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David Kirby: When you’re in a hole over vaccines and autism, get out the back hoe and dig deeper!

Pity poor David Kirby.

Nearly three years ago now, he published his now-infamous Evidence of Harm: Mercury in Vaccines and the Autism Epidemic, A Medical Mystery. Hooking up with the most vocal of the mercury militia, his book blamed mercury in vaccines as the major cause of autism. Unfortunately for Kirby, time has not been kind to him. Although he still manages to retain his rock star status among the antivaccination glitterati, each successive study failing to find a link between thimerosal-containing vaccines (TCVs) and autism put another nail in the coffin of Kirby’s relevance, to the point where a year ago he was reduced to blaming mercury in pollution from China and from the teeth of corpses being cremated in California as the reasons for the continued increase in autism prevalence in the California Department of Developmental Services database reported a mere three weeks ago. Of course, Kirby’s smart enough to know that blaming mercury in vaccines for autism was a hypothesis that made a very powerful prediction that could be tested. That prediction, of course, was that the removal of thimerosal from vaccines should lead to a relatively rapid decrease in the rate of autism in children born after the removal. It’s been nearly six years since the last lots of TCVs expired and went out of circulation, and we’re still waiting for that decrease (or even a decrease in the rate of increase), leaving Kirby and other members of the mercury militia to–shall we say?–diversify their concept of what causes autism beyond just mercury. Naturally, antivaccinationists piled on, trying to find a flaw in the CDDS study. They mostly failed, and I always suspected that Kirby was too clever to join his less deft fellow travelers who keep sticking their fingers in their ears and saying that it really, truly is the mercury. Really.

Instead, Kirby is trying a new tack. Whereas before it was all about the mercury, now he’s branching out into becoming openly antivaccinationist.

Last week, I expressed some of my usual not-so-Respectful Insolence at the producers of an ABC television show whose pilot is set to air on Thursday night. The pilot episode of the show, Eli Stone, is chock-full of antivaccination propaganda, so much so that the New York Times, in a rare piece of good science reporting that refused to play the “report both sides judge neither” game, told it like it was and pointed out that there was no scientific evidence supporting a link between thimerosal-containing vaccines (TCVs) and autism and pointed out that the show made it look as though there was still a real scientific controversy about this issue when there really isn’t. In response, the American Academy of Pediatrics (AAP) has done what such groups should do when faced with an idiotic television show that spreads lies likely to scare parents about vaccines. It’s written an open letter to Disney and ABC, scheduled to be made public this afternoon, asking that the show be pulled or, at the very least, that a disclaimer stating that “”no scientific link exists between vaccines and autism” be run. (I’ve seen the letter but won’t quote it extensively it before it is released.) Kirby has responded in his usual smarmy manner on–where else–that propaganda wing for the antivaccination movement, that bastion of apologists for the mercury militia, namely The Huffington Post:

I share the AAP’s concern that parents should not be driven away from protecting their children from dangerous, even deadly diseases. But parents are far too smart to base such an important decision as immunization on the “content of the episode” of a single drama on broadcast television.

In fact, if I were Dr. Jenkins, I would be far more concerned about real news happening in the real world – events that not only suggest the possibility of some sort of link between mercury, vaccines and autism, but might alarm parents more than any fictional account written for ratings-grabbing mass entertainment.

If I were Dr. Jenkins, instead of fretting over a fake family engaged in a mock trial held in a make-believe court on some LA soundstage, I would be up at night wondering why the Federal Government recently conceded a real vaccine-autism lawsuit in a real court and will soon pay a real (taxpayer-funded) settlement to a real American family and a very real child with autism.

Apparently Kirby, who claims to be a reporter, didn’t bother to look into this. Luckily Kathleen Seidel (whose Neurodiversity blog is essential reading) set Kirby straight in the comments:

An award has been approved to the petitioners in Poling v. HHS because this autistic child experienced a compensable vaccine reaction. This does not mean that a vaccine reaction caused the Poling child to become autistic, or that thimerosal caused harm. Vaccine reactions happen; the NVICP exists so that individuals and families can obtain fair compensation without incurring the expense generally associated with civil litigation. There are ca. 5,000 autism cases pending in Vaccine Court, and it is likely that some of these autistic children will be found to have suffered from vaccine reactions. As for the supposedly “secretive action” of the court in “sealing” the records of the case — filings in NVICP proceedings are only made available to the Special Master and the parties to the case. Even though transcripts for the first three test case hearings were made available to the public, this was an exception to SOP, made with the consent of the families involved. You will find that if you try to download any other case documents from the docket sheet at, you will not be allowed to do so. So, if you want to see the records, why don’t you ask the Poling family to share them with you, instead of insisting that the Special Masters violate NVICP policy.

Poor Kirby, buddy that he is with the antivaccination movement, I wonder why he didn’t think of this simple action. Isn’t that what a real reporter would do? But David Kirby hasn’t been a real reporter in quite a long time, if he ever really was. As if this isn’t enough, though, Kirby has to crank the stupid up to 11:

If I were the AAP, or ABC for that matter, I would feel downright silly stating that “no scientific link exists,” so soon after the Journal of Child Neurology published a study titled, “Blood Levels of Mercury Are Related to Diagnosis of Autism: A Reanalysis of an Important Data Set.” I would also worry about parental reaction to learning that researchers had done due diligence and reanalyzed data from a prior, hugely influential study that (erroneously) found zero connection between mercury levels and autism.

Instead of trying to silence the fictional words of “Eli Stone” co-creators Greg Berlanti and Marc Guggenheim, I would pay closer attention to the real words of Journal authors M. Catherine DeSoto and Robert Hitlan, who found a major flaw in the original study that found no link. In fact, they concluded, “a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder,” and that “hair sample analysis results offer some support for the idea that persons with autism may be less efficient … at eliminating mercury from the blood,” something that proponents of the mercury-autism hypothesis have long contended.

Silly Kirby. I can’t believe he’s citing that paper. It’s the same paper that Representative Dan Burton (R-Indiana) tried to ram down the Special Masters’ throats and that Deirdre Imus gloated about as “evidence” that mercury causes autism that is being “ignored.” In reality, the DeSoto and Hitlan paper is nothing more than a bit of post hoc statistical fiddling with the dataset of study by Ip et al on hair and blood mercury levels in autistic children compared to non-autistic controls to create a “statistically significant difference” between hair and blood mercury levels in the autistic and non-autistic groups. For all the attention given to DeSoto and Hitlan by the mercury militia and that their sycophants trumpeting their reanalysis of the data as if it were God Himself delivering the proof from on high that mercury causes autism give to this dataset, you’d think it was the California Department of Developmental Services database or the dataset used in the recent New England Journal of Medicine study that failed to find a relationship between thimerosal-containing vaccines and adverse neurodevelopmental events.

It wasn’t. It was a decent study, but certainly nothing earth-shattering. If it weren’t for the mercury militia, it would have long ago faded into the mass of other workman-like but not outstanding studies that make up the bulk of the biomedical literature.

Dad of Cameron and Interverbal have teamed up to analyze the Hitlan and DeSoto study. Suffice it to say, Hitlan and DeSoto used some rather dubious assumptions (for example, assuming that the data must go in one direction), leading them to choose a statistical test for their reanalysis that was probably not appropriate. They also cited some rather dubious papers to support their analysis. In response, Hitlan and DeSoto in essence went ballistic, so much so that they published a highly indignant FAQ about their study. It’s rather interesting reading, if only for the self-righteous defense of citing articles in Medical Hypotheses. In any case, D’oC and Interverbal have responded to the FAQ in not one, but three, parts (part one, part two, part three). Prometheus has also weighed in. Suffice it to say, they all leave Hitlan and DeSoto not looking so good.

Finally, here’s the favorite gambit of antivaccinationists trying to argue in the face of all this evidence otherwise that it really, truly the mercury:

Another study, freshly out of Harvard, likewise shows a potential link between mercury and the autopsied brains of young people with autism. The American Journal of Biochemistry and Biotechnology reports that a marker for oxidative stress was 68.9% higher in autistic brain issue than controls (a statistically significant result), while mercury levels were 68.2% higher.

And though the mercury results did not quite reach statistical significance (probably due to the small number of autistic brains studied: 9), the authors cautioned that, “However, there was a positive correlation between (oxidative stress and mercury levels),” meaning the two might be associated.

I noted a couple of things. First, this journal does not appear to be yet indexed by Medline. Probably this is because it’s a new journal, with only one year worth of issues. New journals are frequently hard-up for papers, and frequently will ask for submissions, leading to some less-than-stellar publications. It’s tough to get a journal off the ground. Of course, that doesn’t mean that this paper isn’t worthwhile, so I perused it. It seems to be a bit of a hodge-podge. For instance, the authors included a toxicity curve of methyl mercury on a cultured human glioma cell line for no apparent reason, as it didn’t really seem to relate to anything else in the paper. In fact, the numbers are all over the place, with huge error bars, making it hard to conclude much of anything. The authors claim that mercury levels are higher in autistic brains, but it was not statistically significant. Of note, the authors did not present a p-value for this that I could see; they just say that the difference was not statistically significant. There’s a big difference between a p-value of, say, 0.07 (almost statistically significant) and a p-value of, say, 0.50 (nowhere near statistically significant). I found this particularly odd, given that they presented these values separately in their own table. Another problem is that the brain tissue was harvested an average of 15.5 hours after death for the controls and 21.6 hours for autistics. Although this wouldn’t make a difference for measuring a metal, like mercury, I have to wonder what it means for the measurement of markers of oxidative stress. Another curious thing about the paper is that the “money figure,” where it is shown that the level of 3-NT, a marker of oxidative stress, is higher in autistic brain homogenates, includes only nine of the controls (there were ten controls total) and six of the autistics (there were a total of nine). No reason is given. What happened to the values for the other control and the three other autistic brains? Suffice it to say that this paper wasn’t particularly convincing, particularly in light of the much stronger epidemiological evidence that emphatically fails to find a linkage between mercury and autism.

Finally, Kirby abandons mercury completely and lets his true antivaccination flag fly:

Finally, if part of my AAP job description was to ensure that every American child is vaccinated as early and often as possible, I would be hugely apprehensive, not about a new courtroom drama, but rather about a dramatic new study soon to appear in the Journal of Allergy and Clinical Immunology.

In the article, “Delay in DPT vaccination is associated with a reduced risk of childhood asthma,” Anita Kozyrskyj, an asthma researcher at the University of Manitoba, and other scientists combed the medical records of 14,000 children born in Manitoba in 1995 (when many Canadian shots still contained mercury, by the way).

They found that children who received the DPT (diphtheria, pertussis and tetanus) vaccine at two months of age were 2.63 times more likely to develop asthma (at a rate of 13.9%) than children who were not given the shot until after four months of age (5.9%). “We’re thinking that maybe if you delay this allergic response until a bit later, the child’s immune system is more developed and maybe you’re not seeing this effect,” Kozyrskyj told the Winnipeg Free Press, which just broke the story.

First of all, the Winnipeg Free Press article is an execrable bit of “present both sides” journalism, full of quotes from parents who blame vaccines for their children’s asthma and no one questioning whether this is true. The problem, of course, is this is a retrospective study. Because it’s an E-pub ahead of print, I was unable to get a hold of it from home last night, but one thing that can be said is that retrospective studies have to be very carefully designed to control for confounding factors. One big confoundign factor that comes to mind that I don’t see mentioned in the abstract is why the vaccines were delayed. Was it because of lower socioeconomic status? Was it because of a rural surrounding, where getting to doctors in a timely fashion is difficult? Was it because the child was ill around the time the vaccine is normally given, resulting in a delay? Perhaps it was:

Overall, nearly 12 per cent of the children who received at least four doses of DPT had asthma. The majority of children who had asthma lived in urban areas and were predominantly male.

Gee, you don’t think the pollution in the urban environment and the exposure to pollution might have something to do with asthma, do you? I’m guessing the paper itself mentions this possibility and tried to take it into account, but I can’t check until I can get a hold of the paper. Naturally, such a possibility would not even occur to Kirby, who apparently only read Winnipeg Free Press article. In any case, it’s just one article, and, as far as I could tell from some PubMed searches, the only one to have looked at this specific question. It would require replication and extension to be believed. Moreover, delaying vaccination is not without its cost, as Kozyrskyj pointed out in the article that Japan recommended children under 10 months not be vaccinated between 1975 and 1988, and the country saw a spike in the number of childhood cases of whooping cough.

Kirby then launches into a beautiful example of a “correlation does not necessarily mean causation” fallacy coupled with “if this, then that” innuendo and a ludicrous accusation against the AAP of censorchip. It’s all so mind-numbingly idiotic that even now I stand in brain-fried awe at it:

Even more importantly, if too-early vaccination causes asthma in some kids, could the practice cause other disorders? There is absolutely nothing to link this vaccine study to autism, of course. But consider the following:

1) Many asthma cases have been linked to autoimmunity. The same with autism.
2) Childhood asthma has been dramatically increasing for two decades. The same with autism.
3) Most of the children with asthma in the vaccine study were boys. The same with autism.

Any way you look at it, this study is hardly reassuring news to parents who are about to vaccinate their kids (though think how comforting it would be to allow them to delay this shot by two months). Medicine and the media constantly tell us that all vaccines are safe for all children. When parents try to jive that information with studies that imply the opposite, their faith and trust in public health and the immunization program begin to take a nosedive, along with vaccination rates.

It’s not just the broadcast of fiction out of ABC that might drive parents away from immunization. It is the negation of fact out of the AAP as well. And if unvaccinated children get sick, will the esteemed Academy also “bear responsibility,” or just heap it all upon the network?

ABC executives could cave in and cancel the broadcast, but I don’t think they will. And even if America’s pediatricians manage to successfully censor fiction and crush artistic freedom, they will never be able to stifle the facts.

“Crush artistic freedom”? Get a grip, Kirby. The AAP just wrote a letter expressing free speech! In any case, I’m half tempted to reply to his three “gotchas” above with: Internet usage has risen dramatically in the last two decades. The same with autism and asthma. Therefore Internet usage causes asthma and autism. It’s so obvious, isn’t it?

In Kirby-world, that’s what passes for argument: Studies that are either cherry-picked or not particularly relevant coupled with conspiracy-mongering and non causa pro causa. No wonder he’s becoming increasingly irrelevant, except to the antivaccinationists who showed up in the comments of his article to shower him with praise for his “brave” stand. To them, Kirby is a god smiting the dreaded vaccine infidel.

But, no, believe him when he says he isn’t antivaccine.

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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