Saturday, April 23, 2011

Responding to an antivaxxer

Seth Mnookin, author of "The Panic Virus: A True Story of Medicine, Science, and Fear" has responded to an ad hominem attack on him by antivaxxers in this blog.

In the comments, an antivaxxer who appears to use the name "ChildHealthSafet" (perhaps it's been cut short by my browser) has challenged Seth to respond to 8 points, claiming he hasn't done so. (I haven't read the book yet - it's not available on kindle in the UK, and the paper version is expensive - I expect he has answered the points, but that ChildHealthSafet has simply failed to recognise or acknowledge this.)

Still, let's have a go... I haven't included the citations - they add little, but you can see them at Seth's blog  if you want to.


A) the current President of Merck’s Vaccines Division, Julie Gerberding confirmed to CBS News when she was Director of the US Centres for Disease Control that: “So if a child was immunized, got a fever, had other complications from the vaccines. And if you’re predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.” [1]

This is argument from authority. Unless you can tell us the scientific basis for Gerberding’s comments, it is meaningless.

B) Autistic conditions can result from encephalopathy following vaccination. The US Health Resources and Services Administration (HRSA) confirmed to CBS News that of 1322 cases of vaccine injury compensation settled out of court by the US Government in secret settlements: “We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.” [2], [2a], [3].

No medical treatment is 100% safe, but commonly used vaccines are extremely safe. It is not clear precisely how often vaccines cause encephalopathy – if they do at all – because the extent to which they do so is so low that it’s hard to be sure whether the rate is increased compared to baseline rates. Even if encephalopathy causes autism – and I’m not clear that there’s good evidence to support this – the diseases that vaccination prevents commonly cause encephalopathy, so it’s much safer to be vaccinated (and protected against the disease) than to get the disease.

C) It is biologically plausible that a live virus vaccine like MMR [which] contains live viruses one of which is scientifically accepted as causing autism. The first known cause of autism was rubella virus.
… rubella (congenital rubella syndrome) is one of the few proven causes of autism.“ Walter A. Orenstein, M.D. US as Assistant Surgeon General, Director National Immunization Program in a letter to the UK’s Chief Medical Officer 15 February 2002.
rubella virus is one of the few known causes of autism.” US Center for Disease Control.

rubella can cause autism” The Pediatrician’s Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children – PEDIATRICS Vol. 107 No. 5 May 2001;107/5/1221

Your argument is an argument in favour of vaccination. The best thing to do is to have the vaccine which can protect you (and your unborn child) from rubella, as the vaccine has been proven NOT to cause autism.

D) Autistic conditions can result from acute disseminated encephalomyelitis (ADEM) following MMR vaccination as held by the US Federal Court in the case of Bailey Banks [4].
In his conclusion, US Federal Court Special Master Abell ruled that Petitioners had proven that the MMR had directly caused a brain inflammation illness called acute disseminated encephalomyelitis (ADEM) which, in turn, had caused the autism spectrum disorder PDD-NOS in the child:
The Court found that Bailey’s ADEM was both caused-in-fact and proximately caused by his vaccination. It is well-understood that the vaccination at issue can cause ADEM, and the Court found, based upon a full reading and hearing of the pertinent facts in this case, that it did actually cause the ADEM. Furthermore, Bailey’s ADEM was severe enough to cause lasting, residual damage, and retarded his developmental progress, which fits under the generalized heading of Pervasive Developmental Delay, or PDD [an autism spectrum disorder]. The Court found that Bailey would not have suffered this delay but for the administration of the MMR vaccine, and that this chain of causation was… a proximate sequence of cause and effect leading inexorably from vaccination to Pervasive Developmental Delay.

Unfortunately courts do not always base their findings on science. This is another argument from authority, and the comments I made to your argument A apply: Unless you can tell us the scientific basis for the court’s findings they are meaningless.

E) Autism is not caused by genes. And what does not cause autism?
Dr Francis S. Collins, M.D., Ph.D. the 16th and current Director of the US$30.5 billion budget National Institutes of Health [nominated by President Obama: NIH News Release 17th August 2009 ] stated in evidence to US House of Representatives Committee May 2006 when Director of the US National Human Genome Research Institute [5]:
“Recent increases in chronic diseases like diabetes, childhood asthma, obesity or autism cannot be due to major shifts in the human gene pool as those changes take much more time to occur. They must be due to changes in the environment, including diet and physical activity, which may produce disease in genetically predisposed persons.“

What is your argument here? Autism is a complex condition, with multifactorial aetiology – in other words, lots of things can involved in causing it. If it’s even a single condition. You don’t need to know what causes autism to be able to show – as has been done very thoroughly – that vaccines do not cause it.

F) Autistic conditions affect approximately 1 in 100 US children. They affect 1 in 64 British children [1 in 40 are boys] according to a Cambridge University study [6].
“Conclusions: The prevalence estimate of known cases of ASC, using different methods of ascertainment converges around 1%. The ratio of known to unknown cases means that for every three known cases there are another two unknown cases. This has implications for planning diagnostic, social and health services.”

Again, what is your point here? So what?

G) It is estimated to cost the UK £28 billion per annum [roughly US$42 billion]: [7]

Again, what is your point here? So what?
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