One of my goals in writing for this blog is to educate the general public about how to evaluate a scientific study, specifically medical studies. New studies are being reported in the press all the time, and the analysis provided by your average journalist leaves much to be desired. Generally, they fail to put the study into context, often get the bottom line incorrect, and then some headline writer puts a sensationalistic bow on top.

In addition to mediocre science journalism we also face dedicated ideological groups who go out of their way to spin, distort, and mutilate the scientific literature all in one direction. The anti-vaccine community is a shining example of this – they can dismiss any study whose conclusions they do not like, while promoting any horrible worthless study as long as it casts suspicion on vaccines.

Yesterday on Age of Autism (the propaganda blog for Generation Rescue) Mark Blaxill gave us another example of this, presenting a terrible pilot study as if we could draw any conclusions from it. The study is yet another publication apparently squeezed out of the same data set that Laura Hewitson has been milking for several years now - a study involving macaque infants and vaccinations. In this study Hewitson claims a significant difference in brain maturation between vaccinated and unvaccinated macaque infants, by MRI and PET analysis. Blaxill presents the study without noting any of its crippling limitations, and the commenters predictably gush.

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This bit of good news is already spreading around the science blogosphere, but I wanted to chime in also. The New South Wales Health Care Complaints Commission (HCCC) has issued a very damning statement against Australia’s largest anti-vaccination organization, the Australian Vaccination Network (AVN). According to reports:

The HCCC accuses the AVN of providing inaccurate and misleading information and selectively quoting research out of context to argue against vaccination.

The report has also noted accusations that the AVN harassed the parents of a child who died of whooping cough last year, after the parents advocated the importance of childhood vaccination.

This is the result of a long investigation – but also the result of a campaign by my friends and colleagues “down undah,” specifically Rachael Dunlop (Dr. Rachie) who spearheads the anti-antivax efforts of the Australian Skeptics. They have done an excellent job of keeping the pressure on the AVN and have been scoring huge victories in the media.

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It has been a slow blogging week for me. I have been far busier than I thought completing my project – which I will be happy to tell you all about once I have the green light to promote it.

Meanwhile, here is an excellent article by Trine Tsouderos regarding OSR#1, which is an oral chelator being used by some to treat their kids with autism. The marketing of OSR#1 represents many of the problems that I and others have been blogging about for years.

OSR#1 was originally developed as a chelating agent to be used in industry – not for medical use. It binds to heavy metals, like mercury, and therefore those in the anti-vaccine community who still cling to the discredited notion that autism is a form of mercury toxicity believe it can be used to treat autism.

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I am out of town this week on a special project – more details will follow when I have the green light to start promoting it. So my posting will be a bit erratic this week.

Just a quick post for today. I want to point out that Age of Autism, the anti-vaccine propaganda blog of Generation Rescue, has really gone over the top in their witch hunt against anyone who dares try to educate the public about vaccines and correct the constant flow of misinformation that comes from the anti-vaccine ideologues. Their chosen method of attack is alleged conflicts of interest – and it is truly a witch hunt.

The core features of a witch hunt are that the accusation of guilt is treated as being equal to guilt, and that the rules of evidence of so fluid and vague that even “spectral” evidence is accepted – anything that creates even the impression of guilt.

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The anti-vaccine movement is nothing if not savvy about marketing their nonsense – at least in the last decade. One of their successful slogans has been “too many, too soon” – implying that children are receiving too many vaccines while they are still too young to deal with them. The result, anti-vaccinationists argue, is potential neurological toxicity or “overwhelming” the immune system.

The slogan also serves double duty, allowing anti-vaccinationists to argue that they are not “anti-vaccine” just “pro-safe vaccine.” This is just more marketing savvy, however – a deliberate deception, as many of the people who make this claim also state that they would never vaccinate. (Orac has pointed this out many times in great insolent detail.)

But there are some parents who have bought into this notion and have reduced and/or delayed the number of vaccines their children receive in the hopes that they can strike a better balance of risk vs benefit than the experts have struck. And there are fringe doctors, like Dr. Jay Gordon, who promotes his own evidence-free alternate vaccine schedule, playing into the “too many, too soon” meme.

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One of the burning controversies in the autism community is whether or not special diets, specifically gluten-free or casein-free, are of benefit to the symptoms of autism. About 1 in 5 children with autism are on a special diet, and many parents strongly believe it is of benefit, but there has been no scientific evidence to back up their anecdotal observations.

A recent study adds to the evidence for a lack of benefit from such diets. The study is not yet published, but is summarized on the University of Rochester website. The main weakness of the study is that it is small – the study enrolled 22 children and 14 completed the study. It’s strength is that it was tightly controlled. Children were placed on a gluten-free (no wheat and barley) and casein-free (no dairy products) diet for 4 weeks. They were then challenged in a double-blind manner with snacks containing gluten, casein, both, or neither (placebo) and observed for behavior and GI symptoms. The study found no benefit for any outcome measure.

By itself this study is far from definitive and I am sure it will not be the last word. It is a small addition to the growing evidence showing lack of benefit from such special diets in autism.

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Last night Frontline aired a show called The Vaccine Wars. You can watch the full episode online here. Overall, they did a good job of representing the current state of the science, and the anti-scientific nature of the anti-vaccine movement.

The overall theme of the piece was that anti-vaccine parents are irresponsible and go against the science. In fact, their view are immune to science, as they dismiss the evidence which contradicts their position, and constantly shift the goalposts when evidence goes against a link between vaccines and autism.

The piece did cut some corners on details, but probably will only be noticed by someone steeped in the anti-vaccine movement.

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The anti-vaccine movement, as is probably typical for ideological movements, has natural enemies and allies. Once the notion that mercury in the form of thimerosal in vaccines might be responsible for neurodevelopmental disorders (it’s not) became popular in the anti-vaccine crowd, this made them natural allies with the “mercury-militia” – those who blame environmental mercury for a host of ills. The fact that some anti-vaccinationists seek to provide their children on the autism spectrum with unconventional biological treatments, based on their disproved “toxin” hypothesis, made them natural allies with the alternative medicine community. Both seek freedom from pesky regulation, and rail against the perceived deficiencies of science-based medicine.

Another ideological alliance is brewing – that between the anti-vaccine movement and extreme environmentalists. This post is not a commentary on environmentalism, and please do not take it as such – the purposes and claims of the two movements are quite distinct. But they share a common thread: distrust of scientific experts and government regulators who reassure the public that environmental exposures are safe.

Robert F. Kennedy Jr. has been the most prominent environmentalist to take up the anti-vaccine cause, in several articles and speeches. While he appears to be only a part-time anti-vaccinationist, his celebrity and street cred among environmentalists lend a great deal of weight to his paranoid musings about scientific fraud and government cover ups. It seems he wants to recapitulate the moral clarity that his uncles displayed in the 1960s, defending the little guy against abuses by the powerful and privileged. He is ready to see a conspiracy, and he wants to be the crusader for environmental justice – and if kids are the alleged victims, all the better. His article in the Huffington Post – “Attack on Mothers,” says it all.

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Imagine a ring of car thieves lobbying the government to soften the laws against stealing cars. Don’t blame the thieves – people should be more responsible for their own cars, and that is just the chance you take when you own a car. Under the radar, without any comment by the media, in state after state they successfully lobby the legislatures to pass laws that make it more difficult to prosecute and punish car thieves.

Of course this is outrageous, but not just because it’s silly to consider that something like stealing a car should not be a serious crime. It is also outrageous for someone who is violating regulations to lobby for those very regulations to be weakened so that they can continue to break the regulations without fear of action being taken against them. At the very least such action should garner significant attention and debate, and lawmakers should consider carefully if the public’s best interest is being met, or simply the person who doesn’t want to be regulated.

This is exactly what is happening in many states with so-called “health care freedom laws” – practitioners of dubious treatments are lobbying state legislatures to weaken regulations against practicing dubious treatments. There are even specific cases in which an individual practitioner was found to be practicing below the acceptable standard of care, but was able to escape regulation because of laws specifically passed to protect substandard care. This is exactly what happened with Dr. William Hammesfahr – he was found to be practicing substandard care by the State of Florida, but was able to appeal and win on the grounds that his treatment was “alternative” and therefore magically exempt from the standard of care under Florida’s new health care freedom law.

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I love a good sequel. Aliens, of course, was the best sequel ever – that rare event when the sequel is actually better than the original movie (of course, the series went down hill from there, like Star Trek it peaked with the second movie).

Last year we heard the results of the Autism Omnibus – a special court with three special masters set up to resolve about 5,000 cases before the vaccine court claiming that autism resulted from vaccines – either the MMR vaccine or thimerosal (a mercury-based preservative in some vaccines, but removed from most by 2002). In the US there is a Vaccine Injury Compensation Program (VICP) which bypasses the regular courts and awards compensation to those injured by vaccines, paid for by a small tax on each dose of vaccine given. The purpose is to rapidly compensate those who might have been injured (the threshold for evidence is quite low) and to encourage pharmaceutical companies to manufacture vaccines (the threat of suit would make it not viable otherwise).

Over 2008 the Autism Omnibus heard three cases that were presented as the test cases (presumably the best cases they could come up with) for the theory that the  MMR vaccine (with or without thimerosal from other vaccines – MMR never had thimerosal) caused or contributed to autism in some individuals. They ruled against all three cases, stating in very strong terms that there is no evidence to back up the claims of a link between MMR and autism. Judge Hasting wrote of one case – Cedillo:

Considering all of the evidence, I found that the petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to causing immune dysfunction, or that the MMR vaccine can contribute to causing either autism or gastrointestinal dysfunction. I further conclude that while Michelle Cedillo has tragically suffered from autism and other severe conditions, the petitioners have also failed to demonstrate that her vaccinations played any role at all in causing those problems.

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