am aware of no recoveries or settlements in any of the other 4000+/- cases pending in the Vaccine Court that allege that vaccination or vaccine preservatives cause ASD, and in a couple of cases in which there have been decisions, recovery has been denied.
So, I'll stick with my original response -- the Poling case was a fluke. She's not autistic.
I'm not arguing that she's autistic. I'm not even arguing that vaccines cause autism, although I grant you my posts may sound that way.
It just seems oh-so-convenient that the only situation where folks will even concede the possibility of a link is dismissed as "not autism," but instead "a mitochondrial disorder that mimics the symptoms of autism."
My question then is: How many kids are diagnosed with autism who actually have this same mitochondrial disorder? How many of those kids' medical histories added together would it take to show a possible causal link?
Those who decry "anectodal evidence" (put forth by parents for whom alternative therapies are working) are missing the point. These are real kids, with real parents, the vast majority of whom can't afford to fund a scientific study to determine whether or not GFCF diets (for example) actually work. They simply try it, and it does (or doesn't).
For Offit to simply broad-brush the entirety of alternative therapies and anti-vaccine folks is as unscientific as he is accusing them of being.
He is probably right about much of what he says, but he is not objective and he should not be setting govt policy. I don't trust him.
If you have enough knowledge, interest, and experience to be trusted, you should be involved with the people doing research (primarily the vaccine companies). To consider qualifications to be "bias" might make sense in law (which deals with agreement rather than truth). It does not make sense in science.
Do you distrust astronomers who have links to NASA?
You do not understand what science is.
If a diagnostic technique or therapy has been studied scientifically, then (if we assume the researcher was competent and honest), then we can call it scientific.
Everything else is unscientific. So Offitt is doing little more than offering a tautology -- if it ain't science, it ain't science.
Not only are all the alt ideas unscientific, most are also antiscientific.
That axis took many years to recognize the threat of mercury in vaccines... and those skeptics who Offit is disparaging here were the ones who forced this recognition. Tell me... how many here want to pound a bunch of shots of mercury into your children today? 'til very recently, the Offits of this world recommended you do so... and would have the law force you to do so if they could (always a sweet deal when you can have the government create a market for your products, eh?).
These doctors fiddled and cashed checks as that mercury was pumped into millions of children, many times the "safe" dose for them.
Anecdotally, I gave up on flu shots following bad reactions, and realization that it may not always or often offer anything of value.
I have a choice, but what of those who have none... the children? Should we force immature, undeveloped children to be injected with a witch's brew before 24 months? Stuff with no longterm study... stuff pushed by the Offits, who gave us mercury vaccines and profited off same, and would still be doing so if they weren't forced to do otherwise by we "skeptics"?
What about "live" vaccines, as opposed to killed virus vaccines? Live polio vaccines supposedly caused problems, perhaps even spreading the disease itself. Salk himself warned against this, but the Offits ignored him until 1996, when they switched to a killed virus vaccine. What longterm study is there on any of this?
How are all these women winding up with breast cancer? I have my suspicions, and they center around a little-studied prescription drug Offit's buddies have been distributing for some decades.
Be skeptical. Brother Paulson's recent raid on the treasury and our pocketbooks wasn't the first time a government/corporate axis combined to profit themselves. Do you think Offit's axis has any more probability of benefiting us than Paulson's?
I don't know.
"I'd like to see the evidence for that."
Hart's column sums it up better than I can. Flu vacine is measurably effective —so perhaps useless was the wrong word— but the cost to benefit ratios are questionable, as are the diagnoses used by governments to measure efficacy. It's no different than the governments' continual boasts how they reduced kids' drug abuse; if you believed half of it there would be no drug abuse at all.
Ontario, with its mandated flu vaccine, has been a good test-bed, and the results are far from clear. That by itself is a clear indication that efficacy is mismeasured and misrepresented.
When results are as medically unsure as the flu vaccine, compulsion (as Offit is supporting) is counterproductive and may even be harmful.
There is a wide consensus that autism IS on the rise and it is NOT just due to better diagnosis. So maybe not a fluke. However I see no reason to assert vaccines are the primary cause. To assert causation in this case, I think we would need to also rule out other possible causes.
The cause I think is behind the increase is plain ol' natural selection caused by people with mild Asperger's Syndrome suddenly being more prised for mates because of the success of the IT industry.
Also I am not exactly pro- or anti- vaccine. I just think that we need to be more cautious about increasing the numbers given. I completely oppose routine flu shots, and aside from the big vaccines (DTAP, Polio, MMR, and propably Pneumonococcus,sp?), I think vaccines should be given to at people who are unusually at risk only.
What bullshit. Even if there were a few instances where someone got Polio that might not have gotten it otherwise, that's a small price to pay for effectively ending the transmission of Polio in most of the World's population (idiots in Africa and India notwithstanding).
Unless you can actually prove that any unpleasant side-effects outweigh the benefit of wiping out a major disease, then yes, we should continue to vaccinate children. As I mentioned above, people have died because of instances where anti-vaccination sentiment created pockets of unvaccinated children large enough to allow Measles and other diseases to re-emerge.
Unless you can actually prove that his conflict of interest has distorted his research, or that the research backing his position is erroneous, then it doesn't matter whether or not he was a paid lobbyist at one point - that doesn't automatically skew research. It might give you reason to more closely examine his research, but that's it.
You might have further buttressed your remarks about the significance of the Poling case by referencing the original publication in the Journal of Child Neurology, and that journal's reproach of Dr. Poling for his lack of candor when the article was submitted for publication without disclosing to the editors that there was pending litigation. The other authors on the paper, including a prominent autism researcher, had not known that either and were not happy to learn it only after the editor demanded an explanation from Dr. Poling. When the Polings sought compensation in the Court of Federal Claims, they claimed their daughter experienced dramatic neurologic regression within days of her immunizations (e.g., stopped talking), yet they did not seek medical attention at the time, something most curious given that the father is a Hopkins trained MD PhD neurologist and the mother a nurse.
You have misunderstood what Dr. Offit meant about the "10,000 vaccines" that an infant could tolerate. He was not talking about 10,000 vaccinations (that is, injections or oral doses). He was talking about the number of antigens. A single vaccine may contain as many as 200 antigens. In other words, he is perfectly well aware that subjecting a child to 10,000 vaccinations would be excessive. He was making the entirely correct point that the theory of the vaccination-causes-autism cultists, that children are overwhelmed by the number of vaccines that they receive, doesn't hold water since we know that even exposure to a much larger number of antigens than they are talking about is not problematic.
I'm 52, going on 53. The Sabin vaccine was authorized for general use in 1962 but human trials began in 1957. We may have been in one of the later human trials. I'm certain of the general timing because we moved when I was five and I have a very definite memory of this being at the old house.
I do remember pictures of people in iron lungs. I'm a little too young actually to have experienced concerns about public pools and drinking fountains, though I've heard about them.
Bill
Another thing that people my age are probably about the last to remember is mastoid scars. Quite a few people of my parents' generation had them. They disappeared once effective antibiotics came in after WWII.
There is a point to our exchange, or sort of one...many of those who have enjoyed the benefits of modern vaccines are younger and have done so unknowingly, blissfully unappreciative of the serious effects of the infectious diseases the vaccines protect us against. Hence, attention has shifted away from the very real and significant benefits conferred by modern vaccines and toward the infrequent complications of vaccines, those that are real, those that are purportedly vaccine-related, and those that have nothing to do with the administered vaccines.
No, I don't remember the x-ray machines in shoe stores. Before my time, I guess.
I agree as to the point of our exchange. (An irony here is that my father happened to have published a couple of papers on Guillain-Barre Syndrome, which was not exactly a hot topic, so as a result of the Swine Flu he made loads of money evaluating medical records for lawyers and testifying in the resulting lawsuits.)
There was no misunderstanding; it is you who obviously don’t understand. Having experienced a “major, almost holy event” you cannot fathom than ‘vaccine’ can be anything except virtuous. Spare us, you have become part of the communication problem.
Offit should have never said what he did. It was preaching to the choir (you) but it also alienated every non-choir parent in America who frets over the fever and bad reactions children get from just a couple of injections.
Offit’s problem is his mouth. It may have been a technically, theoretically proper statement. But it doesn’t meet the most cursory reality-in-the-doctors-office test, and it makes him out to be another ‘vaccines can do no harm’ apologist.
Your response is devoid of substantive content. No, I haven't misunderstood, and you don't provide even a hint of evidence or argument that I have. If you look at the context and know anything about vaccines, it is perfectly clear what Offit meant. And I have never even hinted that "vaccines can do no harm". In fact, if you knew what Guillain-Barre syndrome was, you would know from my mention of my father's work that I am well aware of the harm that vaccines can cause. What I do believe is that the good done by vaccines vastly exceeds the harm. If you compare the very low incidence of problems like Guillain-Barre syndrome with the eradication of smallpox and near eradication of polio, to take but two examples, it is very hard to see how anyone could conclude otherwise.
Harry,
I most certainly do. I'm not willing to abandon scientific principles to bolster the argument I believe.
And how many alternative therapies have been studied scientifically? How many have even a chance of being so studied when a "respected" researcher broad-brushes them as hogwash? How scientific is it of that researcher to make such statements in the absence of those studies, and with the wealth of anecdotal evidence that they actually work in many cases?
How magnanimous. So now we're to bow to the wisdom of a doctor who says "alt therapies don't work, period" (even though they sometimes do), and by painting those who use those therapies as "looney-tunes," we can effectively kill any chance there'll ever be a scientific study done on their effectiveness.
Fine, if that's the way you want to do it, but don't call it scientific.
But even if autism isn't at issue, would you not agree that there is a full spectrum of OTHER issues involved here, and that the true believers tipped their disingenuous hand, when they were finally forced to relent on the mercury issue? Forced by we skeptics, that is. Do you think the true believers are open to review those other issues, after they engaged in scorched earth over just that one issue? I'm skeptical.
Tell me, would you today pound mercury-laden injections into your children, Eagar? Would you support the government/corporate axis forcing you to do so?
Do you expect such types to engage in robust, longterm study of these products? I am skeptical. They're out there and profitable, so why bother? That's the nature of corporations, as we should know by now. And if things turn sour, the Paulsons and Bushes and Franks will always be there, of course.
My antenna are always up when I see somebody present the "science is settled" argument, as Adler is doing here with Offit. For engaging in such behavior, Mr. Gore will likely be pilloried mercilessly over the next 10-20 years here... deservedly so.
NowAm I certain of all this? No, but reflect back on an earlier discussion here, looking ahead on100 years of potential technical advancements, and things that would be rejected by then. I felt that the medical field would yield much of these. Wanna bet that 100 years from now, we'll look back with horror at the days when we injected children with crude, largely-untested concoctions as we are today?
And it'll likely take 100 years to collect the data for us to make such judgments. Why don't you true believers spit the bayonet from your teeth, and allow us to start collecting?
Offit, with Adler's support, seems to be making his stand on the Autism Line... this far and no farther.
Neil Z. Miller claims that most epidemic infectious diseases were declining before mass inoculations came on. From 1915-1958, measles death rate dropped by 95 percent in both US/UK. Diptheria down by about 90 percent. Polio down by about 50 percent. Surprised? I was, and yes we know the likely reasons, likely the same reasons cholera epidemics slam to a halt at the US/Mexico border. But we still must include this data in our analysis, not ignore it and blindly reach for the next ampule.
There are other considerations here. Let's consider them, particularly if the cure has potential to be worse than the problem.
And absent longterm study, we don't have that knowledge, do we? Given a choice between pure faith in a corrupt system, and faith tempered by a cold eyed search and review of the data, I'll take the latter.
There's more vaccine hiccups than the mercury thing above, and the "live" vaccine snafu, and these affect far more than polio vacccinations as you should know.
Let's put aside this attempt to bludgeon "skeptics", Mr Adler. It's unseemly of us. And it's certain to put somebody in the history books, and not for reasons they'd want to be there.
I know this fallacy has a name, but I cannot recall it right now.
Loonies: Mercury causes autism!
Scientists: We don't think so.
Loonies: It does! It does!
Scientists: We've conducted studies and not found any evidence to support that, nor a mechanism by which that happens.
Loonies: It does! It does!
Scientists: We don't know what else to tell you.
Loonies: We aren't vaccinating our kids! Take that!
(measles outbreak goes through society because of concentration of unvaccinated kids)
Scientists: Told you so.
Loonies: Mercury!
Scientists: (*sigh*) Okay, we'll take out the mercury, at great cost, and see what happens, okay? Now will you please get your kids immunized so they don't infect the rest of us?
(mercury is removed. nothing changes)
Loonies: Aha! They took out mercury! There must have been something wrong!
If you're implying that mercury isn't a known toxin, then I suggest you publish your treatise immediately. I've spent much of an engineering career removing microscopic traces of it from our waters and air emissions, and I'm sure my clients would welcome the cost savings your theories potentially offer.
Plus, we could go back to injecting our children with it... which is nice.
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Your crude response does make my point, though it's not the point you think you're making,
The true believers actually fought to retain mercury additives... and that's surreal. You don't even have to be a skeptic to question their global approach, if that was their response on this one skeptics' challenge.
Read that guy's post, Adler. It's sad... but that's the road you've turned down here... with the "settled science" thing.
The JAMA reported that in a survey taken of obstetricians, 90 percent refused to take the rubella vaccine, and well over 1/2 of pediatricians surveyed also refused it. Evidently, per the JAMA's article, they feared unforseen reactions.
Now, this is anecdotal, no doubt, and perhaps dated. Still, might it give one pause? Particularly since rubella vaccine effectiveness appears to be quite low. It sure ain't "wiping out" anything, it appears.
Am I a skeptic? Who wouldn't be?
The only sin here is a blind adherence to a single subset of ideas.
Can we dismiss the autism connection? Perhaps, but that shouldn't close a door, it should open one.
Do you doubt that the Hib (haemophilus influenzae) vaccine hasn't dramatically reduced the number of children who develop serious ear infection and meningitis, some of them going deaf or dying? How many American children have developed SSPE (subacute sclerosing panencephalitis)since the advent of the measles vaccine? A great reduction in the number of babies born with severe birth defects (or aborted) since the advent of the rubella vaccine? You do understand, don't you, that the decision to recommend the less protective killed polio vaccine over the more protective and easily administered live one came about because the live vaccine had been so successful in preventing community-acquired polio that the dozen or so cases of polio the US had in most years was from the live vaccine itself?
Are you kidding? I did have my children vaccinated, and I do support the government's forcing nitwits to have their children vaccinated in order to protect my children and, now, grandchildren.
I, too, recall the days Bill Poser and neurodoc wrote about. My mother would not let me attend movies during the summers in Georgia, for fear of polio. (She wouldn't let me go other times during ringworm outbreaks; I had to play outside a lot.)
I wanted to put my feet in the Xray machine but was not permitted. Got thyroid cancer anyway, go figure.
I vividly remember the first Salk shots. A school holiday was declared, and working moms stayed home to take their children to clinics. We stood in line with hundreds of people, and it was an unusually quiet crowd. Our clinic was in an older part of town, with leafy trees arching over the street, where people waited in dappled sunlight. The effect was rather like a cathedral, and the event was treated like a sacrament.
If you're alive, still working and typing that post, then that likely means that both you and your FDA colleague were not born when mercury was recognized as a toxin, back when my collegial predecessors were working hard to remove people from exposure to it. You'll need a long arm, reaching back through a time warp, if you're patting yourself on the back for first recognition of mercury toxicity.
It seems clear that the medical profession/industry was delinquent in acting on this known toxicity, re vaccines. It's only been a short time since they even consented that it COULD be toxic, let alone acted on that possibility.
Is mercury still an additive in any of these vaccines, btw?
Hey, the skeptic tent is big, perhaps including you, but definitely including anybody who challenged the AAP and AAFP's silence on this matter, before finally succumbing to skeptic pressure. Thus the mistrust of them re the broad range of issues re vaccines.
If I told you that I've personally worked on many hundreds of millions of dollars of projects removing mercury from our exposure, and the total tab for same in this country likely runs into the trillions, would that jar you into recognition of the disconnect those numbers represent with the medical profession/industry's reluctance to come up with a preservative other than mercury? I think it should.
Would you pound those previous injections into your children, doc? You seemed to spit on it, but this a critical question, and I'd appreciate your answer.
And I'd rather that Eagar's views not hold sway, so that others aren't forced to submit to Mr. Eagar's eagerness to inject mercury into them.
Now, since I answered your question about the choices we have made for our children, perhaps you will answer this one for me - do you allow anyone in your family, most especially children and young women who may become pregnant, to eat tuna fish? How do exposures to mercury from eating tuna fish compare to those from routine immunizations? (BTW, are we talking "organic" or "inorganic" mercury?)
And how about those questions I posed you regarding the indisputable benefits of various vaccines versus what the anti-vaccine crowd claims are the risks? (To be sure, there are some risks, and there are contraindications to some vaccines, but they are not what the anti-vaccine crowd would have everyone believe.)
Yes, as you mention, upon implementation of the live polio vaccine (which Salk opposed evidently), it became immediately known that the only reported polio cases were being caused by the vaccine itself.
That should give you pause, even if it does arise in Neil Miller's writings.
Now another personal note beyond my attempt to guess your age - you didn't happen to spend part of your youth growing up in VT, did you? I don't expect so, if only because VT is a small state, but if you did then I think you might be the offspring of a colleague.
Sorry about the delay, doc... battery issues (dang mercury again!)
I hate to be presumptuous with a trained professional, but I'm gonna. I don't think I can answer your questions... nor can you. Not enough data available to firmly do so, and my guess above was that it'll be 100 years before we have such data. Known-knowns, known-unknowns... unknown-knowns... and all that rap.
Hey, I'm not anti vaccines, they have saved millions of lives. But do we TRULY KNOW how they work, and what they comprehensively do to our systems, including developing children? Is that balanced equation known... costs vs. benefits? I think we're still developing that. I think you think so, too.
You see me here grabbing a few stray threads and tugging, and yes I believe these threads represent grounds to be skeptical of the medical industry/profession's actions overall. But, how could it be different, given the short time we've been at this vaccination thing?
I think you get into trouble when you get a bit too sure of what you know... and forget how much you don't know, and that the government/corporate axis will often default to an expediency ignoring all knowing... as I believe they did re thimerosal. And as mentioned ad nauseum, that is only one thread.
Beware the "settled science" mindset. Sure, the skeptics are a pain in the ass. We all deal with it. Every time a bridge falls down and kills somebody in MN, I've got a foursome full of my retard buddies riding me about "you dumb engineers" (as if a layman knows what went on there).
Grow some thicker skin. The skeptics have a kernel of benefit to you, and you're the less for it if you (and Adler) go dark on them.
No need for your CV, I believe your qualifications are well in order, and I appreciate your respectful tone.
Now, you didn't QUITE answer my question. I asked if you'd inject your children TODAY with mercury vaccines. I hate hypotheticals, and I realize we can't unring the bell of science, but the intensity of your answer might be informative for you. If you're seeking to know the skeptics' mind, your own might aid you.
My kids are grown and fully vacci-mercurized, but I believe the grand kids are being selectively vaccinated. Tuna isn't a big part of our diet, although seafood exposure is only a fraction of the vaccination exposure, depending on who's counting. And infants don't eat tuna, but they do get vaccinated.
Keep up the good work. We need you, even us shrill skeptics.
p.s. Is Miller some type of pariah? I just got that bit of his data off the shelf somewhere, and if you dispute it, I'd be interested in getting a taste of why you do.
What do you think of the Verstraten study?
I wish that the NYT article had mentioned that Offit was on the ACIP when they approved the Rotavirus vaccine, and he was working on RotaTeq (the second one approved, RotaShield was approved and pulled from the market).Or why Rotashield was voted on by the ACIP even before the FDA licensed it (according to the CDC they know of no other time this has happened).
I don't know if vaccines cause autism, if they contribute to autism or anything else, but the pro vaccine side reminds me of the global warming types for whom any questioning of the belief is a sign that you are ignorant and don't care about the planet/children. You can't questiion them, and if you point out the fact that both the Pharma industry and AAP have a vested interest in promoting vaccines (how many well baby visits will people show up for without the vaccines?) then you are looked at like you are on your way to see Elvis in Area 51.
And for those who claim that the reason for the rise in ASD diagnosis is due to diagnosis, an new study from UC Davis that shows this is not the case (Published in the January 2009 issue of the journal Epidemiology).
That is exactly what you misunderstand. The vast majority of normal folks aren’t going to look at nuanced context, and regardless, they don’t know a lot about vaccines. Normal people know their children get reactions from two or three vaccinations at a time, and claiming their children can have “hundred or thousands” of these is outrageous.
[Offit does not use the word ‘antigens’; he says ‘vaccinations’. It’s most probable he was talking about antigens as you claim, not shots, but he doesn’t say that. Nonetheless, I would challenge his statement anyway; it’s theoretical and unsupported by any science. For a anti-anti-science guy, he should never have said it.]
As an advocate, Offit fails —and so does Poser— until they can grasp how normal people perceive their claims. Normal people will never accept that vaccines are “holy” or “sacramental”. They are medicines, and like any other have a benefit-to-harm ratio.
As long as advocates preach holiness of a medical treatment, as long as they conjure up imagery of babies turned into pincushions of hypodermics, normal people will resist the message. A portion of those normal people will reject the message entirely —indeed, vaccines are not holy and children will never tolerate thousands of shots— and seek alternatives.
Vaccines are generally good things, but with vaccination advocates like these, it’s no wonder some people look to voodoo.
gran habano – Mercury's has been known to be toxic for hundreds of years.
Under its more common name, thimerosal was used by millions of people. Until the 1960s it was the second or third most common disinfectant to treat minor cuts, abrasions, fungal and bacterial infections. It was finally discontinued in favor of less painful products.
These applications —dosing people at billions of times the vaccine amounts— has never been shown to be toxic, much less a factor in autism.
Autism? It ain’t mercury.
Thank you for the complement. I don't tend to cite articles from journals such as Journal of Child Neurology in blog comments because (1) generally they aren't available on-line, and (2) anything written at above the technical level of say articles in Scientific American or Discover usually is beyond what lay persons like lawyers can understand. People who like organic chem or who like doing regression analysis aren't commonly found in law schools.
For those interest is less than light reading who wonder what life was like before the standard vaccination schedule, I suggest:
APPENDIX G
Data and Statistics
Reported Cases and Deaths
from Vaccine-Preventable Diseases: 1950-2007*. G-1
Impact of Vaccines in the 20th &21st Centuries. G-7
Vaccine Coverage Levels: 1962-2006. G-8
online at www.cdc.gov as part of the Pinkbook's appendicies
and
Impact of Specific Medical Interventions on Reducing the Prevalence of Mental Retardation
Jeffrey P. Brosco, MD, PhD; Michael Mattingly, BS; Lee M. Sanders, MD, MPH
Arch Pediatr Adolesc Med. 2006;160:302-309 online at
http://archpedi.ama-assn.org
Just because they were called "childhood illnesses" doesn't mean that there were not significant numbers of children who died or were permanently disabled by them.
Dear Aggle:
Sorry if I was a little short with you. I have ex-in-laws who are firmly alties -- and try to push every currently in-fad CAM treatment on my children. I've learned to dig beneath claims of success.
RE: info on mitochondrial disorders, I'd recommend going to Prometheus' and Dr. Novella's sites, and searching their archives. Dr. Novella has written several articles along those lines.
And, "Yes" there is significant funding for research on the effectiveness of CAM. I think that the NIH budget for CAM research this fiscal year is $125 Million. Sen. Harkin (D. Iowa) is a big proponent of CAM. The problem isn't lack of research. The problem for CAM is that studies generally don't support the claims of CAM proponents as to CAM treatments' effectiveness.
And, as to autism particularly, remember that it is developmental delay, not developmental stoppage. That there will be progress is expected -- even without "treatment." Treatments that can show replicatable results or which cannot be explained as to why they should be effective are suspect. The parents of ASD children are desperate. Unfortunately, whenever there are desperate people, flim-flam artists show up to prey on them. And, since some of the CAM treatments -- like chelation -- can be dangerous, "trust but verify" is a required strategy.
Really einhverfr? Says who? See
Is the Rise In Autism Rates Real? by Dr. Novella, Jan 9, 2009 online at www.theness.com/neurologicablog/?p=454 It questions the study published in the Jan 2009 edition of Epidemiology.
While I personally believe that there is a rise in ASD incidence, I still maintain my skepticism.
Before DSM-III was published in 1980 there was no generally accepted "autism" diagnosis. DSM-III introduced PDD as a separate diagnosis. There were still people who exhibited the same clinical symptoms. They had different diagnoses.
Still, in addition to the reasons Dr. Novella discusses, I can think of 2 add'l reasons for the rise in diagnosed ASD cases. One is that parents are no longer ashamed of having FLKs ("Funny Looking Kids") as children. My late father was a psychiatrist and my late mother was a psychiatric social worker. There was a time when people who had children with "problems" would have them committed to a State Hospital on the other side of the State. Or, there were the Maiden Aunt kept in the attic. Truman Capote's short stories about his somewhat strange acting aunt would likely give Neurodoc a field day in writing a paper about her proper diagnosis. Ever heard of "Bachelor Luthern Farmers"? People like that existed -- and still exist. Some of my current in-laws are farmers. They know any number of people who are quiet, not very social, come to the church their parents attended and sit in the same place in back every Sunday and go to the same buffet restaurant just like they used to go with their parents, never dated or married, and are pretty good doing mechanical things and following the schedule that the people from the Agricultural Extension Service recommend for their farms. No one has diagnosed them as high functioning PDD-NOS, unless services from the state are being sought. But, today, having such a diagnosis isn't looked down upon, and so if that opens the door to services, it's obtained.
My second idea is "College -- the place where Geeks Meet and Mate". The evidence is mounting for genetic underpinnings for autisms (plural deliberate -- I believe there are a number of different distinct types of autism which eventually objective tests will be developed for). People who were "strange" but "bookish" can more readily go to college, and grad school. And, as various studies have shown, high income potential becomes more and more attractive the better educated and mature women are. As a female friend puts it: "Cheesecake is nice to look at, but a solid six figure income is sexy as all hell."
Dear Joe Strummer:
The patent for RotaTeq was assigned to The Children's Hospital of Philadelphia and The Winstar Institute of Anatomy and Biology. This is available from the publicly accessible full-text patent database on the US Patent and Trademark Office's website. I understand that The Children's Hospital Foundation subsequently sold its royalty interest to Royalty Pharma for $182 million in cash. Dr. Offit isn't making money on this patent.
You'd think somebody would have noticed.
From the New England Journal of Medicine “Dr. Offit reports being a co-inventor and co-holder of a patent on the rotavirus vaccine RotaTeq, from which he and his institution receive royalties, as well as serving on a scientific advisory board for Merck.”
In addition, he is on record as having received ongoing payments from Merck, including while he was on the ACIP, and was one of the subjects of a congression inquiry into conflicts of interest in August 2000 (Committee on Government Reform "Conflict of Interest in Vaccine Policy Making") Dr Offit was repeatedly mentioned by name in the report.
From the New England Journal of Medicine “Dr. Offit reports being a co-inventor and co-holder of a patent on the rotavirus vaccine RotaTeq, from which he and his institution receive royalties, as well as serving on a scientific advisory board for Merck.”
In addition, he is on record as having received ongoing payments from Merck, including while he was on the ACIP, and was one of the subjects of a congression inquiry into conflicts of interest in August 2000 (Committee on Government Reform "Conflict of Interest in Vaccine Policy Making") Dr Offit was repeatedly mentioned by name in the report.
A book is always a nice way to launder some payoff money, too, as politicians know so well. Amazing how some of these stooges somehow manage to unload pallets-ful of some forgettable screed.... almost like... like... well... like people aren't buying to read it, but rather buying it to buy the writer. I wasn't gonna broach this about Mr. Offit's book, but now that somebody else is questioning his ethics, I'd say it's now fair game in here.
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Oh and Eagar, I'm guessin' there's a whole lot you don't notice. If you need any help, let me know.
I mentioned the Journal of Child Neurology because that's where the Poling article was published. And that's where Dr. Poling was rebuked by the editor for disingenuity, which might call into question his credibility, especially as to the temporal relationship between his daughter's immunizations and the first neurologic symptoms thereafter. But in any event, only the anti-vaccine crowd makes a big deal about the Poling case, failing to understand as they do that some with mitochondrial disorders (there are a great many different ones, with no doubt many more yet to be recognized and studied) may suffer serious injuries from non-specific stressors, like fever after an immunization or in the face of an otherwise inconsequential infection.
The rotavirus vaccine - I don't know what bearing that story has on the question of vaccines as a cause of autism or other serious neurologic injuries. After the vaccine was licensed and marketed for awhile, it was appreciated that some infants were developing bowel intussuceptions on account of swelling of lymphoid tissue after getting the vaccine. When that was appreciated as a complication of the vaccine, the vaccine was quickly taken off the market. A small number of babies required surgery to reduce their bowels, and they were compensated for those injuries. Much less common for a vaccine to be taken off the market like that than for it to happen with a drug, but it does happen. If Dr. Offitt is somehow tainted by his involvement with the development and licensing of that vaccine, and I don't know that he was, then it may bear on his credibility, but it says nothing about the merits of his arguments regarding the safety of routine childhood immunizations.
gran habano, my children were vaccinated years ago, and have only had some "adult" vaccines since. If I had grandchildren, I would certainly want them to have all the routine immunizations according to the recommended schedules, as would all those I count as knowledgeable about these things, and I know a good many of them professionally and personally.
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Nieporent,
The credential you're evidently praising in Mr. Offit is one that ethical folks eschew, particularly we engineers.
However, if that was a backhanded slap at me, then let's talk about my "credentials" and contributions to the prevention of infectious diseases. Those statistics I presented earlier, re the large decline of deaths due to infectitious diseases BEFORE mass vaccination began, are significant. Well over 50 percent drop in many of them before 1958.
Assuming you're a typical, technically-illiterate lawyer (and pardon me if you're not, but I find that most lawyers are, and most of them just love to play engineer, foolishly so), then you may not know how that decline came about. You should learn it.
Now, I certainly didn't initiate the saving of those millions of lives, but folks just like me DID, and I've faithfully carried through on the path they set, as a professional. The work we do has even more benefits thann disease prevention, but it has that as well, and millions are alive because of it... arguably more than might be credited to neurodoc's functional group. Both are important... no doubt.
And my payment for same has come above the table, and without recourse to political influence, an eye to personal investment, and while spurning the overtures of those to whom Mr. Offit has apparently succumbed longterm.
Pardon me if my slaps are a little more than backhanded... a cryptic, snobby, opaque post is just as distasteful to me as this likely is to you.
I get the feeling Offit doesn't do much turning away from profit.
And prior to Jimmy Carter, Dem. Presidents turned away opportunities to cash in on having been President, and since Carter, Repub. Presidents have avoided cashing in on having been President.
Dear gran habano:
Please identify which vaccines to which you refer, and provide citations to support your conclusion that even those that did contain thimerosal had it in amounts sufficient to raise questions about their safety (Hints: (1) MMR never contained thimerosal; (2) Jenny McCarthy, David Kirby, Dan Olmsted, J. B. Handley, DAN! and Age of Autism are not credible sources).
gran habano, why would I give children today the older versions of any vaccine rather than the improved versions of them? It is not my position that the vaccines which contained very small amounts of mercury in their thiomerosal component were superior to what is marketed now. Do I have any regrets that my children received all the routine childhood immunizations or would I do anything differently in that regard if we could go back in time? No.
Now, please answer wfjag's question about the amounts of mercury actually present in vaccines that had and/or still have mercury in them. And then compare those amounts to how much the average American takes in through their consumption of fish and other means, as I asked you to do before wfjag picked up the beat.
Dear Neurodoc: I hope not. Although I may be a well-informed layperson in this area, those whose expertise are involved need to state why such CAM nonsense is both Poppycock* and dangerous.
*I usually use somewhat stronger language. Being retired military, being PC isn't high on my agenda. Being an honors grad from an Ivy League university, I'm both not intimidated by "degrees" and also believe I can learn to understand a subject provided I am willing to spend the necessary time studying it and applying sound scientific methodology, and am ruthless in cutting through the nonsense that too often offered as insight. I have an autistic child, who, since I regained custody is making considerable progress. I have, however, had to battle the ex, and ex in-laws (who are all firmly alties) on this and related subjects - in and out of court. I have, also, seen the tragedy that can result when based on nonsense about the "dangers of vaccines" parents fail to have their children vaccinated. Those "childhood diseases" can kill and cripple -- and can do so when the opportunity arises. So, "No" please do not lessen your participation and attempts to educate against this dangerous nonsense. Re-double your efforts.
Such "spills" today would call out the hazmat team and require a half-million-dollar "remediation."
I understand the dangers of mercury, but we co-evolved with the stuff and if microscopic amounts were as bad as some people think, we'd have gone extinct a couple million years ago.
Same with dioxin.
With that understood, now you can go to work explaining the incongruity between my profession's and society's longtime trillions-of-dollars effort (Eagar doesn't understand this effort, hopefully you do) to remove our exposure to mercury, vs. the medical industry/government axis' refusal to address the issue of mercury as vaccine preservative.
And THAT effort sure as hell didn't cost trillions, as we know. How much? Let me guess... and guess HIGH... $500 per person as expensed cost... say 2M persons per year... $1B per year...
And no O&M and and upgrade costs, as in my group's efforts. It's a one off development expense. One and done.
These numbers are simply incongruous. Thus, the skepticism, on the numbers alone, even ignoring the "settled science" which your absence of humility leads you to believe you have in-hand... even though you spent a post above excusing a previous blunder... and excusing Offit's involvement in it.
I'm gonna read through that again, and decide what/if I have to say about that incident... but right off hand, it smacks of a huge blunder... and I'd hope to see a bit more from you than excusing it.
Yes, I'm a layman, but you've found your way onto my radar screen... and if you're honest, you'll look for reasons why. My radar screen sure ain't tuned to a vaccine wavelength, as you should understand from my posts. You put yourself onto it. Why?
Remember, me and my fellow engineers take our marching orders from you neurodocs... as you know. On which side of this have you guys dropped the ball? Past toxicology or present?
and remember, you guys DID finally acknowledge that MMR and hep B contained nearly 100 times an infant safe dose of mercury. Mercury is a toxin to cells... which I'm assuming is why it was used in the first place. Why'd it take you guys so long to acknowledge this... particularly with the above incongruity in mind?
I addressed seafood consumption of mercury, and noted that it's fractional to past vaccine inputs, depending who's counting.
I don't advocate for either, and find this comparative discussion rather odious, coming from you in particular.
Is it a toxin or isn't it, Doctor?
Would you inject your children with it?
Editorially, you may want to leave the above relativity and value judgements to hardbitten engineers, because, and I'll condescend again... we are in better position and training to take the full measure and cost/benefit analysis, if we're going across a broad spectrum of sources of intake... and weighting and assigning priorities to them. Not that you're a bad guy, but the axis doesn't seem to do well when forced to go cross functional, and the med profession has given us reasons to be skeptical re their past actions re nutrition. Be honest here... and give me your own essay on those reasons for our skepticism. You're a good guy... and good guys embrace Lessons Learned, doc.
I'll leave you to answer that guy's questions re ingredients, as I've been ignoring him as a pure interested advocate, which I am not. The known ingredients are something we should be able to agree upon. The studied affects... well... you know my position on current studies. See me in 100 years. Start with the composition of MMR, because I think he needs that. First year engrg students do qualitative analysis, same as you guys no doubt. The presence or absence of mercury in a vaccine dose is likely fairly easy to come up with, and I doubt a bunch of folks have blown first year chem. methodology on their historical MMR vaccine anal. , even if the mfr is deceptive with their ingredients.
Plus, the guy seems to think Reagan didn't cash in on that well-publicized $1 Japan speech, and Bush I didn't cash in on his ME consulting firm. I don't care if they did, they're politicians, bought and paid for, but remember, more is expected of you and I, and your colleague Offit. I may return to him later, as mentioned.
This is more global than that. For me, it's about process. I'm skeptical that the corporate/government axis has a legitimate process. These few threads I'm discussing are an indicator of that. Bludgeons won't get us to solid process... and as I mentioned earlier, I suspect that Mr. Gore is about to get a long seminar on what the fruits of bludgeonary science bring on. See me in 100 years on that one, too.
gran habano -- let me explain this to you in very short words -- No vaccine using a weakened virus to trigger the immune response ever contained any form of any mercury. Thirmerosal kills viruses. The MMR vaccine has never – not ever – contained thirmerosal. A thirmerosal free Hepatitis B Vaccine has been available since September 1999 and was approved at that time for vaccinations to children less than 6 months old. Please see the CDC website, which contains accurate information.
Are you familiar with the idea of "dose/response"? I didn't think so.
Any substance -- I a mean any substance including H2O and O2 - is lethal in sufficiently high concentrations.
I requested that you provide references for you assertions. You haven't. I suggest that you check your info sources. I also suggest that you look at ScienceBlog blogs, since that group doesn't allow cranks and pseudoscientists to post on blogs they operate.
He could speak for himself, but I interpreted his response to mean that, if those vaccines were the best we still had, he would.
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