Sunday, September 21, 2014

Some Notes on Vaccines and Autism




By Professor Doom

     There seems to be a scandal brewing at the CDC about a study that may have shown a devastating link between a vaccine and autism, especially in African-American children. Depending on who you read, it’s either a huge deal, or it “may” have “altered” an “interpretation” of the data “in some instances” leading to an “implication” that “maybe” there’s a link “in some cases.”

     In short, either it’s bad, or it’s a minor statistical quirk that should be ignored. Naturally, “conspiracy” themed sites lean towards bad, while official government/mainstream news lean towards the “nothing to see here, move along” interpretation.

     Before discussing vaccines, I want to talk about tobacco.


--Freud knew smoking and cancer were related in 1923. That’s over 40 years before surgeon general’s warnings appeared on cigarette packages. You really think Freud was the only one to know?

     See, everyone knew smoking was bad for you, long, long, before the government managed to overcome the tobacco lobby long enough to admit, that, yeah, there’s a problem with tobacco products.

     Taking decades to figure out the obvious is really a problem with modern science, especially when it’s government-controlled. Pre-colonial American Indians also knew tobacco was bad, but they still smoked. American Indians, despite not having advanced scientists or a government to protect them, figured out that smoking can take decades to kill you; thus only the elders of the tribe were allowed to smoke, generally on special occasions—if you’re unlikely to live more than a few more years, the potential harm from smoking drops off sharply. For most of America’s history, if you wanted honest advice about smoking, you were better off asking American Indians (“in moderation, the old can do it, the young should not”) than government scientists (“smoke all you want, start young!”).

      In regard to vaccines, the government is saying “vaccinate as much as possible, start young!”   On the other hand, the natives are starting to whisper there’s a problem here.

      People would like honest advice about what to do. “Everyone knows” something’s wrong with our children’s health, and the finger is getting pointed at vaccines. Now, just because “everyone knows” it, doesn’t mean it’s true. That’s why we use statistical and scientific tests to get a better approximation of the truth than just what “everyone” says.

--there’s a huge conflict of interest between the people selling the vaccines and the government. It’s reasonable not to trust the government saying the vaccines are safe, just as it was reasonable not to trust the tobacco industry when it said smoking was safe.


      Unfortunately, statistical tests can prove nothing. All they can do is give a probability that one assumption or the other is true, and ultimately, it’s going to be a personal decision as to whether the test shows there’s a link, or shows nothing. With enough money on the line, a personal decision can be anything, which is why tobacco executives, for years, saw no problem with selling their wares…conflicts of interest can cloud judgment.

     And now back to vaccines. There are two camps, with lots of people in between:

     The pro-vaccine camp claims, vociferously: “all vaccines are always safe for all people under all circumstances.” These people get annoyed when anyone questions this claim. I exaggerate, but not as much as I could hope; lots of folks really hate the idea that vaccines aren’t perfectly safe for everyone.

” I've talked to a health care worker at a nursing home and they call flu shot day, "culling day."
--Just because nursing home workers see it with their own eyes, doesn’t make it true. I guess.


     So, the claim is vaccines are perfectly safe. This is an extraordinary claim, and thus requires extraordinary evidence. None has ever been given, although the simple fact that tens of millions of vaccines are given every year, and we “only” have tens of thousands of deaths/serious injuries that “might, maybe” be related to vaccinations, means that vaccines aren’t particularly deadly—vehicles kill far more people, after all.

      The pro-vaccine camp also points out that many diseases have disappeared after vaccination, most especially smallpox. This is quite true, although horsepox has also disappeared, and this related (but different!) disease never was targeted by a vaccination campaign; horsepox may even be extinct now...but there never even was a vaccine for it, much less an eradication campaign. Obviously, just because a disease isn’t as common as it once was, doesn’t mean there must have been a vaccination program that got rid of it. And, even if the smallpox vaccine is safe, that doesn’t automatically make all other vaccines safe.

     The anti-vaccine camp claims “there’s something wrong with the vaccines, at least sometimes,” and, for my next essay or two, I’ll append, “especially when it comes to autism” although vaccines have also been claimed to be linked to other ailments.

     This strikes me at not nearly so extraordinary a claim, but I’ll present arguments against it. Diseases come and go, which is what one could say about horsepox…but autism isn’t a viral disease (as far as we can tell), and parents really seem to notice that their children “turns” autistic shortly after vaccination—much like American Indians noticed it took years of smoking before someone died of a hacking cough. Of course, anecdotal evidence, even when it numbers in the thousands, still doesn’t count for much in a world of science. 

      It’s the modern world, a world of science, and that’s what we should use to make our scientific decisions about the scientific practice of vaccination.

      Autism rates have been shooting up dramatically, up over 1,000% percent in the last 40 years. Yes, 1,000% (A quick warning about the many links: often the autism rates are different in each link; autism rates are up 30% in the last 2 years, so “old” links from wayyyy back in 2012 are obsolete in this regard). A 10-fold increase in my lifetime.

     Vaccination rates have also been shooting up, a child today receives about 70 vaccine doses before he’s 18…compared to the half dozen or so doses I received as a child, this is also an over a 10-fold increase. 

     This still proves absolutely nothing. Let me just go over a few reasonable counter-arguments:

     We eat more microwaved food than 40 years ago, and are surrounded by far more electronics as well (I’m looking at you, cell phones!). We don’t exercise as much as we used to. We wear more synthetic clothing, our food is more heavily processed…the list of changes in how we live over the last 40 years is extensive. It’s very natural to blame a new, bad thing on something else that is new.

     In addition, autism was so rare decades ago that it probably was misdiagnosed as mentally disabled in some other way. And, it’s quite possibly being over-diagnosed today (much like the hideously over-diagnosed Attention Deficit Disorder, which many of my students claim to have, but only one had any symptoms that I could discern…over the course of 25 years of dealing with ADD students). It’s possible, maybe, that autism has always been far more common than we thought…or that it’s not as common today as we’ve been told.

      All that said, mainstream media continues to say things that are flat out wrong, and to overlook real, scientific, evidence that very strongly suggests that, indeed, not all vaccines are always safe for all people at all times.

     A recent CNN article, with some seriously misleading reporting, prompted me to write about this. Above, I’ve presented the best case I reasonably can for the pro-vaccine crowd, by way of Devil’s advocacy: people tend to believe what they’ve read first.

     Obviously, you must follow your heart when it comes time to vaccinate you or your children. Next time, however, I’m going to look at that CNN article, make some corrections, and present some unarguable facts of the matter.


12 comments:

  1. Actually, you are incorrect. Testing of old and new vaccines for both safety and effectiveness has been done extensively in the past, and is ongoing: http://www.cdc.gov/vaccinesafety/Vaccine_monitoring/Index.html

    Regarding the current controversy, you can read the original paper here: https://retractionwatch.files.wordpress.com/2014/08/translational-neurodegeneration.pdf

    My analysis of that paper's results with proper correction for multiple comparisons (not even considering the fishing expedition they did to pick out only a specific gender, race and age of vaccination to focus on) actually suggest that their results aren't even statistically significant at the totally arbitrary 0.05 (1 out of 20) cutoff.

    I certainly don't remember any colloquial claims that autism and vaccines were related before Andrew Wakefield published his paper in 1998, but I heard from my father that colloquial claims about smoking and lung cancer were common at least in the 40s and 50s. Also note that Wakefield stood to make a lot of money if the MMR vaccine/autism link he published on was true (this is well reported, it's even on Wikipedia).

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    1. I just noticed you said "Above, I’ve presented the best case I reasonably can for the pro-vaccine crowd," which I actually misread as you presenting the best case for the anti-vaccine crowd.

      If that is the best case you can present, you are terribly biased.

      What about the history of the smallpox vaccine, with it disappearing from cities as the vaccine was given?

      You claim horsepox as a disease that just disappeared, but the truth is that it went away as humans (the main mammal that has a lot of contact with horses) were inoculated against smallpox.

      You neglected to mention that, since Wakefield's 1998 paper, there have been Measles and Whooping Cough outbreaks in low vaccination communities (mostly west coast, upper middle class, liberal communities).

      Your claim, "The pro-vaccine camp claims, vociferously: 'all vaccines are always safe for all people under all circumstances.'" is flat out false. Just look at the CDC website I linked above.

      The rebuttals against Wakefield and this new paper didn't come from some nebulous government agency, they came from statisticians whose are experts in the very field the statistics the anti-vaccination group is relying on to make its point. Scientists (doubly so for those with tenure) are hardly under the thumb of the government. If you believe this, you clearly haven't spent much time at a Research One university.

      Nevertheless, I await your "unarguable facts." But if they go back to Wakefield again, then calling them that is bald lie.

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    2. Oh, I just found where you got this quote: "I've talked to a health care worker at a nursing home and they call flu shot day, 'culling day.'"
      --Just because nursing home workers see it with their own eyes, doesn’t make it true. I guess."

      It comes from a comments section on this alternative medicine website:
      http://www.ageofautism.com/2012/10/do-nursing-home-diseases-and-death-increase-after-influenza-vaccination.html

      Here is an outside description of that website I found with only a tiny amount of Googling:
      http://rationalwiki.org/wiki/Age_of_Autism

      Seems legit.

      Note: The reason I am posting all this is I have been lurking here a while, and you seemed like a bastion of rational thought regarding the community college system. Therefore, I am posting this due to the possibility that you are just misinformed and might be able to change your mind on this topic. If you are clearly determined to not change, I will kindly quit bothering you.

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    3. Heh, you link a site that describes another website as "crankery"...that source might be a teensy bit biased. Just sayin'. Rationalwiki already has a pretty hefty reputation for bias, anyway.

      And, it really was just an alleged quote from an alleged health care worker (I've heard others say as much, since I used to teach at a nursing school). You do know that many healthcare workers are reluctant to vaccinate, right? Why do YOU think they have a problem with it? (I think they should, mind you, but it's hard to argue with what they see with their own eyes).

      I'm not determined to "not change"...I'm just asking some reasonable questions.

      Absolutely, smallpox disappeared. So did horsepox, even though there was no vaccine. Like I said.

      And, yes, even tenured scientists are heavily dependent upon government for their research money. Not sure how you could think otherwise. I'll address the rest later if need be.

      Certainly, there have been outbreaks of some of the vaccinated diseases. What of it? That's not the issue here, at no point do I claim that all vaccines are always ineffective in all cases.

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    4. To clarify, I think healthcare workers SHOULD vaccinate. And, to reiterate, I already said "especially" smallpox...I'm not talking about smallpox when I refer to "all vaccines", since the smallpox vaccine almost certainly was a valid vaccine once perfected.

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    5. I love how the guy comes in with namecalling and labeling, and cites a site that starts with namecalling.

      "the truth is that it went away as humans (the main mammal that has a lot of contact with horses) were inoculated against smallpox.
      " Uh, the fallacy here is called Post Hoc, Ergo Proctor Hoc. If you believe your argument to be true, then you believe modern medicine is wrong about many things (a vaccine for one virus actually kills off a completely different virus? Magic!). If you don't believe it, then obviously you believe modern medicine is wrong about many things. That's why you don't use fallacies for arguments!

      I've met quite a few vacciners myself that insist all vaccines are perfectly safe, and also immediately go to namecalling as soon as anyone suggests that the magic word "vaccine" doesn't necessarily guarantee safety.

      True science is always willing to keep an open mind. You know you're not talking to a scientist the second he says "the matter is settled". This guy's mind is already closed.

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    6. I don't think that's fair. I'm sure Liu calls me biased in the sense of "you have a point of view I don't agree with", and not as namecalling, and poisoning the well with the "baldfaced lie" comment and others is easy enough to let slide.

      I did look at the raionalwiki site more carefully, and found this on their posting guidelines page:

      "We have our own version: SPOV. SPOV means two things:
      Snarky point of view — This is the meaning most people refer to. It means that, to keep our articles from being dry and boring, we spice it up with humor, sarcasm, skepticism, satire, and wit. "

      So, yeah, I'm not going to take that site seriously...but that doesn't mean they're necessarily wrong. That said, if that's the standard of "seems legit", I don't anticipate much more argument from Liu past this point (and realize, ALL statistical studies are open to argument).

      So, let's chill out a bit, and remain tolerant of other points of view.

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    7. I apologize for my comments being adversarial. They were made very late at night, and I also didn't realize what RationalWiki was.

      I am clearly not wanted here (hi psychor) so I'll disappear. However I'll try to leave a few things to think about and I'll try to not be an asshole about it. Sorry.

      1. I would recommend, for the sake of your blog's credibility if any scientists who read it, that you do a bit of research into how money gets from the US taxpayer, through the NIH and NSF, to national and school labs. Here is a website to get you started:
      http://grants.nih.gov/grants/peer_review_process.htm
      However, I would strongly not recommend you just use the web for this. Instead, some primary investigator, research scientist or postdoc at a local university would probably be willing to talk to you about the process. There is some real dirty laundry here, but you seem to be mis-aiming, as it is.

      2. Yeah, you don't like Wakefield, neither do I, but see if you can find anything older than his work. I have tried hard to find anything older than 1998 for the vaccines/autism thing, and have failed. But maybe you can succeed here. Articles on Pubmed (goes way back beyond 1998) or newspaper articles scanned on the internet (Google now has a lot) would be the gold standard, but archive.org might work too.

      3. When levelling accusations against scientists of bias due to the source of their income, also consider that scientists generally have to disclose all conflicts of interest. Note that the curators of "Age of Autism" do not. However, this may not come up as many of them are quite open about their related businesses to autism that may profit from the vaccinations/autism link.
      I realize there is no need to be fair here, this is a blog after all. However, I think that a broader understanding would note the financial gains (and, perhaps more important to scientists, notariety gains, especially for challenging well established things) that both sides have to gain here.

      4. Adios

      Also, since I know you are an RPGer, here is heavily biased link just for fun:
      http://therpgpundit.blogspot.com/2014/09/cracked-monday_22.html

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    8. I'm sorry you don't feel welcome, but allow me to address your concerns.

      1. I've been PI on a few studies, and contributed to others. So, I'll just ask myself. My answer? "Yes, if you want to run a study confirming the party line, you'll have a much easier time getting funding than if you want a study contradicting the party line." As a tiny example, I had no trouble getting funding for research starting online courses/setting them up for easy verification of success. Getting funding for research answering obvious questions about online education showing that it can't possibly be that great an idea, or that cheating could explain most of the "benefits"? Not a chance. At all. I sort-of have a blog post relating to that ("Obvious Question" about online education).

      I encourage you to do look and see what researchers had to say about getting funding about studies supporting global warming, to verity that, yeah, things aren't absolutely 100% perfect in every way there.

      I do concede I don't know all there is to know about such things...but I'm hoping you'll at least concede the possibility that there's the slightest chance for the potential of conflict of interest in vaccine safety studies right now?

      2. I'm not sure why "Wakefield was first" is a counter-argument...I mean, someone has to be first, right? Why can't it be someone named "Wakefield"? Anyway, here's a study from 1993: http://mercola.fileburst.com/PDF/Singh.pdf (if you don't like this one, at least read the 2nd paragraph of the introduction for at least half a dozen other viable sources pre-dating 1998).

      3. Absolutely, the corporations that make vaccines stand to make billions of dollars on vaccines (and more importantly, lose many billions if found liable, not that they can be due to the conflicts of interest involved). The anti-vaccine scientists absolutely will get credit for saving lives, and many thousands of dollars, assuming their careers don't get destroyed long before then. In the meantime, of course, they get a trickle of money just for being the opposition. Everyone has an agenda, I realize that.

      I totally concede both sides might well have a vested interest. I'm sorry if I haven't been clear on that before.

      One of my points in these articles is, of course, that CNN seems to be a little one-sided. There is research supporting both sides, is all.

      4) Sorry if you feel the need to leave, you're certainly welcome. I'll be getting back to education soon. I appreciate your contributions, honest.

      Yeah, the pundit writes as entertainment. Maybe I do too, I admit.

      Funny story. I was PI on a study that developed a confidence cone technique for reduced error estimation for mineral veins in geological surveys...my own institution said it couldn't count as research (despite, you know, the money I got for it) because they couldn't tell if it had any mathematics in it. A guy with a Ph.D. in Math Education was on the committee that made that determination, by the way.

      Research in academia is nuts, so perhaps it's biased my opinion of other bureaucratically funded and supported research. Mea culpa if so.

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  2. As far as Wakefield, you're absolutely correct his small sample study proved nothing (because no study can), and is pretty weak evidence of anything. That said, it's curious there was a multi-year witchhunt over it. I mean, there are doctors that have literally killed people for money that barely got a slap on the wrist.

    So, I find the Wakefield study weak and uninteresting. I find the response to the study very, very, interesting.

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  3. Hello! I am a US medical student with some unique perspectives on this subject (who happens to love your blog!). I think some of these may be helpful for you to consider.
    First off: I have met 10 individuals (including a close relative) who had very similar similar experiences; completely normal development, bad reaction within a minute to 2 hours following the vaccination which persisted and accompanied the child becoming mentally retarded.
    Secondly before matriculating I shadowed under a physician who worked with a large number of children who had become disabled immediately following vaccination and the ones capable of communicating often stated the shot they received messed them up and left them with a deep fear that has not gone away.
    Most of these children's parents were categorically denounced/called crazy for insinuating the vaccination could have had anything to do with what happened to their children by every single physician they spoke to (with the exception of the doctor I shadowed). I recently got in contact with her and she gave me 20 cases she had from the last year (she doesn't specialize in this subject but often gets them referred to her).
    Third: Within the school I go to, stating vaccinations are harmful in any shape manner or form is extremely taboo and can be a career ending blackmark for you. We've had a few lectures by strongly pro immunization teachers who have openly challeneged anyone to bring evidence showing vaccinations are harmful, as "there is no evidence any harm exists and if you believe that you are both a complete irrational idiot and should not be practicing medicine."
    Multiple students and a few faculty I asked (who I had a good enough relationship with to be able to speak openly) told me they believe this perspective is incorrect, and as they do believe vaccinations are harmful, but under no circumstances should I stick my head up or entertain the debate due to the consequences being too high (I had wanted to bring one of the physicians patients with me and present a stack of case studies).
    Fourth: The best book I have come across so far that I felt gave a good case against vaccinations was "what doctor's don't tell you" by Lynn Mctaggart.
    Fifth: I agree with your general gist, or as I would word it "if there is a strong incentive to doctor the truth on something, it will normally get doctored even if it seems unbelievable that could ever happen," and since this has consistently happened in the past it will most likely continue happening, and the large scale evidence is thus somewhat unreliable for judging the subject.
    Sixth: Due to the political pressure on this subject, I think a hardline in the sand has been drawn for admitting vaccinations could have any problems what so ever, as in my belief admitting any degree of fault with them opens up a slipperly slope to admitting more is wrong.
    Two of the bigger issues with vaccinations are giving a large amount of them to a child simultanously and the presevatives in them. Neither of these are necessary to do, and I feel if the practices were stopped, the instances of vaccines causing damage to children would drop a lot. However, since the hard line has been drawn with vaccinations, neither of these options are ever up for debate.

    Anyways, hope you find that helpful; love your blog!

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    1. Thanks for the many kinds words. I too have heard many anecdotes (I've worked at schools with strong med-school ties)...but I'm mostly going to focus on the non-anecdotes, even as, I concede, there are so many thousands of them that it's tough to simply ignore them all.

      And yeah, citing a CDC study saying the CDC is blameless means nothing to me. I've seen way too many administrators investigate themselves and clear themselves of wrongdoing to put much stock when the conflicts of interests are so severe.

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