Thank you, Andy, for the Measles

This excellent piece by Michael Fitzpatrick in the Times of London shows what happens when enough people in a country with a lot of visitors stop vaccinating their toddlers against measles. You get a measles epidemic. Measles is a very serious disease that can kill.

A lot of the blame for this has to go to Andrew Wakefield and his bogus theory linking the MMR shot to autism. You can't fault the man for having a faulty hypothesis. But to continue profiting from it in the face of all scientific evidence is shameful, even more shameful to play the martyr when the scientific community refuses to jump in step with your foolishness.

Luckily, Americans are a bit more level-headed, or perhaps too busy watching YouTube to clue into the latest quack theories. The latest MMWR data show that vaccination rates are holding steady in the U.S., despite the scares that affect chunks of fearful parents in certain communities.

Epidemiology in the Dock

After two weeks of examining arcane biological theories for Michelle Cedillo’s autism, the federal “vaccine court” on Monday heard a final day of testimony that centered on two dozen population studies of the possible link between vaccines and autism—evidence that has convinced the world’s major health agencies there is no such connection.

The case was put forward by Eric Fombonne, a leading autism expert who described evidence from Japanese, European and North American studies that refute the link. Thimerosal was removed from the vaccine schedule in Canada and Denmark in the 1990s, while Japanese children have not routinely received MMR vaccination since 1992. These situations created experimental conditions for scientists to examine the thesis that removing thimerosal—or the triple MMR shot—would cause autism rates to decline. In no case did this occur. To the contrary, autism prevalence rates have increased in every country where awareness of autism has increased.

MMR Theory Comes Under Fire in Court

In April 2000, with the British MMR scare in full flower and thousands of alarmed parents refusing to vaccinate their kids, scientists Andrew Wakefield and John O’Leary appeared in the circus-like hearing room of Rep. Dan Burton (R-Ind) to present their evidence that the measles-mumps-rubella “jab” was causing a gut infection that turned kids autistic.

With the approval of the partisan audience attending the Government Reform Committee hearing, O’Leary stated that his laboratory had found measles in 24 of the 25 samples from the GI tracts of autistic children under the care of Wakefield, whose 1998 article in the Lancet had kicked off the theory that MMR vaccination caused autism.

Painful home videos in the autism/vaccines trial

The government began its defense against the vaccines-cause-autism theory on Monday with expert testimony that Michelle Cedillo was showing symptoms of autism well before she got a measles vaccine. Using some of the same videos that the court had viewed during the testimony of Cedillo’s mom, Dr. Eric Fombonne pointed out behaviors in baby Michelle that he said were evidence of developmental delays.

Teresa Cedillo had presented the videos to show that the girl was normal before she got the MMR shot in December 1995, when she was 16 months old. But Fombonne, director of child psychiaty at McGill University in Montreal, asserted that her failure to respond to parental promptings, and her hand flapping, mouthing, and single-minded obsession with a Sesame Street video—all of these occurring when she was as young as 8 months old--were early warning signs of autism.

Are they seriously trying to win this case?

After the first week of a hearing into the claims of nearly 5,000 autistic children, the case of a tragically ill Arizona girl seemed to hinge on the legitimacy of an Irish laboratory’s findings of measles virus fragments in the girl's GI tract.

Autism in Court - Day 1

At 8:58 a.m. this morning,  Teresa and Michael Cedillo of Yuma, Arizona pushed their 12-year-old, wheelchair-bound daughter Michelle to the front of a gleaming federal claims courtroom. While the court officers listened in silence, Michelle, a pudgy girl with short hair, yelled and groaned and punched herself in the face for a few minutes, before her guardians wheeled her back out of the room. No one was to misunderstand what this proceeding was about.

Snarkiness at Autism Speaks

Fox News this week has a report on the dispute between Autism Speaks founders Bob and Suzanna Wright (he's chairman of NBC), and their daughter Katie. The issue of vaccines and autism is at the center of their argument. Katie, whose son Christian is autistic, blames vaccines for the disorder. But Autism Speaks has been soft-pedaling the issue as it seeks hegemony in the advocacy world.

The Vaccination Zeitgeist Reaches Hollywood

Am I the only one who noticed that the thimerosal theory has hit the Hollywood big time? In a most unexpected place. Tonight I saw the very crude, hilarious new movie Knocked Up, directed by Judd Apatow. It’s a very simple story—gentle, unemployed stoner (Seth Rogen) knocks up up-and-coming Hollywood entertainment journalist (Katherine Heigl) during a drunken one night stand; she decides to have the baby; they figure out how to get along while enduring a lot of shouting matches and hijinks, leading to a sweet conclusion.

Vaers and Veritas

The conservative legal group Judicial Watch last week issued a news release announcing that it had uncovered three deaths linked to the human papilloma virus vaccine (HPV), which has been the subject of furious debate around the country as states decide whether to require 6th grade girls to be vaccinated before admitting them to school. The release, in which Judicial Watch claimed that its perusal of adverse event reports from the vaccine also turned up cases of autoimmune disease and fetal damage in vaccinated pregnant women, produced a minor media splash, with articles in the Wall Street Journal and the Washington Times. The story didn’t get play in most other outlets, probably for this simple reason: It’s bullshit.

Autism, the 'Environment' and the IOM

The Institute of Medicine held a workshop this past week to examine research into the "environmental" causes of autism. It was an opportunity for discussion among scientists pursuing possible links, and a chance for some of the autism "advocacy" community to press their research priorities. No less a bigwig than Alan Leshner, president of the AAAS and editor of Science, presided over the meeting, also attended by the directors of two of the National Institutes of Health.

The opinions of the parents of autistics, especially angry parents, occupy pride of place in our Oprah-fied public culture. Ignore them at your own peril. This is not an entirely bad thing. But there's a weird disparity between what's expected of the scientists and advocates in a setting like this.

Vaccines and the Rule of Three

Among writers there's a phenomenon known as the Rule of Three. It's based on the strange but true fact that threes are more satisfying than twos, or fours, for that matter--in humor, scholarship, and argumentation, at least. There seems to be a natural economy to threes. Three little pigs, three stooges, three Marx brothers. Many titles of books, articles, and scholarly talks have three elements.  Such as in this (invented) history of German baseball: Nietzsche, Nazism and Knuckleballers: Three Reichs and You're Out.

Well, the same seems to hold true when it comes to arguments about vaccine mandates, which explains why the HPV mandate is a bad idea at this time.

CBS Sunday Morning - "A Shot in the Arm'

I was interviewed by CBS Sunday Morning a few weeks ago for a program on vaccination that aired today, April 1st. They did a nice job unearthing historical footage about vaccines, including some film of Salk vaccinating kids against polio. Unfortunately, they didn't handle the autism question very well. I wrote the following letter to one of their producers:

HPV, HBV, Rotateq and the Taliban

While I was on NPR's Science Friday discussing the latest vaccination controversy--over the human papilloma virus vaccine--several past controversies were playing themselves out with interesting, at times sad results.

The Fear Industrial Complex

I generally dislike John Stossel's reporting. He's overly simplistic, a bit cruel and supercilious, and like all TV journalists of his type would rather kick you in the groin than tell the truth. But I admit, I enjoyed watching him rake Barbara Loe Fisher and the DTP lawyer Allen McDonnell over the coals on 20/20 on Sunday. To be sure, he rounds off a few facts. It's not true to say that the IOM found no cases of brain damage from the DTP shot. In fact they held that it was likely there were rare cases of brain damage from the shot. Paul Offit disagrees but he's not the only vaccinologist with an informed opinion on the subject.  But as for the autism link, I agree with Stossel--there isn't one. Click here for the URL:

Book tour tales

I have done some stupid things in my life, but I managed to avoid one while in Portland last week on my book tour. I had scheduled a one-on-one basketball game against J.B. Handley, a particularly noxious mercury militiaman. I had impulsively agreed to the match a week earlier, but my wife's better judgement and my own vestigial adulthood eventually kicked in, and I bailed at the last minute...

"Vaccine" Correction/Clarification

On page 253 of my book, there is an error pertaining to Barbara Loe Fisher, a vaccine skeptic and vaccine safety advocate. I stated in my book that her son had a reaction to his third DPT shot, when in fact it was his fourth shot, when he was two and a half years old. In addition, the book inadequately described the symptoms Fisher witnessed her son experience after his fourth DPT shot:

A more complete, substitute description follows:

Rotateq trouble?

The AP and Reuters are reporting tonight that the FDA has issued guidance asking pediatricians and parents to be on the lookout for cases of intussusception--a paintful twisting of the bowels--in infants who receive Mercks' Rotateq vaccine. 28 cases of intussusception have been reported over the past year to VAERS, the Vaccine Adverse Events Reporting System, which is run by the CDC and FDA. Intussusception can be deadly; in 16 of the 28 cases children had to be hospitalized for surgery following the obstruction, which occurs when a part of the bowel telescopes into another. It's believed to be caused by viral infections, and the Rotateq, like all rotavirus vaccines, is a live viral vaccine that's given orally. The previously marketed rotavirus vaccine, Wyeth-Ayerst's Rotashield, was withdrawn from the market in 1999 because it caused the bowel problem--at a rate, studies later determined, of about 1/20,000.

The wire stories failed to record a key point in the FDA letter, which is that the 28 cases post-Rotateq are below the expected background rate of 18-43/100,000 cases in an unvaccinated population. 3.5 million doses of Rotateq have been distributed in that year. Though not all of them have been used, if only half had been given to children, 28 intussusceptions would still be far lower than one would expect in an unvaccinated population. On the other hand, VAERS is generally considered to underreport reactions associated with vaccines. This may be why FDA has asked pediatricians et al to look more carefully for intussusceptions. Merck and the CDC have been conducting post-marketing safety studies of Rotateq since it was licensed in 2005.

I have a slight conflict of interest in reporting this issue, which is that Paul Offit, one of the inventors of the Rotateq vaccine and a champion of the need for a rotavirus vaccine for American and the world, is a friend of mine and blurbed my book. I obviously hope that eventually his vaccine's name is cleared. If it isn't, I won't hesitate to report on it. I don't imagine that Paul will shirk the evidence either. Maurice Hilleman, the world's leading vaccine maker (at Merck) before his death a few years ago, use to say that he was never sure one of his vaccines was really safe until it had been given to 3 million children. Vaccines are a tough business. But since rotavirus kills hundreds of thousands of children each year, mainly in the Third World, and hospitalizes thousands of American children, it's obviously worth having a vaccine to prevent it.

HPV? Yes, But Don’t Rush Me

Sometimes, good policy is a question of good timing. The HPV vaccine, which Texas mandated for its 6th grade girls last week, is a good example. I've written and spoken in favor of mandating this vaccine, but consistency, as they say, is the hobgoblin of small minds. And I've recently learned from some public health contacts that the push to mandate HPV vaccine may be misguided. Hence the following, a version of which appeared in today's Dallas Morning News:

2007 Nominations for the next Vaccines-Cause-Autism theory....

Barbara Loe Fisher's National Vaccine Information Center is a resource center for people who think that their children were injured by vaccines as well as others who think vaccines are harmful for one reason or another. I subscribe to her listserv, which is always on the 'qui vive' for bad news from the vaccine front.

Today, however, she reports the latest autism statistics from California, with an observation that will not be cheering to Safe Minds, Generation Rescue and others who blame mercury in vaccines for the "autism epidemic." Most scientists and others who understand how autism diagnosis and reporting have changed over the past three decades see the steady increase of autism reports as largely an artifact of new discovery methods. But nevermind them -- let's say there is an epidemic. It doesn't take a toxicologist to observe that the numbers from 2002 to 2006 completely overturn the thimerosal thesis. Over a period in which thimerosal in vaccines was at levels lower than in the 1960s, the number of diagnoses grew from just over 20,000 to just under 33,000, with the sharpest increase in the 3-5 year olds, the group that got those largely thimerosal-free vaccines.

Vaccination's Santa Claus

Two interesting, upbeat vaccine-related pieces in the news over the weekend reveal how much good a billionaire can do, even if he’s a billionaire whose business practices have excited a lot of mistrust and loathing. The Gates Foundation’s decision to go into vaccines in a big way, with a $750 million down commitment in 1999, was kind of the tipping point that seems, for the moment at least, to have transformed vaccines from a loss leader of the pharmaceutical industry into something that can provide decent bucks for the drug companies while saving millions of lives.

Vaccine - the Op/Ed

Here is my editorial on vaccination from this morning's New York Times. A quick run through the concept of herd immunity, and a quick shot in the arm for flu vaccination.

HPV - Massa's vaccine?

To change the subject from thimerosal for a moment, in today's Washington Post, Courtland Milloy goes off against making the human papilloma virus vaccine mandatory. Milloy argues, in his usual competent and convincing way, that it would be better if the D.C., Virginia and Maryland governments--among at least 10 states currently considering making the HPV shot mandatory for pre-teen girls--encouraged people to get their daughters vaccinated against the virus, rather than acting like "some antebellum massa" by forcing the vaccine down their throats, or rather jamming it into their daughter's arms.

Who can argue with this noble liberal sentiment? Me, for one

A story with legs

On Jan. 13 in San Diego, I debated author David Kirby over his hypothesis that a mercury-containing vaccine preservative had caused an epidemic of autism. David insists that he isn't wedded to his narrative--that indifferent drug companies and careless government officials poisoned a generation of children by putting mercury in their vaccines until courageous citizen moms and doctors stood up and blew the whistle. But he certainly does his damnedest to push the thesis in the face of opposing evidence.

DK has sold the rights to his book to Participant Productions, makers of "Syriana" and other marquee films, and I presume that if the hypothesis doesn't fly, neither does the movie. A film that handled the thimerosal story as a fabulously marketed but eventually discarded scientific hypothesis would probably be more interesting than, say, "A Civil Action," but I doubt it would get financing.

Vaccination and Politics

It took the world about a decade of concerted effort to eradicate smallpox -- the last "wild" case of the disease was in Somalia in 1978 (someone died of the pox in a British lab accident a few years later). The campaign to eradicate polio began in 1988 and will certainly reach the 20-year mark without finishing. To understand why, it's helpful to read this sad Reuters post from Iraq. http://www.alertnet.org/thenews/newsdesk/IRIN/cde520844242e6fd0dc635d48580390a.htm

HPV - The Ad

Last week, late at night in my Japanese-style 8x6 New York City hotel room, I was zapping through the TV channels when I came upon a most peculiar advertisement. In it, black, white and Hispanic tweens, teens and young women were skipping rope, running in marathons, waiting for subway trains and generally looking proud to be young and female. They were also smiling happily and holding up signs that had the number "1" printed or painted on them. This, it turned out, was an ad for Merck's new Gardasil vaccine, which protects against the human papilloma virus, the microorganism that causes cervical cancer. The theme of the ad was "One Less Life Affected by Cervical Cancer."

Flu Vaccination--why bother?

Not always for the reasons you'd think