Antivaccine nonsense Autism Complementary and alternative medicine Medicine Quackery

The mercury militia go to court

I’ve been a bit remiss when it comes to writing about the lunacy in which it is claimed that vaccines cause autism, allegedly due to the mercury in the thimerosal preservative that was in most childhood vaccines until the end of 2002, when it was removed from all but flu vaccines. It turns out that the class action suit by parents who think that vaccines caused their children’s autism will be going to court in June. Hearings for this suit, known as the Autism Omnibus, will mark a new phase in the pseudoscientific pursuit of “compensation” for nonexistent “vaccine injuries.” Even though science and epidemiology have clearly refuted the thimerosal/autism hypothesis (and, as I like to say, dignifying the idea as a “hypothesis” is something that now causes me to choke on the word, given how poor the evidence supporting the idea is and how copious the evidence refuting it is), there is actually a possibility that these parents might win, as Arthur Allen described in Slate earlier this week:

In June, the U.S. Federal Claims Court, across Lafayette Square from the White House, will begin hearings on 4,800 claims filed by parents of children on the autism spectrum who think that the government’s vaccine program caused their children’s disorders. The scientific consensus rejects the idea that thimerosal, a mercury-containing preservative used in vaccines, causes autism. Still, it’s conceivable that some of the claimants could win, because the vaccine court requires a lower standard of scientific evidence than regular courts. And so the parents are trying to enhance the legitimacy of their arguments.

In April, the government-funded Institute of Medicine held a two-day workshop to discuss ways to research possible toxic causes of autism. Leading voices among the parents who believe in the thimerosal-autism link shared their views with Science publisher Alan Leshner, who ran the meeting, as well as senior government scientists. Two of the groups, Safe Minds and the National Autism Association, later issued a news release that appeared to distort the remarks of a CDC scientist to make it appear that he shared their views. The meeting probably wouldn’t have taken place without the support of several members of Congress, including Sen. Joe Lieberman, D-Conn., and Rep. Dan Burton, R-Ind. Other activists have taken to harassing scientists whose results they don’t like.

I’ve actually written about the latter incident to which Allen refers. He’s talking about Paul Shattuck, whose study showing that the “autism epidemic” is very likely due to nothing more than broadening of the diagnostic classification criteria for autism and autism spectrum disorders (ASDs) resulted in the knives coming out for him by members of the mercury militia. What I particularly like about Allen’s take on this is how he nails the intellectual dishonesty that is Mark and David Geier:

Then there is the activists’ reliance on Dr. Mark Geier, a fixture as an expert witness in vaccine court, where he has testified about 100 times. Geier and his son, David, who holds an undergraduate biology degree, operate under various business names from a house in suburban Maryland. The special masters who run the vaccine court have tossed out their testimony on 10 occasions, and federal district courts have been similarly skeptical. One judge recently described Geier as “intellectually dishonest,” and a special master called him “a professional witness in areas for which he has no training, expertise, and experience.”

eier and his son have published several journal articles claiming to show a link between autism and vaccines containing the mercury-based preservative thimerosal. But the papers have been contradicted by study after study, and the mainstream medical community has proclaimed their work on the subject to be bunk. (The Geiers did not respond to e-mail and telephone requests to be interviewed for this article.)

“Bunk” is putting it kindly. As I’ve documented before, the Geiers perform highly dubious research that involves fitting curves to inappropriate data based on preconceived notions in a ludicrously simplistic manner (or, as I like to call it, “dumpster-diving“). More recently, they’ve been treating autistic children with Lupron, a very powerful sex hormone suppressing drug that is most commonly used to treat men with prostate cancer by blocking testosterone production or in women undergoing in vitro fertilization to suppress estrogen and other hormones and allow total control of hormone levels (and thus control of maturation of egg follicles and prevent premature rupture) by exogenously administered hormones. It’s also occasionally used for chemical castration for various reasons. All the while, the Geiers have been publishing in crap journals like Medical Hypotheses, which intentionally publishes speculative “hypotheses,” and the rabidly antivaccination “libertarian” wingnut publication Journal of American Physicians and Surgeons, which has in the past published anti-immigrant screeds and rants against peer review. When they venture into legitimate peer-reviewed journals, they somehow managed to find a journal where the co-editors are both listed as experts for the plaintiffs in the Autism Omnibus.

Allen’s article is generally excellent and well worth reading, as he discusses the way the Geiers set up a rubber-stamp IRB to “approve” their “clinical trial” with the Lupron protocol, as I’ve discussed before. One thing that I’ve wondered ever since Kathleen Seidel informed me of the Geiers’ mendacity is how the Geiers could get away with such an obviously dubious “study.” Given the lack of action by the FDA over Jim Tassano’s selling of home brew dichloroacetate, I’m beginning to understand. For one thing, the Geiers do not receive government funding, nor are they trying to get a drug FDA-approved, which means that they may not be subject to the Common Rule, although Maryland state law may say otherwise. For another thing, it requires that someone report them. Also, they are using an already approved drug for an “off-label” indication. They can’t hide behind that excuse, however, because (1) there is no legitimate medical indication for the off-label use of Lupron in autism and (2) they are trying to publish their results in medical journals and going through the motions of having their research approved by an IRB. It is research. Incompetent, unethical, and vile research, but research. Worse, it’s painful. As Allen points out, it’s not unusual for autistic children under the Geiers care to get 60 injections a month.

One thing that Allen did report that I didn’t already know is that the Geiers are now reportedly using Androcur in some children, a drug that is not FDA-approved and thus not available in the US, as Lupron is. It does, however, appear to be available from online pharmacies. If the justification for using a drug like Lupron in children is exceedingly tenuous, the use of a drug like Androcure is even more so. Besides not being approved for use in this country, its known side effects include depression, liver damage, and blood-clotting abnormalities.

Finally, lately, the Geiers have been trying to publish in more “respectable” journals, and, indeed, they’ve managed to get a couple of their usual low quality papers into actual peer reviewed journals. No doubt this is for the purpose of the Autism Omnibus hearings. Real experts recognize that Medical Hypotheses and JAPandS are justifiably not taken seriously. The first is simply a sounding board for “out there” ideas, and the seccond is utter crap. If they are to be taken the least bit seriously as “expert” witnesses, it is imperative that they publish in real journal, in particular in the J. Toxicol. Environ. Health and Neuro. Endocrinol. Lett, the latter of which is particularly disturbing because it references the Geiers’ bogus IRB as having given approval to the study. I’ve been meaning to look at these papers in more detail. I think I’ve just been procrastinating because it causes me pain to actually read a Geier paper, with its invariable bad science and now, with their Lupron work, dubious ethics. I feel dirty after reading one. However, with the the Autism Omnibus getting into high gear, I may not have the luxury.

I may have to dive in and get dirty, just like Mike Rowe.

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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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