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Discover: Why Does the Vaccine/Autism Controversy Live On?

Unfortunately, Orac has been feeling a bit under the weather since last night–so much so that he actually did something he rarely does and stayed home from work.

But enough with the third person schtick. If I feel better later, maybe I’ll post something. Hopefully I’ll be back to 100% tonight and can produce the usual Insolence that readers know and expect for tomorrow. Right now I can’t say. What I can say, however, that, whatever I post, at least today it won’t be about Jenny McCarthy’s and J.B. Handley’s appearance on The Doctors yesterday. My gastrointestinal status is tenuous enough as it is, and I see no need to stress it by watching that barf-inducing display. Adding extra nausea due to watching Jenny McCarthy spew her stupidity and J.B. Handley rant on ignorantly on top of my current nausea could push me over the edge.

I will, however, refer you to some good reading on the topic. Chris Mooney has written an excellent article for Discover entitled Why Does the Vaccine/Autism Controversy Live On? You might even recognize one or more of the people he interviewed.

Now there’s a reasonable remedy to calm my queasy stomach: Actual science and reason in a major popular science magazine.

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]

42 replies on “Discover: Why Does the Vaccine/Autism Controversy Live On?”

I know another good remedy to your being under the weather! Perhaps you would like to go to the The OSTP blog (which I am sure you already know about) – the recently started blog as the face of President Obama’s community science initiative.

I am sure you and your readers would be able to offer valuable opinions on the subject of Science and Science Education there.

So far the responses in that blog have been largely (not completely, though) free from spectacular displays of irrationality, but given that this is teh intertubez, there is no guarantee how much longer it would remain so.

Oh, and the linkout to the Stop Jenny McCarthy website (left panel, way down) is broken. There is no ‘site’ in the link, it is simply http://www.stopjenny.com.

Orac,

Just started reading a couple days ago. Great stuff, although the subject matter tends to make my blood boil as an epidemiologist.

Wanted to bring to your attention (if you haven’t seen it already) a great article on vaccine refusal and risk of vaccine-preventable diseases in the NEJM that came out today:

http://content.nejm.org/cgi/content/full/360/19/1981

Go Blue

I went home last night and watched it too, just to see that old fat phuc J.B. on TV. I have to say, the ‘doctors’ playing the devils advocate did not do a very good job dealing with his ‘concerns’ and spent entirely too much time ass-kissing. I would have liked to ask some questions, such as how do we know J.B. is not a robot? I mean we have never run any tests? At what point could we do enough of every conceivable examination and experiment to be absolutely, firmly convinced he’s not a robot? I would have also asked the doctor on stage with Jenny tow things 1) why doesn’t he run a study and publish his findings in his clinic, with other doctors/scientists to add to the body of knowledge and make a bonafide difference in the world (if it is legitimate) instead of writing book$…oops, answered my own question and 2) what mechanism(s) does he propose that explain how antigens in a vaccine(s) cause a specific type of reaction (I am assuming he would say autoimmunity, but whatever he would propose) that would have extremely specific effects on specific parts of the brain that result in the specific category of behaviors described as ASDs. They spent the majority of the time arguing that there isn’t enough research done to make a conclusion, THEREFORE, vaccines can cause autism rather than proposing an actual mechanism, based on actual data.

The main point was hit on in the show though (and was very apparent with what Jenny and J.B. was saying, and the pictures of the ‘Green our Vaccines’ rally…these people want someone to blame. These poor victims need someone to blame for their tragedy…having to be afflicted with a child that is ‘damaged’ and not ‘normal’. Scumbags.

Yeah, well at least Chris Mooney has the courage to identify himself!! You keep hiding behind your blog name, don’t you??!! When will you reveal yourself you cowardly bastard??!! [/sarcasm]

(actually both this blog and its owner are identified by name… it is the worst kept secret on the interwebs)

(also you will note that when he posts the identical content under his own name on the other blog certain clown folks stay away and only come to play here, like this example)

Well Orac, I never pictured you as a “David”. So now we know.

I can – but I can’t stop thinking of a certain astronaut’s (apocryphal) joke……

Oh, it was barf-inducing alright, but the worst part were the doctors themselves. From the commercial, I expected them to take on the antivax nonsense. It didn’t really happen. I wouldn’t let anyone on that show be my doctor.

Orac, I hope you don’t have the swine flu. This might be indicative of punishment from a divine anti-vaccination enthusiast.

The most telling paragraph from the NEJM is the following;

Some clinicians have discontinued or have considered discontinuing their provider relationship with families that refuse vaccines.60,61 In a national survey of members of the American Academy of Pediatrics, almost 40% of respondents said they would not provide care to a family that refused all vaccines, and 28% said they would not provide care to a family that refused some vaccines.

The key is engagement by providers and constant communication. If the “doc” turns their back on the patient, then the case is half made for the anti-vaxxers.

Tritely, hate the sin, but love the sinner…

Sorry about your illness, Orac. I hope you feel much better soon. Take care!

~David D.G.

David? Really?

I agree with the conclusion that the challenge is building public trust not “disproving” the vaccine/autism link. However, the PR stuff leaves me cold. Hold a series of town hall meetings? Ha, yeah, that’ll do it. How about better disclosure of conflicts of interest with respect to big pharma and academia? Why should the public be expected to trust an institution that’s NOT TRANSPARENT? How about campaign finance reform? Big business, including big pharma, owns congress. Let’s do something about that. Perhaps public trust has eroded for good reason. http://www.boston.com/news/local/massachusetts/articles/2009/03/21/senator_broadens_inquiry_into_psychiatrist/

ps I’m not a crazy person, nor am I anti-government. I’m pro-vaccine, but I also happen to be pro=reform.

@SiMPel MYnd: It is no big secret who the blog owner is. If you had actually read Chris Mooney’s article, you would know who Orac really is.

The key is engagement by providers and constant communication. If the “doc” turns their back on the patient, then the case is half made for the anti-vaxxers.

Tritely, hate the sin, but love the sinner…

I see your point, but I would argue that a physician also has a responsibility to protect their other patients. My child’s pediatrician refers vaccine refusers to other doctors. I feel more comfortable knowing that there is less chance of a child spreading a vaccine preventable disease in the waiting room.

@SiMPel MYnd: I guess the [/sarcasm] was lost on some readers. ^

@notmercury: Yep. Looks like I needed to put SARCASM-ALERT in a 100 point font at the top of my post.

Yes, I read Chris Mooney’s article (a great article by the way). Yes, I’ve read other articles Orac has written and cross-posted under his real name elsewhere. Yes, I know who Orac/David really is.

I was trying to do a send-up of one of one of the clowns from several weeks ago (may have been the DaveScot mentioned in comment #3) who, in a mind-boggling lack of any intelligence, refused to follow even the simplest of bread-crumb trails offered him to find out who Orac really is. It reminded me a lot of watching Dora the Explorer with my kid:

Dora: “Do you see the blue book?”
Me (screaming in my head): “IT’S RIGHT THE F**K THERE!!!”
Me (to my daughter): “Don’t you want to watch SpongeBob instead?”

Clueless guy: “Why don’t you reveal your identity Orac?”
Me (screaming at the computer screen): “HE’S RIGHT THE F**K THERE!!!”

OOps, I missed the sarcasm tag. Guilty of reading too fast trying to finish up before having to be elsewhere.[blush}

Sorry to hear you are unwell: you have my sympathy. My bloke and I have both been down with some kind of cold or flu this week, too. I have decided that it is teh swine flue (not the swine flu), because this provides for endless rounds of bad jokes. Have fun, and drink plenty of hot toddies.

Just this week someone on another blog commented that sarcasm is easily lost in words/blogs. Tone of voice is missing. My bad.

Hm.. were it monday or saturday I’d suspect the Wine Flu.
hope you’re feeling better soon, Orac.
[signed]
Guy who posts under initials.

I hope it’s not Dutch Elm’s disease or Chestnut blight both have a high mortality rate (for trees). Just as Dangerous bacon I think he can back me up just don’t let ‘Them’ know…

Cath – it can only be the Dreaded Lurgy. Quick woman, play this cardboard saxophone!

Conflict of interest statement from the NEJM article May 7, 2009 – Vaccine Refusal and Risk of Vaccine-Preventable Diseases

“Dr. Salmon reports serving on the Merck Vaccine Policy Advisory Board; Dr Orenstein, receiving research funds from Novartis, Merck, and Sanofi Pasteur and a training grant from the Merck Foundation and serving on data and safety monitoring boards associated with GlaxoSmithKline and Encorium; and Dr. Halsey, receiving research funds from Wyeth and Berna, lecture fees from Sanofi, and payments for testimony to the Department of Justice regarding several vaccine compensation cases and serving on data and safety monitoring committees associated with Novartis and Merck. No other potential conflict of interest relevant to this article was reported.”

Of course anyone who agrees with your perspective practices science and reason. Anyone who disagrees including Dr. B. Healy, Dr. J. Herberding, Dr. D. Alexandre, all involved at the highest levels with the CDC and the NIH, who have cited a need for more research on possible autism vaccine connections is accused of practicing “woo” to use your scientific vocabulary.

Then there is Dr. Jon Poling, who in addition to being a Dad of an autistic child, is a neurologist and who successfully brought action on behalf of his vaccine injured autistic daughter. Of course in settling, as in Banks, the government kept the media distracted from the implicit admission of liability and of course they buried the result further by pointing to one part of the causal chain, the mitochondrial disorder which combined with the vaccine resulted in the autism disorder.

I do not pretend to be a scientist. I am a skeptic though and I am very skeptical of your purported objectivity and claims to solid science when you ignore the critiques offered by so many reputable scientific and medical minds, some of whom are almost of your self esteemed caliber.

http://autisminnb.blogspot.com/2009/05/vaccine-autism-war-discover-does.html

I am a skeptic though and I am very skeptical of your purported objectivity and claims to solid science when you ignore the critiques offered by so many reputable scientific and medical minds, some of whom are almost of your self esteemed caliber.

No, you are clearly not a skeptic, and I have in the past addressed the claims of “so many reputable scientific minds” on numerous occasions, including Dr. Poling and Dr. Healy.

Nice logical fallacy, though. Can you say “appeal to authority”?

Harold invokes authority only when it’s convenient. It’s his favorite argumentative technique, although he only has two argumentative techniques I can think of, the other being concern trolling.

He easily ignores authority and consensus when he sees fit. In other words, he cherry-picks authority.

This is all pretty similar to claims by creationists and global warming denialists to the effect that “many experts” agree with their position. (But see Project Steve for a parody of these sorts of claims.)

Real skeptics rarely use arguments from authority. Personally, I don’t like them and stay away from them, even though they can be an OK heuristic, like Occam’s Razor.

I have mixed feelings about doctors not wanting to treat patients who refuse vaccines. On one hand, those people are putting other patients at risk in the waiting room. On the other hand, those are the people who need care the most. I guess there is no easy way to separate the anti-vaccine patients from the rest. The only think I can think of is separate waiting rooms or different hours for them, both of which the doctors might not be able to afford. If I were a doctor, especially a pediatrician, I don’t know what I would decide.

Antivax arguments from authority on this issue are necessarily cherry-picked, since the firm consensus among the actual authorities is definitely provax.

snerd @26
Cath – it can only be the Dreaded Lurgy. Quick woman, play this cardboard saxophone!

What what what what what! – Your advice is dangerous. Accordning to my medical advisor Hercules Gritpype Thynn only playing an actual brass instrument is effective against the dreaded lurgi. A cardboard saxophone would be a woodwind.

The only think I can think of is separate waiting rooms or different hours for them>>>>>>>>>>>>>

Good grief, you seem to be equating being unvaccinated with being disease-ridden.

Frankly, there are all sorts of nasty bugs that there aren’t any vaccines for that you and your kids are just as likely to be exposed to. (Strep, MRSA, Fifth Disease, just to name a few.)

If you’re *that* afraid of infectious disease, I might suggest that you seal yourself and your family in a plastic bubble, because disease-causing germs are everywhere!

Jen,

Some such risk is unavoidable, yes. But arguing that because there is some unavoidable risk, measures should not be taken to reduce significant avoidable additional risks, is quite silly.

I drive to and from work every day. I accept the risk of an accident to do so. That doesn’t mean I’ll blaze down the highway at 100!

Don’t listen to snerd, Orac, or that scoundrel Militant Agnostic. It’s all a conspiracy on the part of Big Brass. MA is a paid shill for Messrs Hoosey & Bawkes!! Stand back, I shall see him off with a batter pudding. Yackaboo!

Why Does the Vaccine/Autism Controversy Live On?

Because no one’s remembered to bring garlic and a stake to a debate yet.

@38 Sapristi nuckoes this could mean the end of the horse drawn zeppelin.

Cath you leave me no choice – since I dont have my British miltary saxaphone, I will now play a loaded sackbut from the kneeling position.

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