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Mercury and autism: RFK Jr. drops another stinky one on the blogosphere

I had wanted to let this cup pass, but couldn’t, not after several readers e-mailed it to me and I went and experienced its inanity first hand. As Michael Corleone said in The Godfather, Part III: “Just when I thought I was finally out, they drag me back in again!” In this case, it was Robert F. Kennedy, Jr. who did the dragging.

Yes, RFK Jr. has dropped one more steamy, stinky turd on the blogosphere. No, it’s not nearly as big and stinky as the first one that he dropped back in June, but that’s almost certainly only because it’s a short blog piece, rather than a full feature article for and Rolling Stone. I’m sure if RFK had expanded the article to the length of his infamous June Stone article, he’d have almost certainly matched or exceeded its foulness. (The man seldom disappoints in that respect.) I commented on the many distortions and examples of faulty reasoning in RFK Jr.’s article shortly after it came out. Several other skeptical bloggers ripped into the article’s mendacity, including Skeptico (whose exposure of the utterly dishonest and deceptive manner in which RFK Jr. misrepresented the Simpsonwood Conference as a secret meeting in which dire conspiracies were discussed, not unlike the Cigarette Smoking Man would have thought up on the X-Files, was a classic in skeptical blogging, as was his later revelation about how RFK Jr. super-selectively quote-mined the Institute of Medicine report to make it appear as though there was a cover-up about thimerosal in vaccines when there wasn’t); Majikthise, who came to pretty much the same conclusion about the Simpsonwood Meeting; and Autism Diva , who pointed out even more errors and distortions in the article.

Yes, on The Huffington Post, that repository of altie woo, ranging from the antivaxer who claims he isn’t, pediatrician Dr. Jay Gordon, and that tireless purveyor of quantum physics pseudoscientific New Age nonsense Deepak Chopra, RFK Jr. has, after a several month absence, returned to resurrect his conspiracy-mongering regarding the CDC and vaccines.

Not unexpectedly, RFK Jr.’s article, Time for the CDC to come clean, starts poorly, with a blanket statement that is unsupported by science:

Thimerosal is the mercury-based vaccine preservative that has been linked to epidemics of neurological disorders, including autism, in American children born after 1989.

Yes, it’s more of the same old assertions without evidence. (See the links at the end of this article for multiple discussions about why this assertion is unsupported and almost certainly incorrect.) The article then gets to the meat of RFK Jr.’s conspiracy-mongering, proceeding to an accusation that the CDC quietly turned down an offer by SmithKline Beecham Pharmaceuticals in 1999 to begin production of thimerosal-free vaccines immediately:

But the newly released documents show that behind the scenes CDC was quietly discouraging Thimerosal’s removal. In a July 1999 letter, vaccine producer SmithKline Beecham tells CDC that it is ready to produce non-Thimerosal DTP (Diptheria/Tetanus/Pertussis) vaccines immediately and has sufficient inventories to supply the entire U.S. market during the remainder of 1999 and the first half of 2000, by which time other vaccine manufacturers would have their Thimerosal-free DTP vaccines on line.

It doesn’t help that RFK Jr. links directly to an site touting the supposed link between thimerosal and autism, but let’s look at the actual letters, shall we? The letter from SmithKline Beecham to me looks like a pitch for an exclusive contract to supply vaccines, stating early in the letter:

As a manufacturer, we agree that, despite the absence of any scientific data that thimerosal causes any adverse effects, whenever possible “thimerosal-containing vaccines should be removed as soon as possible,” as is recommended in the July 7 Joint Statement of the AAP and the U.S. Public Health Service (PHS). For this reason we wish to inform you that SB is in a position to supply Infanrix (Diptheria and Tetanous Toxoids and Acellular Pertussis Vaccine Adsorbed), the only U.S. licensed DTPa vaccine that does not use thimerosal as a preservative, in enough quantities to supply the estimated U.S. market needs for at least the remainder of 1999 and the first half of 2000. By that time, other thimerosal-free DTPa products, including SB’s pentavalent DTPa/HB/IPV, will likely be available, pending FDA approval.

Near the end of the letter, SB makes its intent explicit:

Several weeks ago, SmithKline Beecham was approached by the vaccine contracting department at the CDC inquiring about our ability to supply the entire U.S. DTPa market with Infanrix and the potential for an exclusive DTPa contract., until other nonthimerosal DTPa vaccines were licensed. In reviewing our inventory levels, SmithKline Beecham is now in the position to move forward with such a contract. We believe the exclusive availability of Infanrix DTPa moves the AAP, CDC, and PHS much closer to their stated objectives of thimerosal-free vaccines in the U.S.

So, basically, SmithKline Beecham had been approached about the possibility of providing thimerosal-free DTPa (which begs the question of why the CDC would have approached SB in the first place about thimerosal-free vaccines if it were so intent on promoting thimerosal, but I digress). Based on that contact, the company was now making a pitch that it could fulfill an exclusive contract, which no doubt would have been highly profitable. The reply letter, which RFK described as “rejecting SmithKline’s offer,” actually did nothing of the sort. Here’s how it concluded:

The Centers for Disease Control and Prevention (CDC) National Immunization Program staff has communicated this updated information regarding your supply to the 64 immunization projects. CDC also plans to monitor DTaP ordering patterns and continue to provide the States with a choice among currently licensed brands of DTaP vaccine.

In essence, it sounds as though the CDC took the pitch under advisement and wanted to keep its options open for the 64 vaccination programs under its auspices. So upon what does RFK Jr. base his dire-sounding insinuations of conspiracy? Upon what appears to be a single anonymous “federal health official,” who claims that the motivation was largely to protect the financial interests of the CDC’s “vaccine industry friends.” It may be true that anonymous sources are a time-honored technique in journalism, but they are also a risky one, mainly because it’s impossible for the reader to evaluate their veracity, reliability, or potential conflict of interest. Given the way RFK Jr. has utterly destroyed his credibility on this issue by selectively quoting the Simpsonwood transcript and the Institute of Medicine report to the point that I have to wonder if he was outright lying, by cherry-picking all the dubious data that supposedly supports a link between mercury and autism and ignores the much better evidence that refutes such a link, and confuses correlation with causation again and again and again, I can no longer give him the benefit of the doubt on any assertion he makes, much less his use of a single anonymous source. Could there have been a big conspiracy by the CDC to promote thimerosal in order to protect the pharmaceutical industry? I suppose it’s possible, but RFK Jr. certainly hasn’t made the case that it’s true, either last June or now. To me, the one assertion by this anonymous source that rings true is this:

“There was also concern,” says the federal official, “that an immediate withdrawal might discredit the international vaccine programs for which CDC is an important partner.” The World Health Organization has urged CDC against the banning of Thimerosal in U.S. vaccines since that prohibition might discredit WHO’s third world inoculation programs.

Indeed, why should WHO remove thimerosal when there was no good evidence that it caused autism or any other neurological diseaese, particularly when doing so could deal a severe blow to efforts to vaccination programs in poor nations?

Near the end of the article, RFK Jr. makes this accusation:

CDC continues to exert muscular efforts to derail studies of American cohorts — the Amish, Christian Scientists, and home-schooled children — who were not exposed to Thimerosal vaccines. Preliminary studies of these groups indicate very low levels of the neurological disorders, including autism, that have been associated with Thimerosal in vaccinated populations.

Of course, RFK Jr. presents no evidence whatsoever that the CDC was or is trying to derail any vaccine studies in any population. (I guess we just have to take his word for it.) Indeed, his assertion that there are lower rates of autism and neurological disorders in these children is also flawed. In reality there is no credible evidence to support this contention, which has been popularized by UPI reporter Dan Olmstead. I addressed one such bit of credulity towards unsupported claims about unvaccinated patients in the suburbs of Chicago, and pointed out how this supposed finding was based solely on the undocumented and unsubstantiated recollection of a single practice of altie doctors. (Can you say confirmation bias? Sure, I knew your could.) Prometheus ably took on the claim that the Amish have a lower incidence of autism, pointing out that, even if that were the case, there are so many other factors, genetic and environmental, that could be just as plausible an explanation for such a difference that it is curious that antivaccination advocates would automatically zero in on vaccines without even acknowledging these other possibilities.

The bottom line is that at present there is no compelling epidemiological, scientific, or clinical trial evidence that mercury in thimerosal in vaccines causes autism, RFK Jr.’s conspiracy-mongering notwithstanding. Indeed, now that thimerosal has been removed from all routine pediatric vaccines except the flu vaccine since 2003, there is as yet no evidence of a decrease in the rate of autism. In other nations, such as Denmark, there has been no evidence of a decrease in the rate of new diagnoses of autism even 13 years after thimerosal was removed from vaccines. This is pretty strong epidemiological evidence that there is no link between the two. At best, one can postulate that a very small percentage of the population might be susceptible to mercury, a population that is such a small percentage of the overall populationthat it wasn’t detected, but that’s a far cry from the dogmatic statements of groups like Generation Rescue that “autism is a misdiagnosis for mercury poisoning.” In addition, there isn’t really any good evidence that such a population exists or that mercury causes autism in it. In fact, the symptoms of autism don’t even resemble the symptoms of mercury poisoning. (Look up Pink Disease, if you don’t believe me, particularly the skin changes associated with mercury poisoning in children.)

So why does this pseudoscience persist? Certainly it’s not because of good science. The available evidence does not support a link between thimerosal in vaccines and autism, and the articles published by those claiming a link is usually published in journals that are either ideologically biased or not peer-reviewed. Articles in better journals that are touted as showing a link almost always, upon closer examination (such as reading the entire article rather than just the abstract) do not support a link or are very weak evidence at best. Kathleen Seidel correctly points out one reason:

It’s time for RFK Jr. to come clean about the fact that he represents the interests of private litigants seeking compensation for supposed vaccine injury when in fact many of those litigants have no evidence that such injury occurred. Many never even suspected that their children were “damaged” until they were convinced after the fact that vaccines offered the only possible explanation for their children’s autism. The sense of entitlement and certainty expressed by many autism=poisoning crusaders is not always based on a careful review of a wide range of information. The numerous studies exonerating vaccines as a cause of autism are often dismissed out of hand, simply because they do not support litigants’ preconceptions.

I agree. For what they no doubt consider to be noble motives, people like RFK Jr. and David Kirby have foolishly hitched their names to a cause that is primarily at its heart not about finding the cause of or better treatments for autism, but rather about trial lawyers seeking to sue the National Vaccine Injury Compensation Program (VCIP). Indeed, as I wrote about recently, this litigation has tainted a major vaccine adverse events reporting database. Perhaps the chief driving force behind this movement are the father-and-son tag team of autism quacks and providers of “expert testimony” and legal services to parents seeking to sue the VCIP, Mark and David Geier. They publish highly speculative papers in non-peer-reviewed journals like Medical Hypotheses (which is dedicated to “radical ideas outside the mainstream) or poor quality articles in which they dumpster-dive this tainted database in really crappy woo-filled journals like The Journal of American Physicians and Surgeons, and then use these papers to support their litigation.

Far more harmful is how this widespread belief in an almost certainly nonexistent link between mercury and autism provides an opening to a wide variety of quack “therapies” purported to “cure” autism or greatly mitigate its symptoms, assisted by dubious labs hawking nonstandard “provoked” mercury testing. Chief among these quack therapies is chelation therapy, which, its supporters say to parents, will remove the mercury that is supposedly causing their children’s autism. Sadly, it is an ineffective therapy that has led to at least one death, and the quacks don’t do it cheaply. Worse, as I pointed out just last week, utterly speculative and even more scientifically implausible variants of chelation therapy have been proposed by the Geiers, the most bizarre of which is their claim that somehow testosterone potentiates the toxicity of mercury and prevents chelation therapy from properly removing mercury. This speculation (I won’t dignify it by calling it a “hypothesis” or “theory”) has led them to propose an even more bizarre and potentially dangerous solution to this nonexistent problem: the use of Lupron to chemically castrate autistic children in order to make chelation “more effective.” I wonder if RFK Jr. knows what bizarre forms chelation for autism has evolved into in the eight months since his original article appeared in Rolling Stone.

Madness. A whole industry of quackery has sprouted up to prey on the desperation of these parents, who will do anything to help their autistic children.

But that’s not all. There’s still one last harmful effect from this “mercury=autism” hysteria, and it may be the worse effect of all. This intense focus on thimerosal as the “cause” of autism, as the Holy Grail that will lead to cures through chelation, driven by advocacy and pseudoscience rather than sound epidemiology and science, has diverted money, research time, and researchers’ attention to rebutting the pseudoscience used to justify the “mercury-autism” link and away from more productive avenues of research into the true etiology and pathogenesis of autism.

That will be RFK Jr.’s legacy for coming down on the wrong side of this issue.

Some previous posts on this topic:

  • flushes its credibility down the toilet
  • Swimming through the thimerosal
  • Thimerosal and autism: Two questions
  • Sadly, it was only a matter of time: An autistic boy dies during chelation therapy
  • Kirby tries to cover his posterior
  • Selective outrage over treatment-related deaths
  • The autopsy results
  • The CDC flubs it
  • How vaccine litigation distorts the VAERS database
  • Why not just castrate them?
  • By Orac

    Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

    That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

    DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

    To contact Orac: [email protected]

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