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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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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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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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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This week on Science-Based Medicine I wrote an article about a new study looking at the onset of autism symptoms, showing that most children who will later be diagnosed with autism will show clear signs of autism at 12 months of age, but not 6 months. This is an interesting study that sheds light on the natural course of autism. I also discussed the implications of this study for the claim that autism is caused by vaccines.

Unfortunately, I made a statement that is simply wrong. I wrote:

Many children are diagnosed between the age of 2 and 3, during the height of the childhood vaccine schedule.

First, this was a vague statement – not quantitative, and was sloppily written, giving a different impression from the one I intended. I make these kinds of errors from time to time – that is one of the perils of daily blogging about technical topics, and posting blogs without editorial or peer-review. Most blog readers understand this, and typically I will simply clarify my prose or correct mistakes when they are pointed out.

However, since I often write about topics that interest dedicated ideologues who seek to sow anti-science and confusion, sometimes these errors open the door for the flame warriors. That is what happened in this case.

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The current process of districting in this country has many critics. Essentially their point is that congressmen carve up districts in odd ways so as to create an artificial majority for their party in their district. Of course, this leaves a majority for the other party in other districts, so everyone’s happy. This leads to the excessively high re-election rate in the House of Representatives of about 98%.

The best summary of this distorted practice in my opinion is by George Will, who says (and I paraphrase) – this is the practice of having politicians choose their voters rather than voters choosing their representatives.

There is a very similar phenomenon happening in the bizarro world of complementary and alternative medicine (CAM). CAM advocates seem intent on being able to choose their evidence, rather than have the scientific evidence choose which treatments are safe and effective.

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As promised, I watched the Inside Edition segment last night following up on the Desiree Jennings case. If you remember, she is the 25 year old woman who claimed to have a neurological disorder called dystonia following a seasonal flu vaccine. Her story never added up, and the video of her disorder that was made public (and disseminated, of course, on YouTube) did not show dystonia. Every neurologist who viewed the video and commented publicly, including me, were of the opinion that her symptoms were psychogenic.

The question at hand is whether or not she has a neurological disorder and whether it can plausibly be connected to the flu vaccine. I have made a strong case that her symptoms are not neurological but psychological (and to be clear, neither I nor any physician commenting on her case has accused her of lying or hoaxing her symptoms). Despite this, the anti-vaccine movement was quick to jump on the case and exploit Ms. Jennings for their own propaganda purposes. They were also quick to criticize me and others for commenting on her case, and in fact they grossly distorted the opinions we expressed.

Ms. Jennings eventually found her way to Dr. Buttar, who has been criticized by the North Carolina Medical Board for charging patients exorbitant fees for unproven and ineffective treatments. These complaints are still under investigation. Buttar diagnosed Ms. Jennings with both a viral encephalitis and mercury toxicity – when it would be impossible for her to have been exposed to both mercury and a live virus from the same vaccine. He treated her with chelation therapy and a few stints in the hyperbaric chamber, and then claimed a dramatic cure. In fact, I predicted this would happen and further predicted that an improvement in her symptoms that was too quick for any biological cause would confirm the diagnosis of a psychogenic disorder.

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Andrew Wakefield, the UK researcher who sparked unwarranted fears about the risks of the MMR vaccine, has been the subject of a two-and-a-half years ethics investigation by the General Medical Council (GMC). This afternoon the GMC announced their conclusion, ruling that Wakefield acted “dishonestly and irresponsibly” in his research and with “callous disregard” for the children that were the subject of his research.

Wakefield’s Story

In 1998 Wakefield and others published a story in the Lancet where they claimed to find an association between finding the measles virus in the GI tract of children with autism following the MMR vaccine. The study itself was small – only involving 12 children, and the conclusions were modest, not specifically suggesting a link between MMR and autism. But in subsequent press conferences Wakefield raised the alarm, saying, “Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people.”

The result was a significant drop in MMR compliance and a resurgence of measles cases, as this BBC chart demonstrates.

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