17. Oxidative stress in autism (2006)
Goes number 17; Taylor number 17
Chauhan A, Chauhan V. Oxidative stress in autism. Pathophysiology. 2006 Aug;13(3):171-81. Epub 2006 Jun 12. http://www.ncbi.nlm.nih.gov/pubmed/16766163
This is a review article, summarizing the research to date on oxidative stress in autism and some implications for The conclusion:
Preliminary results of some of clinical trials have suggested improved behavior in individuals with autism who receive antioxidant therapy.
Does this paper "demonstrate that vaccines can cause autism"? No.
Friday, July 27, 2012 at 11:06 AM in autism | Permalink | Comments (0) | TrackBack (0)
16. Evidence of toxicity, oxidative stress, and neuronal insult in autism (2006)
Kern JK, Jones AM. Evidence of toxicity, oxidative stress, and neuronal insult in autism. J Toxicol Environ Health B Crit Rev. 2006 Nov-Dec;9(6):485-99.
Does this paper "demonstrate that vaccines can cause autism"? No, this is a review paper rather that an randomized, controlled study of vaccines in autism.
Kern is a co-author on 31 papers. It is worrying that of those, two are positive studies on secretin and 14 have one or both Geiers as co-authors, including two from 2012 and one from 2011. She is currently employed by the Geier chemical-castration-for-autism chain.
15. Large brains in autism: the challenge of pervasive abnormality (2005)
Herbert MR. Large brains in autism: the challenge of pervasive abnormality. Neuroscientist. 2005 Oct;11(5):417-40.
Here's the abstract for the paper:
The most replicated finding in autism neuroanatomy-a tendency to unusually large brains-has seemed paradoxical in relation to the specificity of the abnormalities in three behavioral domains that define autism. We now know a range of things about this phenomenon, including that brains in autism have a growth spurt shortly after birth and then slow in growth a few short years afterward, that only younger but not older brains are larger in autism than in controls, that white matter contributes disproportionately to this volume increase and in a nonuniform pattern suggesting postnatal pathology, that functional connectivity among regions of autistic brains is diminished, and that neuroinflammation (including microgliosis and astrogliosis) appears to be present in autistic brain tissue from childhood through adulthood. Alongside these pervasive brain tissue and functional abnormalities, there have arisen theories of pervasive or widespread neural information processing or signal coordination abnormalities (such as weak central coherence, impaired complex processing, and underconnectivity), which are argued to underlie the specific observable behavioral features of autism. This convergence of findings and models suggests that a systems- and chronic disease-based reformulation of function and pathophysiology in autism needs to be considered, and it opens the possibility for new treatment targets.
The paper is a review of what is known about the differences in brain development and function in autism, and concludes with Dr. Herbert's speculations on autism as a systematic condition.
In October 2006, Dr. Herbert testified as an expert witness in an autism-causation case. The judge found:
Dr. Herbert's publications indicate that she is an outspoken advocate of increased attention to the possibility of environmental influences. Even she, however, despite that acknowledged perspective, speaks in her published work of possibilities and potentialities, rather than of the 'reasonable degree of medical certainty' .... Dr. Herbert's method, to the extent the Court can discern it from the materials offered, is a series of deductions based on possibilities…..Clearly, Dr. Herbert's method is not generally accepted in the scientific community. Dr. Herbert's theory of environmental triggers of autism may some day prove true. It has not yet.
14. Oxidative Stress in Autism: Elevated Cerebellar 3-nitrotyrosine Levels (2008)
Sajdel-Sulkowska EM, Lipinski B, Windom H, Audhya T, McGinnis W. Oxidative Stress in Autism: Elevated Cerebellar 3-nitrotyrosine Levels American Journal of Biochemistry and Biotechnology. 2008; 4: (2) 73-84. DOI: 10.3844/ajbbsp.2008.73.84 not in PubMed
http://thescipub.com/abstract/10.3844/ajbbsp.2008.73.84
This is a post-mortem study of frozen brain tissue drawn from 10 typically-developing subjects and 9 autistic subjects. The oxidative stress marker 3-nitrotyrosine (3-NT) showed statistically significant differences; the differences in mercury was not statistically significant.
While preliminary, the results of the present study add elevated oxidative stress markers in brain to the growing body of data reflecting greater oxidative stress in autism.
I have a number of questions about this paper, that I haven't been able to find answers for. The paper was published in 2008, seven years after thimerosal was removed from childhood vaccines. The paper is silent upon the subjects' thimerosal exposure, or other sources of mercury exposure.
Does this paper "demonstrate that vaccines can cause autism"? No, it demonstrates that these nine autistic brains vary in one oxidative stress marker.
13. Developmental regression and mitochondrial dysfunction in a child with autism (2006)
Poling JS, Frye RE, Shoffner J, Zimmerman AW. Developmental regression and mitochondrial dysfunction in a child with autism. J Child Neurol. 2006 Feb;21(2):170-2.
This is the infamous Poling paper, which was published without Poling's disclosure of conflict of interest.
Kathleen Seidell:
It is simply incredible that a doctor who convenes a press conference to announce the favorable outcome of his child's legal case, and internationally broadcasts her photograph and story — including in a two-page spread in People Magazine — would suggest that he sought to "protect" her by failing to disclose his relevant personal relationship and financial interests in a report submitted to a specialist scientific journal. Equally incredible is his suggestion that he should be excused for his failure to disclose an unquestionably relevant legal claim — a claim with a potential value exceeding $1 million — because it had not yet reached the hearing stage, and because his attorney was navigating the slowly-moving procedural waters for him. Most incredible of all is his suggestion that neither he nor anyone acting as his agent — such as his attorney, who represents hundreds of other VICP petitioners — consented to the disclosure of legal documents which could only have been obtained from parties to the case.
With "Developmental Regression and Mitochondrial Dysfunction in a Child with Autism", Dr. Jon Poling takes his place with Dr. Andrew Wakefield, Dr. Mark Geier and Laura Hewitson, Ph.D. in the ranks of researchers who have concealed relevant legal and financial interests in studies purporting to confirm a causal relationship between vaccines and autism.
July 2000 Hannah Poling vaccinated w/ 5 shots against 9 diseases.
October 25, 2002 Poling family files with Vaccine Injury Compensation Program (VICP)
February 2006 Poling and colleagues publish case study referenced above.
February 25 2008 David Kirby on Poling ruling in Vaccine Court
February 28 2008 Steven Novella MD at Neurologica: Has the Government Conceded That Vaccines Cause Autism?
February 28 2008 Orac at Respectful Insolence: David Kirby and the government "concession that vaccines cause autism": The incredible shrinking causation claim
March 6, 2008 Poling press conference
March 11 2008 Kathleen Seidell at Neurodiversity: A Not-so-Hidden History (previous awards to "autism-like" injuries).
April ll 2008 Jon S. Poling in the Atlanta Journal-Constitution "Child's case shifts autism debate"
April 22 2008 Nikhil Swaminathan in Scientific American Vaccine Injury Case Offers a Clue to the Causes of Autism
April 27, 2008 David Kirby on Poling case relevance
May 15 2008 Offit P Vaccines and Autism Revisited — The Hannah Poling Case N Engl J Med 2008; 358:2089-2091
August 7 2008 LBRB: Jon Poling on Paul Offit in NEJM
Jon S. Poling Correspondence on "Developmental Regression and Mitochondrial Dysfunction in a Child with Autism" J Child Neurol September 2008 23: 1089, doi:10.1177/0883073808322330
Richard E. Frye, Andrew W. Zimmerman, and John M. Shoffner Conflict of Interest Statement Concerning "Developmental Regression and Mitochondrial Dysfunction in a Child With Autism"J Child Neurol September 2008 23: 1089-1090, doi:10.1177/0883073808322336
Roger A. Brumback, The Appalling Poling Saga, J Child Neurol September 2008 23: 1090-1091, doi:10.1177/0883073808322333
October 3 2008 The Appaling Poling Saga: Summary by Kathleen Seidell at Neurodiversity Blog
October 4 2008 Kev at LBRB Jon Poling: No Such Thing As Bad Publicity
In short: Dr. Poling behaved in an appalling manner. There is no question that Hannah Poling has a mitochondrial disorder; in such cases neurological symptoms often develop after 12 months and before 24 months. The "autistic like" symptoms demonstrated by Hannah Poling were part of a global encephalopathy caused by a mitochondrial enzyme deficit.
So: Does this case or this paper "demonstrate that vaccines can cause autism"? No.
Vaccine Exemptions: Conference Call with Richard Pan MD and Paul Offit MD --Pt 2 of 2
Edited to give credit where credit is due:
The conference call was hosted by Amy Pisani of Every Child by Two. I was invited to the call by Christine Vara of Shot of Prevention.
The afternoon of July 24, 2012, I had the distinct pleasure of being on a conference call with Richard Pan MD (who is also a California state representative) and with Paul Offit MD, who is perhaps the US's leading advocate for vaccine safety and efficacy1. The call focused on vaccine exemption issues.
What follows is not a word-for-word transcription (that will be posted at Shot of Prevention) but the gist of Dr. Pan's and Dr Offit's comments. Part 1 focused on Dr. Pan; Part 2 is Dr. Offit's remarks.
Dr. Offit focused on the language we use for vaccine exemptions.
He began by reviewing the facts: Twenty-eight states, including Florida, Massachusetts and New York, allow parents to opt out for medical or religious reasons only. Twenty other states, among them California, Pennsylvania, Texas and Ohio, also allow parents to cite personal or philosophical reasons. Mississippi and West Virginia allow exemptions for medical reasons only.
There are 3 forms of exemption:
Philosophical or Personal Belief
Obviously, medical exemptions are valid. Two examples are allergies to eggs or gelatin, both of which are used in the preparation of some vaccines.
There are 20 states that allow a personal belief or philosophical exemption. Frankly this exemption doesn't make sense. The word philosophical is derived from philo -- the love of and sophos -- wisdom. Any one who is acquainted with the data about vaccine safety and efficacy would get the vaccines. It's hard to see where the wisdom is in the notion of not getting a vaccine is better than getting one. The other phrase, the personal belief exemption, is equally questionable. Vaccines aren't a belief-based system, they are an evidence-based system. If you want to reassure yourself about vaccine safety and efficacy, you need only to look at the research on vaccine safety and efficacy -- there are literally thousands and thousands of studies. You don't have to believe in vaccines, you don't have to believe in a person that tells you that vaccines are safe and effective, you only have to examine the data.
The third type of exemption is the religous exemption. There are 48 states in the US that allow a religious exemption. The two that don't allow them are surprising: West Virginia and Mississippi.
If you argue that your religion does not allow you to be vaccinated, the first question that comes up is, "What religion is that?" All the writings on which the major religions are based -- the old testament, the Torah, the new testament, the Koran, were all written centuries before vaccinations were invented. None of the texts even predict vaccines. Mary Baker Eddy's book, Science and Health, is the basis of Christian Science, and she does write that one should not get the smallpox vaccine as it's not a disease but a mental state, so to treat smallpox you pray. You could argue that the religous basis for refsing vaccines, frankly, just isn't there.
West Virginia and Mississippi don't allow religous exemptions because they were, surprisingly, progressive. Both states' Supreme Courts have ruled that a parent's refusal of vaccines on behalf of their children is a violation of the Equal Protection Clause of the 14th Amendment. The Equal Protection Clause essentially says that all people in the US are entitled to life and liberty, and the parent's religious belief does not trump the child's right to be fully protected from disease.
Offit pointed out that religious freedom is guaranteed by the First Amendment, but acting on those beliefs is not equally protected. For example, Mormons do not get to be polygamous, and the children of Seventh Day Adventists are required to receive medical attention the faith otherwise forbids, such as blood transfusions or chemotherapy.
It might make our public conversations about exemptions if we jettisoned the phrases "personal belief exemption" and (for most) "religious belief exemption" and told the truth about the people seeking them: "I read something scary on the internet that alarmed me so I want to refuse my child the protection of vaccines" exemption.
Todd W of Harpocrates Speaks asked Dr. Offit, "Would it be useful to encourage main-stream religious leaders to speak out in favor of vaccines?"3 Offit replied (if I am remembering correctly) that Todd's suggestion was an intriguing one that he had not previously considered.
A reporter from the Arizona Star (whose name I didn't catch) brought up adult vaccination; both Dr. Pan and Dr. Offit agreed that adult vaccine compliance is very low, and might indeed account for some of the pertussis outbreaks recently in the United States. There's a lot to be done in educating adults about their need for pertussis boosters, particularly.
Shannon Rosa, as an autism parent who "recovered" from the false myth that vaccines cause autism, asked both Dr. Offit and Dr. Pan for a brief statement on vaccines and autism.
Dr. Offit replied (my paraphrase) "It is reasonable to ask the question. From the parent's perspective, the child was fine, the child was given vaccines, then the child is not fine. "
Dr. Offit then recounted an experience of his wife's, who is also a pediatrician. She was seeing an infant who was due for vaccination. As she was preparing the syringes, before he was injected, the infant had a seizure. In fact,the infant went on to develop a seizure disorder. Now if the seizure had occured after the injection, there's a huge possibility that the parent would have blamed the vaccine.
Each time a hypothesis has been proposed (MMR, thimerosal, "too many too soon"), robust studies have been done, and the hypothesis has been refuted.
Edited to add Shannon Rosa's twitter stream
Shannon Rosa @shannonrosa Now @DrPaulOffit talking re: #vaxfax, wants to discuss the nomenclature of vaccine exemptions because not accurate. #vaxfax
Shannon Rosa @shannonrosa The types of vaccine exemptions include Medical (all states) 2) Philosophical exemptions (20 states) 3) personal belief #vaxfax
Shannon Rosa @shannonrosa Dr. Offit says "philosophical" exemptions don't make sense because vaccines are about science not philosophy. #vaxfax
Shannon Rosa @shannonrosa When people choose not to get a vaccine, not making an "informed choice." They are making a misinformed choice, unless medical reason.
Shannon Rosa @shannonrosa Religious reasons to not get vaccinated are absurd, as vaccines were not mentioned or predicted by the Bible or the Koran. #vaxfax
Shannon Rosa @shannonrosa Religious freedom is guaranteed by the 1st amendment, but acting on those beliefs not guaranteed, e.g., Mormons do not get to be polygamous.
Shannon Rosa @shannonrosa Irrational refusal of vaccination is actually a violation of the equal protection cause of the 14th amendment. #vaxfax
Shannon Rosa @shannonrosa Parents do not have the right to make their children (or other peoples' children) martyrs. #vaxfax
Shannon Rosa @shannonrosa Pediatrician on #vaxfax call: His experience with vaccine denialists is that they seem really quite set, will AB 2109 affect them?
Shannon Rosa @shannonrosa Dr. Richard Pan says AB 2109 will make a difference because people dismiss benefits, exaggerate risks. Bill will require education.
Shannon Rosa @shannonrosa Dr. Richard Pan says parents who are dead-set against vaccination are hard to reach. But that's not the majority of parents. #vaxfax
Shannon Rosa @shannonrosa Dr. Richard Pan: We need to ensure that parents who have #vaxfax questions get answers.
Shannon Rosa @shannonrosa AB2109 means parent and health care providers have to agree re: vaccine exemption. #vaxfax
Shannon Rosa @shannonrosa RT @ShotofPrev: RT @hugmeimvaxed: "If you make an informed choice, you'll get a vaccine every time" -Paul Offit @ShotofPrev
Shannon Rosa @shannonrosa What about adults and caregiver vaccinations? Particularly the TDaP? #vaxfax
Shannon Rosa @shannonrosa Recent WA pertussis outbreak: half were kids too young for vaccination, so contracted via caregivers/adults. Adults need to be vaccinated.
3Shannon Rosa @shannonrosa It's reasonable to ask the question about vaccines & #autism, says @DrPaulOffit. But the question has been answered. No link. #vaxfax
Shannon Rosa @shannonrosa If were were in a #vaxfax conspiracy, why would there be so much research effort in trying to see if #autism - vaccine link was valid?
Shannon Rosa @shannonrosa MT @ShotofPrev: @DrPaulOffit; 2 infants who died of pertussis at CHOP contracted it from moms who refused vaccine due to lack of knowledge
Shannon Rosa @shannonrosa @birdonthestreet That's part of what the CA bill is trying to do -- help med professionals understand patients' concerns and assuage them.
Shannon Rosa @shannonrosa We have to remember that those who can't get vaccinated (immune deficiency etc.) depend on the rest of us for protection. #vaxfax
1 A commenter at the previous post suggested that I was dishonest in not mentioning Dr. Offit's vaccine-related income. She was incorrect in that she implied that he was continuing to receive royalties. He is not, and hasn't been for some years.
2 I was intrigued by Dr. Offit's comments so went looking around for examples of religious exemptions to vaccines. Even Christian Science urges church members to conform to vaccination laws.
3 See Todd's most recent post on religious exemptions from vaccines: Praying In Vain for an Exemption
Wednesday, July 25, 2012 at 07:42 PM | Permalink | Comments (2) | TrackBack (0)
Vaccine Exemptions: Conference Call with Richard Pan MD and Paul Offit MD --Pt 1
This afternoon (July 24, 2012) I had the distinct pleasure of being on a conference call with Richard Pan MD (who is also a California state representative) and with Paul Offit MD, who is perhaps the US's leading advocate for vaccine safety and efficacy. The call focused on vaccine exemption issues.
What follows is not a word-for-word transcription (that will be posted at Shot of Prevention) but the gist of Dr. Pan's and Dr Offit's comments. Part 1 will focus on Dr. Pan; Part 2 will be Dr. Offit's remarks. Any mistakes or inaccuracies are solely my own.
Dr. Pan spoke on the bill he introduced, AB 2109, which is a very simple bill. If a parent wishes to send her child to school without the required vaccines, the parent must document having had a face-to-face conversation about vaccine risks and benefits with a health care provider.
That's it. That's all. It doesn't take away "parent choice" or "force parents into a relationship" or any of the other specious objections the anti-vaccine forces, lead by NVIC and the Canary party, have ginned up.
California's current Personal Belief Exemption law is one of the most lax in the nation. All a parent has to do is to merely sign the back of the school immunization form, attesting that their personal beliefs means their children are exempted from vaccines.
This is the extent of the exemption process. Click to enlarge:
That's it: one or two parental signatures, depending on the district.
Going back to the conference call: Pan is a pediatrician and made the case that vaccines are the #1 health care advance of the last two centuries.. His experience as a pediatrician led to two insights: (1) Parents are frightened by the misinformation that is more easily available than accurate information, and (2) the value of vaccination is difficult for the current generation of parents to percieve, because they don't have the personal experience of the misery of mumps and measles (for example). The current generation tends to undervalue the benefit of vaccines. And for everyone, it's hard to appreciate the value of a negative -- that vaccines prevent infection.
In Pan's experience, most parents who are vaccine refusers do so because they are uncertain about the risks and benefits of vaccines, not because they are hard-core anti-vaccinationists. The fence-sitters and the hesitant, provided with answers to their questions and fears, nearly often choose to vaccinate.
On the internet, there is a raft of misrepresentation and confusion about vaccine safety and efficacy; it is easier to find misinformation than accurate information. Pan specifically named Jenny McCarthy as a promoter of vaccine misinformation. Pan felt very strongly that face-to-face conversations between a health-care provider and a family is necessary to dispell the family's fears. One of the anti-vax talking points is "informed choice". Pan countered that the counselling gives parents truly informed choice.
In his closing remarks after his presentation, Pan spoke of what he has learned from experiencing the fervor of the anti-vaccination movement. Many of the anti-vaccine folks have been vociferous. He went on to comment on celebrity opposition to AB 2109, The celebrities didn't do as much research as they might have; they really misrepresented vaccines.
(Dr Pan is being polite. ToddW at Harpocrates Speaks demolishes the anti-AB 2109 talking points and demonstrates anti-vax hypocracy about informed consent. Orac at Respectful Insolence has covered AB 2109 rather thoroughly, in Real Informed Consent; Despite the Anti-vax Movement, AB 2109 Moves On; The Latest Celebrity Antivaccinationist Makes a Fool of Himself; and School Vaccine Mandates: The Nuremburg Code. One of the speakers against AB 2109 at the Senate Health Committee hearing was Julian Whitaker, MD. Recently, the noted skeptic Steven Novella MD debated Dr. Whitaker over the safety and efficacy vaccines. Dr. Novella easily refuted each of Dr. Whitaker's tropes and canards. (So much so that some fun was later had.) Later Orac came back with Dr Whitaker Responds.)
Later in the conference call, there was opportunity for questions and answers.
Russell Saunders MD, who is a pediatrician, commented that he has not had Pan's success with converting the vaccine hesitant.
Pan responded with three points:
There is evidence that the conversation requirement will make a difference: the data from Washington State, which enacted a similar law last year. After just one year, vaccine exemption rates dropped from about 6.2% to 4.5%.
Fence sitters can be persuaded. Pan's experience is that the vaccine-hesitant have been highly underestimating vaccine benefits and exaggerating the risks. For these reasons, a hand-out isn't good enough. Parents need and deserve a face-to-face conversation with a knowledgable health-care provider, with ample opportunities for parents to ask the questions they may have and to express their fears.
Sometimes parents who currently have personal belief exemptions (PBE) aren't actually vaccine refusers or vaccine hesitant at all. The PBE is a matter of convenience not conviction. These kind of parents have experienced some kind of barrier to on-time vaccination, such as not havingtime for vaccine visits, financial difficulty, or other kinds of access barriers. California's form is so easy, compared to getting the student's shots up to day money etc. access. You might say these are vaccine refusers by convenience.
One of the things that has bothered me about AB 2109 is that it doesn't really specify what kind of information needs to be shared with parents. I asked Dr. Pan why the bill did not specify a curriculum, or if there would be a curriculum developed.
Dr. Pan responded with points I hadn't given enough consideration: that what works best in converting vaccine-hesitant parents to vaccine-accepting parents is a conversation that is unique to each set of parents. While there will be common questions and fears, the real issue is to develop more trust and communication between the parent and the health care provider.
(Later, a friend from the California Immunization Coalition suggested that when the bill passes, the California Department of Public Health would likely develop a list of resources similar to that developed by the State of Washington. Here's a copy of the Washington exemption form. Here's a more robust form developed by the Immunization Action Coalition.)
Shannon Rosa asked a question of both Dr. Pan and Dr. Offit, about helping autism parents to understand that vaccines do not cause autism. Dr. Pan spoke about taking parents' vaccine safety concerns seriously. When the question of the MMR being causal in autism came up, the question was addressed by serious research, with multiple studies in multiple countries. When the notion of thimerosal being causal in autism came up, again parents' concerns were taken seriously with multiple large-scale studies. This huge research investment indicates how seriously the medical establishment takes vaccine safety.
Edited to add: two questions from the Moms Who Vax team, Karen Ernst and Ashley Shelby
Karen Ernst asked Dr. Pan about CA AB2109, specifically about the language and how parents were to report that they had had an interaction with a doctor.
Ashley Shelby asked why naturopaths were included on the list.
The questions arose because Ernst and Shelby, who live in Minnesota, would like to have Minnesota's exemption law be strengthened. Currently, exemptions only have to be notarized, and even that was threatened this year by an anti-vaccine legislator.
Dr. Pan responded to both questions. The language was intentionally vague, as the anti-vaccination activists had both attacked the language of the bill as it stands, and had submitted their own proposed amendments with more specific language. As to the naturopaths, the bill allows only naturopaths who are practicing under the direction of a licensed MD.
At the end of the call, Dr. Pan brought up another anti-vaccination talking point, the so-called issue of "parental rights" -- in other words, parents' rights to direct their childrens' medical care. Pan indicated that vaccine advocates shouldn't let that assertion pass unchallenged. He called for vaccine advocates to vigorously present the opposing view: That parental rights end with the parents' own child. Parents who refuse vaccination for their children are making choices for other people and their children--those too young to be vaccinated, those who cannot be vaccinated, those who are immune-compromiased. These people have a right to health that vaccine-refusing parents endanger.
Next I will post on Dr. Offit's remarks, on how the language we use for describing school vaccine exemptions is inaccurate and misleading.
Edited to add Shannon Rosa's tweet stream
Shannon Rosa @shannonrosa Listening to Amy Pisani, exec director of Every Child By Two, about vaccine exemptions affecting our national public health. #vaxfax
Shannon Rosa @shannonrosa Every Child By Two works with orgs nationwide to ensure our kids are vaccinated against vaccine-preventable disease #vaxfax
Shannon Rosa @shannonrosa Will be hearing from Dr. Richard Pan, pediatrician and state legislature member, on CA AB 2109, on tightening vaccine exemptions. #vaxfax
Shannon Rosa @shannonrosa Dr. Pan speaking now. Been in pediatric practice for over 10 yrs feels vaccinations = 1 of our century's most important pub health advances.
Shannon Rosa @shannonrosa Dr. Pan: Have vaccines been too successful? Parents no longer understand the consequences of vaccine-preventable disease, haven't seen them.
Shannon Rosa @shannonrosa And then there's the Internet and Jenny McCarthy, promoting theories like vaccine- #autism causation that have been widely debunked.
Shannon Rosa @shannonrosa Parents come into his office after being scared by woo, but emphasizing benefits of vaccines is hard because evidence = lack of infection.
Shannon Rosa @shannonrosa When parents have a chance to sit down with a health care professional, they generally make the right decision re #vaxfax.
Shannon Rosa @shannonrosa So AB 2109 says that if you want to send your child to school unvaccinated, you have to have a conversation with a health care prof. 1st.
Shannon Rosa @shannonrosa AB 2109 is about *ensuring* informed choice, so they understand broader effects of not vaccinating. #vaxfax
Shannon Rosa @shannonrosa Vaccination rates are falling below herd immunity rates because of ant-vaccination scare-mongering. AB 2109 aims to counter that
Shannon Rosa @shannonrosa AB 2109 will be on CA Governer's desk but the end of this session, unfortunately celebrity anti-vaccination folks are muddying waters.
Tuesday, July 24, 2012 at 07:37 PM in Vaccination | Permalink | Comments (5) | TrackBack (0)
12. Blood levels of mercury are related to diagnosis of autism: a reanalysis of an important data set (2007)
Desoto MC, Hitlan RT. Blood levels of mercury are related to diagnosis of autism: a reanalysis of an important data set. J Child Neurol. 2007 Nov;22(11):1308-11.
The infamous Desoto & Hitlan paper. This was subject to a great deal of critical commentary among scientifically and statistically expert autism parents.
Interverbal & Do'C at Autism Street:
The core statistical argument in DeSoto & Hitlan (2007) centers on whether a one-tailed test or two-tailed test is appropriate. These tailed tests are a means of determining whether statistical significance has been achieved. DeSoto & Hitlan (2007) note that Ip et al. used a two-tailed test. DeSoto & Hitlan (2007) criticize this choice. They claim that the hypothesis made by Ip et al. (2004) was directional. In the opinion of DeSoto & Hitlan, the authors should have used a one-tailed test....
Later in their commentary:
DeSoto & Hitlan (2007) are correct that a one-tailed test would have been a better match to the way Ip et al. described their hypothesis. However, the two tailed test offered by Ip et al. was more cautious. Further still, as DeSoto & Hitlan (2007) describe clearly in their review of literature, the data concerning autistics and mercury can go either way. While most studies have not shown a statistically significant difference in the hair or blood levels of autistic children compared to non-autistic controls, the statistically significant lower levels of hair mercury found in autistic children in one study (Holmes et al.) compared to the control group in the same study, have led some to introduce the poor-excretion hypothesis for autism. This unpredictability in direction necessitates a two-tailed test.
We also should consider a well-known informal rule that most new research students are likely exposed to in their statistics textbooks. One picks the type of tailed test, before one reviews the data. This is to prevent changing the type of test one uses to get a certain result. DeSoto & Hitlan by their own description had already reviewed the data and afterwards selected their one-tailed test. This violates the rule described above.
Orac Knows, in a comment on Mercury, Autism, and A Note on Scientific Honesty
The Hitlan paper exists only to try to spin a positive result out of a negative result. The "investigators" probably saw a p value of around 0.11 in the original study and realized that if they used a one-tail t-test they could cut it in half, to near 0.05.
EpiWonk:
We can conclude absolutely nothing about the association of ethylmercury in vaccines to autism from these data.
Further Commentary:
November 17, 2007 Do'C & Interverbal, Autism Street, A Tale of Two Tails
November 29, 2007, Notorious LTP, Pure Pedantry, Mercury, Autism, and a Note on Scientific Honesty
December 10, 2007 Prometheus, A Photon in the Darkness Winter Potporri
January 23, 2008 Do'C & Interverbal, Autism Street, Desoto & Hitlan, Revisited Part I
January 23, 2008 Do'C & Interverbal, Autism Street, Desoto & Hitlan, Revisited Part II
January 27, 2008 Do'C, Autism Street, Desoto & Hitlan Revisited, Part III
July 19, 2008 EpiWonk at EpiWonk An Introduction to Data Analysis
Desoto and Hitlan published an updated FAQ page at http://www.uni.edu/desoto/desoto_hitlan_autism.html
So. Does this paper "demonstrate that vaccines can cause autism?" No, no matter how much Desoto and Hitlan tried to spin it, this paper doesn't make the case.
Monday, July 23, 2012 at 01:50 PM in autism | Permalink | Comments (2) | TrackBack (0)
11. Validation of the phenomenon of autistic regression using home videotapes (2005)
Werner E, Dawson G. Validation of the phenomenon of autistic regression using home videotapes. Arch Gen Psychiatry. 2005 Aug;62(8):889-95.
This actually is a well-done and interesting paper that took advantage of a technological change (affordable video cameras) to investigate the phenomenon of autistic regression, using 56 children's first and second birthday party videos. Dawson and Werner were able to document the change in 15 children who regressed.
Does this paper then validate the notion that "vaccines can cause autism"? Of course not.
I wonder why the list-makers included this one. I am assuming some reasoning along the lines of:
The regression occurs around the time of one-year-old vaccines
There is a form of autism that has a period of normal development followed by regression
Therefore, vaccines cause autism.
It's the correlation equals causation fallacy.
For those of you who are interested in more recent work on developmental trajectories in autism, this robust 2012 paper might be of interest:
Fountain C, Winter AS, Bearman PS. Six developmental trajectories characterize children with autism. Pediatrics. 2012 May;129(5):e1112-20. Epub 2012 Apr 2.
Smug Promoters of Vaccine-Preventable Disease
Read this from a parent's Facebook account, reposted at a pro-vax FB page
Some of the comments, from provax folk:
Comment one
We're just happy happy little infection spreaders. No thought about any consequences here - its not just other baseball players and Scout campers you are endangering - these kids have homes, where perhaps there are newborns, or pregnant women, or people with compromised immunity. But an anti-vaxxer wouldn't care about that. On a mission to spread illness as widely and indiscrimanently as possible.
Comment two:
I am someone who can't afford to be sick. I have a compromised immune system. A sniffle for most people can take weeks for me to fight, and chicken pox would put me out of commission for a very long time.
The glee this person has about infecting others makes me livid.
Comment three:
Great, just great! Thanks for possibly exposing my immunocompromised son to a disease that can be deadly for him. Seriously, deadly! It could kill him. And you're all "happy, happy joy, joy" about it? Seriously? It is mind boggling the slefishness of some people!
Monday, July 23, 2012 at 11:47 AM | Permalink | Comments (6) | TrackBack (0)