This month’s issue of WIRED features a great story by Amy Wallace: “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All.” It’s an overview of the anti-vaccination movement in the United States, a topic that should be very familiar to anyone who reads Discover‘s baddest astronomer. At ScienceBlogs, Orac and Abel Pharmboy gives big thumbs-up to the article.
The anti-vaccination movement is a little weird — they claim that vaccines, which are universally credited with wiping out smallpox and polio and other bad things, are responsible for causing autism and diabetes and other also-bad things, all just to make a buck for pharmaceutical companies. The underlying motivation seems to be a combination of the conviction that things must happen for a reason — if a child develops autism, there must be an enemy to blame — and a general distrust of science and technology. Certainly the pro-science point of view is fairly unequivocal; like any medicine, vaccines should be used properly, but they have done great good for the world and there are very real dangers of increased risk for epidemics if enough children stop receiving them. Good for WIRED for taking on the issue and publishing an uncompromisingly pro-science piece on it.
But the anti-vax movement is more than just committed; they’re pretty darn virulent. And since the article came out, author Amy Wallace has been subject to all sorts of attacks. She’s been documenting them on her Twitter feed, which I encourage you to check out. Some lowlights:
- I’ve been called stupid, greedy, a whore, a prostitute, and a “fking lib.” I’ve been called the author of “heinous tripe.”
- J.B. Handley, the founder of Generation Rescue, the anti-vaccine group that actress Jenny McCarthy helps promote, sent an essay titled “Paul Offit Rapes (intellectually) Amy Wallace and Wired Magazine.” In it, he implied that Offit had slipped me a date rape drug.
- Just now, I got an email so sexually explicit that I can’t paraphrase it here. Except to say it contained the c-word. And a reference to dead fish.
- In his book, Autism’s False Prophets, Dr. Offit writes about scientists who have been intimidated into staying silent about autism/vaccines. If scientists – who are armed with facts and trained to interpret them – are afraid, can it be any surprise that a lot of parents are, too?
It’s pretty horrifying stuff. But there is good news: Wallace also reports that the large majority of emails she has received were actually in favor of the piece, and expressed gratitude that she had written it. There are strong forces arrayed against science, but the truth is on our side, and a lot of people recognize it. It gives one a bit of hope.
I don’t see the point in getting the flu vaccine if you’re a perfectly healthy adult. I say let the virus run its course, it’s not terribly bad. There’s never been such a push for vaccinations against the common flu, why so much hype for the H1N1? It’s not much different from the common flu, people are overreacting. Vaccines should be reserved for those at highest risk, standard protocol doctors use to prescribe typical medications/treatments.
The reason people are a little more jumpy about H1N1 is that fatalities are much more common in infants and young adults. For example, here in Los Alamos a perfectly healthy 21-year old woman succumbed to H1N1 last month.
22. 22. Eugene Says:
This anti-vaccine “movement” is one of the most bizarre things I found in the US. How the hell did it become such virulent (pun unintended)??
American culture is a fertile medium for anti-vaccine sentiment, which goes back 200 years in the US. The culture favors individualism, and only favors collective action in times of national emergency (WWII, for instance). But there are lots of other reasons. Arthur Allen’s “Vaccine” is a great read in you want to better understand where this insanity comes from.
JB Handley brushes off violent sexual insults with, “I receive more hate mail in a day than Ms. Wallace has probably gotten in her lifetime. Unlike Ms. Wallace an Paul Offit, I just don’t whine about it.”
The content of his character is on full display.
JP: The reason why the H1N1 vaccine is being pushed is due to the fact that there is little to no natural immunity to this strain. Because of that, it is highly likely that most people will fall ill from it during the course of the season. Even if there are no complications, the flu lasts for ~7 days. For that time, you can’t work and are in quite a lot of pain (the flu is awful). Given that a flu shot costs about $20 and that the likelihood of catching this strain without the shot are quite high, economically it makes sense to get the shot. In addition, the normal flu does kill a decent number of people per year, and this strain has been shown to be slightly more lethal in people traditionally considered at lower risk (young people). All of this lines up as a pretty decent case for getting immunized.
I understand those reasons, but the overall survival rate is still around 99%. It’s not significantly more lethal than the common flu, but because of those few deaths among younger people, the cause for concern is being blown out of proportion in my opinion.
JP, have you read anything about how the severity of H1N1 cases has been distributed with respect to age group? As I understand it, the distribution hasn’t conformed with the usually assumed risk profile.
Also, it’s more than a little ironic that this contentious discussion is taking place while most people are going unvaccinated against H1N1 because there isn’t nearly enough of the vaccine available.
As for the pharmaceutical companies “making out”, since when did they consider this an attractive market? Considerable effort by the government and the public health community has been required over the last few decades to ensure that adequate vaccine production capacity is in place. It’s an ongoing problem.
The bottom line is this: Simply allowing large numbers of people to come down with the flu is a damned expensive way to establish immunity in the population. (Again, see Pieter Kok’s comment #21.)
Pingback: Brain Food 10-27-09 « Confluence Culture
You know you’re doing well when the Sloth Himself ventures out of the echo chamber to post on your blog – as comment #1, even! I love it when antivaxers feel cornered – they get even more desperate and make even more implausible claims.
Um, J.B.? We’ve been on to you for quite some time, and the brainier sectors of the media are quickly figuring it out. Produce some of that hate mail, for a start, and prove it wasn’t written by your own sly little self. (Oh, is it ever fun being on the side that gets to demand that others prove a negative!)
I haven’t seen the age distribution of cases, but the peak of H1N1 seems to have passed since its reached pandemic status. By time we get enough vaccines, the H1N1 virus will likely be winding down as the peak of the common flu season occurs. It’s so hard to discern H1N1 from the common flu by symptoms and most doctors have already stopped testing to confirm cases, so we may never truly know the severity of H1N1 over the common flu until after the peak of this common flu season for comparison of hospitalized cases.
Isles, I hope you’re not referring to me as J.B. I’m not an anti-vaccer, I’m simply questioning the hype over H1N1. We simply do not yet know, without a doubt, that H1N1 is any more severe than the common flu and so far it doesn’t seem to be. How many people are hospitalized or die every year from the common flu? Does the media report every one of those case? It’s a short lived hype because we have yet to prove H1N1 is more severe than common flu. Same as the hype when encephalitis first broke out a few years ago.
@JB Handley – Are you board certified medical doctor? Do you have any scientific degrees?
Ali @18 wrote: “everyone I know who’s my age or older got chicken pox and survived quite nicely”
Isn’t there a selection effect biasing your sample?
JP…First: Flu testing costs money. Flu testing takes time away from other testing. When the number of flu cases started increasing at a time when all flu cases should have been almost done for the season (late April/early May), the WHO suggested everyone stop testing on a routine basis. They began relying on the rapid-response flu test, which has a false negative rate for H1N1 of between 40% and 70%, depending on which manufacturer’s test is being used. (http://www.nlm.nih.gov/medlineplus/news/fullstory_87834.html)
What is now being done is lab testing on severe respiratory illnesses. Currently, 99% of all RIs testing positive for flu are Type A; of those that have had subtyping done on them (70%), 99% of those are type 2009 A(H1N1). (See the CDC Flu Weekly Update)
When 99% of flus are testing out as H1N1, why bother testing?
Further, the wave has not peaked yet. Numbers are still increasing. (See the CDC Flu Weekly Update) The normal flu season just started three weeks ago, yet this flu started hitting hard as soon as the school year started across the country, and is currently prevalent across the country. (The Wall St. Journal has a lovely interactive graphic that shows how prevalent last year’s seasonal flu was–at the peak of normal flu season, around February and March–compared to how widespread the flu is currently, at the beginning of normal flu season.)
In addition, whereas in seasonal flu it is usually people older than 60 who are most at risk, with the risk increasing with age, this flu is predominantly hitting people between 5 years of age and 55; if you look at the CDC Flu Weekly Update, you will see that there is hardly any effect on people older than 65, and it is currently behaving like there’s no disease at all for them. This is the pattern that held for the flu epidemic of 1918-1919.
Lastly, seasonal flu deaths for those people older than 65 are typically from after-infections hitting a suppressed immune system–pneumonia, etc. There are currently enough troubling cases in the young people who have died, where they got sick and died rapidly (within two days) that it seems to have *some* (not many, but some) similarity to the flu epidemic of 1918-1919.
(N.B. I am not a doctor or a medical person; I have simply been following this story since it began and have followed the CDC sites and a variety of sites devoted to influenza pandemic planning.)
(N.B. 2: I have not linked to the CDC Flu Weekly Update or to the Wall St. Journal interactive graphic because I don’t want this comment held up in moderation due to too many links.)
Ali @18 wrote: “everyone I know who’s my age or older got chicken pox and survived quite nicely”
Yes, chickenpox is in and of itself not usually a serious illness. However, if you have chickenpox as a kid, sometimes that virus will find places to hide in your body, only to emerge 50 or 60 years later as shingles, a quite nasty disease.
That, plus the occasional person does get a lot sicker – pneumonia, encephalitis, Reye’s Syndrome, blindness can happen:
http://www.webmd.com/hw-popup/complications-of-chickenpox
And if you’re in early pregnancy (you may not even *know* you’re pregnant yet), there’s issues:
http://www.webmd.com/hw-popup/complications-of-chickenpox-during-pregnancy
(Ok, so I’m citing webmd.com – deal with it. 🙂
@ Omega Mom #39. EXCELLENT summary of the situation!
JP, the flu is unpleasant and carries some risk (30-50k die every year). The vaccine is easy and safe. Why not get it. I mean yeah the media likes to blow things out of proportion, but we are looking at a strain of the flu that will kill tens of thousands of people. Why not prevent that?
There are some vaccines, like rabies that are expensive and more risky and those are rightly only given when needed since the risk of getting rabies is very small, but the flu, eh I paid my 20, got my nasal spray and now I don’t have to worry about spending a week in bed in pain.
Phil: My reply in 2 parts, perhaps length was an issue:
Phil:
I have two goals in life:
1. Find out what happened to my son
2. Use that information to help him heal
I feel I’m halfway through those goals, and he has benefitted tremendously by doctors who have helped him heal his damaged body.
Your questions were good ones and you were able to ask them without insults, so I will respond in kind. You brought up 2 recent studies: 1 addresses blood mercury levels in autism, the other that rate of autism amongst an adult population.
Blood mercury levels:
The recent study you made reference to measured blood mercury levels of children with/without ASD and noted no differences, and found that diet (especially consumption of fish) seemed to be one driver of the differences in mercury levels. This has been mistakenly reported by some in the press as proof that “vaccines don’t cause autism.”
Our community is focused on the vaccine schedule, and vaccines in general, as a primary trigger for a normal child to regress into autism. Mercury is viewed as a primary culprit, because its levels were way in excess of any federal guidelines, it’s a potent neurotoxin, and thousands of reports from parents point to regression soon after a vaccine appointment, including my son.
As Burbacher noted in a key work on injected mercury several years ago:
“The initial and terminal half-life of Hg in blood following thimerosal exposure was 2.1 and 8.6 days, which are significantly shorter than the elimination half-life of Hg following MeHg exposure at 21.5 days.”
So, we know mercury’s time in the blood after vaccine injection is very, very short. Only ongoing exposure to mercury, like through fish consumption, would lead to a high mercury blood level reading, unless these children just had a flu shot. Here’s Burbacher: http://www.generationrescue.org/pdf/burbacher.pdf
The lead author on the study you cite said the same thing, but few in the press reported it:
“The bottom line is that blood-mercury levels in both populations were essentially the same,” said the lead author of the study, Irva Hertz-Picciotto, a researcher at the UC Davis, MIND Institute, in a news release. “However, this analysis did not address a causal role, because we measured mercury after the diagnosis was made.”
So, does the mercury included in shots trigger autism? By design, this study does not in any way contribute to answering that question. So, when you cite it as somehow proof that I am wrong, I can’t help but think you only have a superficial understanding of the debate.
Further, we have a material issue of “simultaneity”, the notion of vaccines being added to the schedule very quickly and simultaneously. The data on the cross-reactivity of all these new vaccines is very limited – there’s no study comparing kids who got 6 vaccines at one time with kids who got 0 at one time – how do you measure adverse events without a control? And, of all the vaccines we give, only one – MMR – has ever been studied in any way for its relationship to autism. What about the other 34 shots kids receive? Are they innocent due to the transitive property? That doesn’t seem very scientific to me. I try to explain this in detail at http://www.14studies.org, and the only criticisms of the site I ever read are focused on our grading system, not the central argument that the work has not been done to answer the question, do vaccines cause autism in some kids?
If you are really open, I also recommend reading this report, which raises a lot of really good questions about what is going on with our kids:
http://www.generationrescue.org/pdf/neuronal.pdf
I have no stake whatsoever in this debate except for one small quibble. I find the subtitle of Amy Wallace’s essay a deeply disturbing attack upon my own cognitive liberty and freedom to choose what to do, and what not to do, with my own body. She presupposes an elitist arrogance that good science cannot afford to let stand.
As one of those pesky seniors in this society, i grew up in a world much different than the current mix of impoverished humans battling all manner of viruses (and mostly unconsciously helping them change and become more resistant to the efforts of scientists). My youth was in places that contained polio virus and smallpox, and thus i received vaccines for those. I get my tetanus booster every decade, because i like to be out in the wilds across the landscape. I was too old for the recent DPT and hepatitis vaccines, and contracted hepatitis on top of mononucleosis back in high school. I got my mix of the so-called tropical vaccines so that i could visit the planet in places where human activities help pool terrible viral diseases. Those were all my choice, i was never forced to do that by some edict or government mandate.
I also exercise my cognitive and physical liberty to have never gotten a flu vaccine in my life. Forty-two years of teaching has introduced so many versions of so many of those replicating bastards into me, that my immune system is quite an excellent cold and flu fighter. To be castigated as a “danger to society” because i choose to not get a vaccine for one (or apparently two this year) particular strain of the hundreds in the three major types and couple of dozen subtypes, borders on the same fear mongering as those opposed to all vaccines. I am not a threat, nor a cost, to the society as a whole because i choose not to be vaccinated.
PArt 2:
The second “study” you cite is not even a study. It’s a phone survey completed in the UK. I’m in complete agreement that science, ultimately, will settle who is right and wrong in this debate. Published science. Peer reviewed. Replicable. But, anyone being honest knows science publication is also political, and that there are good studies and bad studies. This thing from Britain, a phone survey, is not a published study. When published studies come out showing 1 in 100 adults have autism, I will listen. All the published research I have read shows the rate of autism is TRULY rising:
The prevalence of neurological disorders amongst children is growing, which means the environment must be playing a role (because genetic conditions can only grow at the rate of population growth).
We cite four published studies that support this position:
Report to the Legislature on the Principle Findings from The Epidemiology of Autism in California: A Comprehensive Pilot Study
MIND Institute, UC Davis, Oct 2002.
Robert Byrd
Using data from California, the state perceived to maintain the best data on autism, this report demonstrates clearly that the rise in autism is not due to improved diagnosis and expanded diagnostic criteria, but is rather a REAL rise for which some external factor must be playing a role. Excerpt:
“There is no evidence that a loosening in the diagnostic criteria has contributed to increased number of autism clients…we conclude that some, if not all, of the observed increase represents a true increase in cases of autism in California…a purely genetic basis for autism does not fully explain the increasing autism prevalence. Other theories that attempt to better explain the observed increase in autism cases include environmental exposures to substances such as mercury; viral exposures; autoimmune disorders; and childhood vaccinations.”
National Autism Prevalence Trends From United States Special Education Data.
Pediatrics, March 2005.
Craig J. Newschaffer, PhD [Johns Hopkins University].
This study shows that the rise in the incidence of autism is real and that the greatest increase took place between 1987 and 1992, which matches the timing of the near-tripling of vaccines given to our children and the tripling of mercury within those vaccines.
I’ll leave you with a press release of a very recent study on autism prevalence from California, a published study in a peer-reviewed journal:
UC DAVIS M.I.N.D. INSTITUTE STUDY SHOWS CALIFORNIA’S AUTISM INCREASE NOT DUE TO BETTER COUNTING, DIAGNOSIS
January 7, 2009
(SACRAMENTO, Calif.) — A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted — and the trend shows no sign of abating.
Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California’s children.
“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher.
Hertz-Picciotto said that many researchers, state officials and advocacy organizations have viewed the rise in autism’s incidence in California with skepticism.
The incidence of autism by age six in California has increased from fewer than nine in 10,000 for children born in 1990 to more than 44 in 10,000 for children born in 2000. Some have argued that this change could have been due to migration into California of families with autistic children, inclusion of children with milder forms of autism in the counting and earlier ages of diagnosis as consequences of improved surveillance or greater awareness.
Hertz-Picciotto and her co-author, Lora Delwiche of the UC Davis Department of Public Health Sciences, initiated the study to address these beliefs, analyzing data collected by the state of California Department of Developmental Services (DDS) from 1990 to 2006, as well as the United States Census Bureau and state of California Department of Public Health Office of Vital Records, which compiles and maintains birth statistics.
Hertz-Picciotto and Delwiche correlated the number of cases of autism reported between 1990 and 2006 with birth records and excluded children not born in California. They used Census Bureau data to calculate the rate of incidence in the population over time and examined the age at diagnosis of all children ages two to 10 years old.
The methodology eliminated migration as a potential cause of the increase in the number of autism cases. It also revealed that no more than 56 percent of the estimated 600-to-700 percent increase, that is, less than one-tenth of the increased number of reported autism cases, could be attributed to the inclusion of milder cases of autism. Only 24 percent of the increase could be attributed to earlier age at diagnosis.
“These are fairly small percentages compared to the size of the increase that we’ve seen in the state,” Hertz-Picciotto said.
Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state’s increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.
“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said.
The study results are also a harbinger of things to come for public-health officials, who should prepare to offer services to the increasing number of children diagnosed with autism in the last decade who are now entering their late teen years, Hertz-Picciotto said.
“These children are now moving toward adulthood, and a sizeable percentage of them have not developed the life skills that would allow them to live independently,” she said.
The question for the state of California, Hertz-Picciotto said, will become: ‘What happens to them when their parents cannot take care of them?’
“These questions are not going to go away and they are only going to loom larger in the future. Until we know the causes and can eliminate them, we as a society need to provide those treatments and interventions that do seem to help these children adapt. We as scientists need to improve available therapies and create new ones,” Hertz-Picciotto said.
Hertz-Picciotto and her colleagues at the M.I.N.D Institute are currently conducting two large studies aimed at discovering the causes of autism. Hertz-Picciotto is the principal investigator on the CHARGE (Childhood Autism Risk from Genetics and the Environment) and MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) studies.
CHARGE is the largest epidemiologic study of reliably confirmed cases of autism to date, and the first major investigation of environmental factors and gene-environment interactions in the disorder. MARBLES is a prospective investigation that follows women who already have had one child with autism, beginning early in or even before a subsequent pregnancy, to search for early markers that predict autism in the younger sibling.
“We’re looking at the possible effects of metals, pesticides and infectious agents on neurodevelopment,” Hertz-Picciotto said. “If we’re going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible.”
JB, I’ve done mild research on the anti-vax movement, but haven’t come across evidence as strong as those in your arguments. I’d like to see American scientists conduct another study on Thimerosal. It seems there’s enough evidence to at least run more studies based on your sources.
Hey, JB. Seen any autistic adults lately?
Even if you’re right and autism rates are rising, JB, it still doesn’t implicate vaccines in the slightest.
I love conspiracy theorists. They’re so oblivious to logic, as in:
1) Doctors advise their patients to vaccinate
2) Pharmaceutical companies advise people to vaccinate
3) Insurance companies advise people to vaccinate
Each of these stands to make a few bucks($25.00 at Publix groceries here in Georgia) off vaccines however:
1) Doctors can make thousands of dollars treating a single individual for complications of a preventable disease.
2) Pharmaceutical companies can make thousands for the drug support of that same individual
3) Hospitals make thousands as well.
4) The only loser here is the insurance company, in whose interests it is to encourage people to PREVENT disease.
So how come those pharmaceutical companies/doctors go to such great lengths to encourage people to vaccinate, when that can only diminish their bottom line?
Could it be they actually want to keep people healthy?
Gee, how financially foolish of them.
I often refer to the Danish study that compared autism rates between 400,000 vaccinated children vs 100,000 unvaccinated children and found no difference between those two groups. As far as I am concerned, that’s pretty much the last word.
Gary 7
@JP: One thing I’ll add. The swine flu isn’t very lethal _right now_. Hopefully it stays that way. Hopefully we get a large proportion of the population vaccinated before it gets bad, if it does.
But all I can say is…I’m sure there were some people in Sept 1918 who were saying “Oh, it doesn’t look that bad”.
Then look what happened.
http://www.nytimes.com/imagepages/2009/04/30/health/0430-nat-1918pandemic.ready.html
I’m NOT saying this is going to happen. I’m saying it’s possible, if it mutates. And vaccination is an incredibly efficient way of making sure that doesn’t happen again.