Please allow me to introduce myself, I'm a man of wealth and taste...
Well, not really. I might have one of the two. Or not.
Be that as it may, I'm Orac, and I blog regularly at Respectful Insolence. In the more than two and a half years I've been with ScienceBlogs (not to mention the more than a year before that on my own), I've become known as its resident "vaccine blogger." True, others around here sometimes do posts about vaccines, antivaccine lunacy, and the discredited idea that vaccines somehow cause autism, but with nowhere near the frequency and intensity that I do. Without a doubt, I've done more posts about the misinformation, pseudoscience, and outright quackery spread by antivaccine activists such as J. B. Handley's Generation Rescue and his recently recruited empty-headed celebrity spokesperson Jenny McCarthy, not to mention a number of others who promote the resurgence of infectious disease by sowing doubts about the safety of the most effective weapon the mind of humans have ever devised against it. The reason that that antivaccine movement and applying science and critical thinking to the myth that mercury-containing vaccines or vaccines themselves somehow cause autism or all sorts of other dire complications have become such a major theme of my home blog is that few uses of "alternative" medicine bother me as much as the antivaccine orientation of so much of the movement supporting it, a movement that has also led to all manner of "biomedical" treatments (quackery). No doubt that's why I was chosen to be one of the bloggers discussing this book, and I'm quite happy to do it.
What you might not know is how I developed my interest in this particular area of dangerous pseudoscience. After all, I'm a cancer surgeon and an NIH-funded cancer investigator, not a pediatrician, immunologist, or neurologist. As hard as it is for me to believe, given that it seems today that I've always been refuting this nonsense, I only first discovered the antivaccine movement about three and a half years ago. True, I had been a regular on certain Usenet newsgroups for at least four or five years before that and had encountered antivaccinationists there before, but my contact with them online had been sporadic, and they seemed "out there" even in comparison to the usual run-of-the-mill alt-med maven. But then in the spring of 2005 I started to notice in a big way the cadre of pseudoscientists, parents of autistic children, and others who pushed the myth that thimerosal-containing vaccines or vaccines in general cause autism. Oddly enough, it started out with the Huffington Post, of all places. In May 2005, Arianna Huffington started a large group blog, chock full of famous pundits and celebrities writing blog posts. Within three weeks of its formation, I had noticed a very disturbing aspect of the Huffington Post, and that was that it appeared to be providing a major soapbox for antivaccinationists, including a post by Janet Grilo of Cure Autism Now, two posts by that propagandist of antivaccinationists David Kirby, and posts by that Santa Monica pediatrician to the children of the stars, Dr. Jay Gordon, a man who assiduously denies being "antivaccine" but parrots the most blatantly obvious talking points of the antivaccine movement and is currently best known as being the pediatrician for Jenny McCarthy's son Evan. At the very least, Dr. Gordon is an apologist for the antivaccination movement, and he has become one of the "go-to" guys for the media looking for physicians who are "vaccine skeptics," making numerous radio and TV appearances to promote his "skepticism."
The next phase of my "awakening" to just how pervasive antivaccine fearmongering and pseudoscience were came when Robert F. Kennedy, Jr. wrote an incredibly dishonest and deceptive screed that got wide coverage in the summer of 2005. His article, called, charmingly enough, Deadly Immunity was a rehash of all the misinformation about thimerosal in vaccines and autism wrapped up with in a bow of conspiracy-mongering worthy of a 9/11 Truther with a penchant for quote-mining that would make a creationist blush. The article appeared simultaneously on Salon.com (which normally doesn't publish such nonsense) and Rolling Stone, a magazine that really should stay away from science and stick to covering entertainment and politics. It was followed by a media blitz by RFK Jr. and antivaccine propagandist David Kirby, best known for his credulous treatment of the thimerosal/autism link, Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy, published a few months before RFK, Jr.'s article, and his subsequent activities posting antivaccine nonsense on Huffington Post and, more recently, on the quackery-promoting antivaccine blog Age of Autism.
Suffice it to say that at the time I prefaced a post about RFK, Jr.'s article by saying that Salon.com had "flushed its credibility down the toilet" and referred to the article itself as the "the biggest, steamingest, drippiest turd Salon.com has ever published." I bring this up so that the reader knows where I am coming from. Indeed, since that time in the summer of 2005, I've been wondering when scientists, public health officials, and physicians supporting science-based medicine would finally wake up and start to push back against this tide of antivaccine nonsense, which is starting to result in the resurgence of measles and other vaccine-preventable diseases. This year, I've seen some hopeful signs, including organizations like Voices for Vaccines and Every Child By Two, as well as other signs of push-back against the antivaccine movement, which, I hate to admit, has been clearly winning the P.R. war. What there hasn't been yet is a book written from a scientific viewpoint that directly addresses the history of the recent resurgence of the antivaccine movement and refutes the pseudoscience that it promotes.
Until now, that is.
Released earlier this month is a direct shot across the bow of the antivaccine movement in the form of a book by vaccine scientist and physician Dr. Paul Offit of the University of Pennsylvania's Childen's Hospital of Philadelphia, a man whom the antivaccine movement views as an unholy combination of Hitler, Stalin, Mao, Darth Vader, and Satan Incarnate because of his staunch advocacy of vaccines and his willingness to stand up to the antivaccine movement. The book is entitled Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. Overall it is an excellent primer on the subject and should be required reading for anyone curious about how the antivaccine movement became so pervasive and powerful.
The book begins with a rather interesting choice for a quote:
When religion was strong and science weak, men mistook magic for medicine. Now, when science is strong and religion weak, men mistake medicine for magic.
Actually, I would quibble about whether religion is actually weak these days. In this country, at least, fundamentalist religion, in particular fundamentalist Christianity, seems stronger than ever, permeating society so thoroughly that it is unthinkable that an atheist President will be elected in my lifetime. Elsewhere, fundamentalist Islam and other religions hold sway. Later in the book Dr. Offit makes the connection between religion and the antivaccine movement, which strikes me as a bit incongruous with this quote. However, the quote does characterize quite succinctly that what we are dealing with in the antivaccine movement is not science. Rather it is more akin to religion, because scientific evidence exonerating vaccines as a cause of autism rarely changes the minds of adherents to the antivaccine faith.
One thing I was not aware of is just how much Dr. Offit has been harassed by antivaccine zealots because of his advocacy for vaccination. He lays it all out right from the very first passage in the book:
I get a lot of hate mail.
Every week people send letters and e-mails calling me "stupid," "callous," an "SOB," or "a prostitute." People ask, "how in the world can you put money before the health of someone's baby?" or "How can you sleep at night?" or "Why did you sell your soul to the devil?" They say "I don't have a conscience," am "directly responsible for the death and damage of hundreds of children," and "have blood on [my] hands." They "pray that the love of Christ will one day flood [my] darkened heart." They warn that my "day of reckoning is coming."
Dr. Offit then describes how he became interested in pediatrics and vaccines and the path that led him to become an infectious disease specialist studying vaccines, describing in moving terms one child he took care of who died of a rotavirus infection and how that led him into his current work. Fairly conventional stuff, but it's necessary to understand where Dr. Offit's coming from. He then goes on to describe how he became an advocate for vaccines in the 1990s and how that led to his daily vilification. (Just search Age of Autism if you want to get a flavor of the sort of stuff Dr. Offit is subjected to day in and day out by his enemies.) As part of this campaign, Dr, Offit has even been subject to death threats and calls in which implied threats were made against his family and children. Indeed, after he had casually mentioned his children's names during Congressional testimony in front of quackery-supporting antivaccinationist Congressman Dan Burton's committee, in which he answered a question by Representative John Tierney about whether he vaccinated his own children, a concerned member Tierney's staff warned him, "Never, never mention the names of your own children in front of a group like this." Some of these threats were credible enough that the University of Pennsylvania routinely checks his mail for suspicious letters and packages and he has periodically required an armed guard.
Personally, I find Dr. Offit's story quite credible. Indeed, I've occasionally been at the receiving end of but a small fraction of the vitriol directed at him. True, I have never been physically threatened (although one time I met someone whom I mistakenly thought--just for an instant--was a particularly persistent antivaccinationist who detested me and it momentarily frightened me), but antivaccinationists have certainly done their best to destroy my Google reputation. Usually, the attacks take the form of slander and ad hominem attacks. For example, not only have I been personally attacked by J.B. Handley of Generation Rescue himself on Age of Autism in a prolonged screed, the comments after which mocked my appearance and questioned my manhood, but one particularly deranged antivaccine advocate, who has in the past shown up at least once in the comments on my own blog and is so off the deep end that even antivaccinationists are embarrassed by him, has written posts accusing me of "sodomizing autistic children" and of being a "member of NAMBLA." (Google it if you don't know what the acronym means.) He bases his accusations on a list circulated on Usenet by Holocaust deniers back around 2000 designed to smear those of us involved in the fight against online Holocaust denial as pedophiles. The list is so obviously a pile of lies, but that didn't stop him and it doesn't stop other cranks from periodically resurrecting this zombie and setting it loose to try to eat the brains of those who see it. Indeed, this same blogger/commenter has even tried to link Kathleen Seidel to NAMBLA as well. (More on her later, as she is a major player in the book.) Now, I'm just a rather insignificant blogger, not a vaccine researcher who has been on national television and testified in front of Congress about vaccine safety, and I've experienced a somewhat disturbing amount of abuse and vitriol. I can only imagine what Dr. Offit has been subjected to.
After describing his stake in this debate, Dr. Offit dives right in, beginning with a brief history of vaccines and then of the condition known as autism, serving as a background, including some earlier forms of autism "treatments" such as facilitated communication, a now discredited technique that led to false accusations of rape and child abuse against parents based on nothing more than suggestibility and the ideomotor effect. He then proceeds to describe how Andrew Wakefield's litigation-funded research published in The Lancet in 1998 led to a scare over the MMR vaccine that has not abated even a decade later and has also led to measles again becoming endemic in the U.K. That's just the warmup. I have to admit that this is the first book I've ever read about a topic that I had been following in detail and writing about myself periodically. Consequently, my review is filtered through that prism, just as Kev's viewpoint is filtered through the prism of his actually "having lived" the story told in this book. It may also be the reason why I found how Dr. Offit structured the first part of his story particularly jarring. He begins the thimerosal story with a chapter entitled "Mercury Rising." This chapter is a fairly straightforward and relatively uncritical recitation of the "science" used by antivaccinationists to show that mercury causes autism. From my perspective, having read and analyzed many of these studies and knowing that they are at best irrelevant and at worst rank pseudoscience, I found this chapter especially disturbing. I think I know what Dr. Offit was trying to do: To show how the steady drumbeat of such studies can give the impression that there is scientific legitimacy to the question fo whether vaccines cause autism, but it was hard to swallow. True, Dr. Offit immediately follows the chapter with "Mercury Falling," in which he demolishes over and over again the "science" claiming to show that mercury in vaccines causes autism, but the overall effect disturbed me. Of course, that's just me. I'd be curious to hear what others who have read the book thought of this structure.
One person who comes in for criticism is Dr. Neal Halsey, who in 1999 was head of the American Academy of Pediatrics' vaccine advisory committee and was also instrumental in persuading the CDC to recommend the removal of thimerosal from vaccines even though there wasn't any real science to show it to be dangerous. Two interesting points come out of this chapter that I hadn't been aware of. First was the dynamic of how this came about. Many of the meetings held to discuss the matter were done by conference calls often dominated by Dr. Halsey. Indeed, the CDC committee was initially not at all enthusiastic about Dr. Halsey's recommendations because they didn't see any science compelling enough to warrant urgency. However, through force of will during several conference calls Dr. Halsey ultimately won the day. What seems to have happened is that, absent sitting in a room with all the players, members of the CDC got the impression that a "snowball" was growing in favor of doing something. Members later said that they were extremely skeptical but that with Dr. Halsey dominating the conversations and the inability to see the body language of other members of the committee, they didn't realize that they were not alone in their extreme skepticism about the advisability of "doing something now." The second point is that the banning of thimerosal absent compelling evidence that it caused harm was a fantastic example of the "precautionary principle" run amok, in which a ban was recommended "just in case." That decision more than any other, argues Dr. Offit, was responsible for the subsequent nine years of antivaccinationist fearmongering over mercury in vaccines. After all, parents not unreasonably think, if the CDC and AAP recommended removing thimerosal from vaccines, there must have been a reason. Maybe there was something wrong that is now being hidden! Reassurances by the CDC that the recommendation was "just as a precautionary measure" designed to "make vaccines even safer" were not particularly convincing in comparison. Actions speak louder than words, after all. In other words, although antivaccine advocates were agitating about thimerosal in the late 1990s and likely would have continued to do so, the ultimate magnitude of the thimerosal scare in the U.S. was largely a self-inflicted wound on the part of the CDC and AAP.
One face familiar to me was featured prominently in this book, a woman named Kathleen Seidel, who created the Neurodiversity website and blog. She has been a thorn in the side of antivaccinationists for several years now. Arguably her biggest contribution is how she has revealed the sordid details of the conflicts of interest and pseudoscience "Behind the Mercury Curtain," so to speak (the title of the chapter in Autism's False Prophets featuring Seidel). She was the first to uncover how Dr. Mark Geier and his son David formed a dubious and "elusive" institute and packed an institutional review board of that institute with their cronies to rubberstamp their unethical "clinical trials" using chelation therapy and the powerful anti-androgenic and -estrogenic drug Lupron under the guise of treating "precocious puberty." Indeed, my learning about the Geiers and their highly unethical research behavior back in 2006 was the second "awakening" I had about the antivaccine movement.
Through the latter part of the book, Dr. Offit reviews all the other major players in the antivaccine movement. They're almost all there: J.B. Handley of Generation Rescue (now rechristened as "Jenny McCarthy's Autism Organization") and Age of Autism; Jenny McCarthy and her "Green Our Vaccines" nonsense; aging shock-jock Don Imus; chemistry professor-turned-antivaccinationist Boyd Haley; Mady Hornig; Richard Deth; David Kirby; and, of course, Robert F. Kennedy, Jr. None of them are spared, nor should they be. For someone as interested as I, there wasn't much there that I didn't already know, although I was surprised to learn just how tightly RFK, Jr. is affiliated with trial lawyers (I had always thought he was idealistic but seriously misguided on the question of vaccines) and how David Kirby apparently used to bluster and bully that he was "with the New York Times" to try to obtain interviews when in fact he was never anything more than a freelancer who was occasionally published in the Gray Lady. However, to those who aren't familiar with these characters, it is potentially eye-opening. Unfortunately, one aspect of this story that is missing is how antivaccine activists have coopted the case of Hannah Poling to serve their propaganda. True, the case didn't really explode onto the scene until March. Perhaps it was too late to include it in the hardcover book, and I hope that Dr. Offit will write an update for the paperback edition. Indeed, the manipulation of the Hannah Poling case and the way that antivaccinationists latched on it as "evidence" that rare mitochondrial disorders are allegedly a factor predisposing to "vaccine injury" causing autism warrant a complete chapter in and of themselves.
The closing third of the book deals with how science is handled in the courts and in society. There is an extensive discussion of the Autism Omnibus and how weak the plaintiff's case was in the first "test case." More importantly, Dr. Offit echoes a lament that I have made time and time again about how science is so frequently misrepresented and abused in the media, describing specific examples. One point he makes is that scientists always tend to qualify their remarks and be very careful about stating conclusions. That's nothing but good science (remember, science can never absolutely prove that there is no correlation between vaccines and autism, only suggest just how very, very unlikely it is that there is one), but such "weasel words," which are normal qualifications of the uncertainty inherent in scientific conclusions, leave the average layperson thinking that there really is a major controversy among scientists. In the case of whether vaccines cause autism, there is not. Dr. Offit also compares the P.R. techniques used by the antivaccine movement to discount the science exonerating thimerosal-containing vaccines or vaccines in general as a cause of or contributor to autism to how the tactics tobacco companies used back in the 1950s and 1960s to try to convince people that there was still a scientific controversy over whether cigarette smoking causes lung cancer. He also points out how, in this age of science, belief in magic and the paranormal remain very common, making the connection between the lack of critical thinking skills that allow such superstition to continue to flourish and how easily pseudoscience can become accepted as "fact"--a point I have made many times before.
Of course, no review would be complete if I didn't briefly mention two things that bugged me about this book. No book is perfect, and Dr. Offit's is no exception. Don't get me wrong, though. Overall Autism's False Prophets is an excellent book that I recommend highly. Nonetheless, I do have two minor nits to pick. The first is that Dr. Offit approvingly quotes Steven Milloy twice and Michael Fumento once, both of whom are well known corporate shills, apologists for conservative politics, antienvironmentalists, and anthropogenic climate change "skeptics." (Indeed, Steve Milloy is known for his famous and dubious "Ultimate Global Warming Challenge.") Moreover, both have been accused of ties to the very tobacco companies to which Dr. Offit compared antivaccinationists to, and both have conflicts of interest in the form of ties to and/or funding from the industries whose interests they virtually always champion, be it big oil, big pharma, or big tobacco. That they happen to be correct in condemning the antivaccination movement is not a good enough reason to cite them, and Dr. Offit could have made his points just as well without including quotes from such tainted sources. Even though the quotes themselves argue Dr. Offit's case about science and society and the law, anyone who has skeptically examined the rhetoric of Milloy or Fumento will know that neither of them is a credible spokesman for science-based medicine.
The second nit is that Dr. Offit comes off as a bit credulous about the National Center for Complementary and Alternative Medicine (NCCAM). Indeed, at one point he states:
But what worried many scientists and physicians about NCCAM was that alternative medicines would be exempt from the scientific method. Fortunately, that hasn't happened.
I would argue that that is exactly what has happened with the rise of NCCAM. Dr. Offit then goes on to argue that NCCAM has tested "several alternative medicines" and concluded that they didn't work, mentioning laetrile. Actually laetrile was tested and found to be ineffective back in the 1980s, several years before the office that was the precursor to NCCCAM was ever established in the NIH. In any case, I invite Dr. Offit to read articles arguing this very point written by Wally Sampson (perhaps the most infamous call for NCCAM to be defunded), Steve Novella, Kimball Atwood, and me that argue otherwise and that NCCAM is a corrosive force against science-based medicine and for the accelerating infiltration of pseudoscience into academic medicine.
Be assured, however, that from my point of view the two nits I just picked are inconsequential compared to what is good and accurate about Autism's False Prophets. Indeed, that I noticed them at all is probably a consequence of my having been active in the skeptical movement a long time (i.e., I "know too much"). After the virtually nonstop barrage of antivaccine propaganda and pseudoscience that has permeated the national zeitgeist, especially since Jenny McCarthy became a convert to antivaccinationism a little more than a year ago, Dr. Offit has provided a refreshing, science-based change of pace on the topic of vaccines and autism that pulls no punches. Every parent who has concerns about vaccines should read it to learn just how weak and without basis in science the claims of antivaccine "scientists" and advocates are and just how riddled with conflicts of interest every bit as bad as any attributed to big pharma so many of the luminaries of the antivaccine movement are. Even better, those out there who might be worried that Dr. Offit will be profiting from sales of his book can take comfort in the fact that Dr. Offit will not receive any money from it. He has promised to donate all royalties from sales of Autism's False Prophets to autism research. Of course, it won't be the type of autism "research" funded by Generation Rescue or performed by the likes of Boyd Haley, the Geiers père et fils, Andrew Wakefield, Laura Hewitson, Raymond Palmer or other false prophets of autism. It will go to real scientists doing real research on the science of autism and treatments designed to help autistic children, rather than subjecting them to a mind-dizzying panoply of "biomedical" interventions that are not only expensive but useless and potentially dangerous.
Education and contributing to science-based medicine, what more could one ask for? What will be amusing is watching Autism's False Prophets being released at the very time as Jenny McCarthy's latest antivaccination Indigo woo-fest Mother Warriors. No doubt McCarthy's book will be a best-seller, as there is an unending appetite for this sort of paranoid conspiracy-mongering. Indeed, there is a reason why Jenny McCarthy has been able to reenergize the antivaccine movement, both with star power (her boyfriend Jim Carrey's star power far more than her D-list star, which had been fading before she latched onto the autism "biomed" movement), money because of the fundraisers she and Carrey can front, and the manner in which she can resurrect Andrew Wakefield's career. It's good to see that there is at least one lone voice calling her, Wakefield, Mark and David Geier, and J.B. Handley, and all the antivaccinationists who endanger public health out for their pseudoscience.
Google Scholar, type THIMEROSAL AUTISM and you'll get at least 2-3 studies that show that thimerosal is not responsible for autism
tanx see you later
Dr. Offit has provided a refreshing, science-based change of pace on the topic of vaccines and autism that pulls no punches. Every parent who has concerns about vaccines should read it to learn just how weak and without basis in science the claims of antivaccine "scientists" and advocates are and just how riddled with conflicts of interest every bit as bad as any attributed to big pharma so many of the luminaries of the antivaccine movement are.
Dr. Offit's book unfortunately does not name the rotavirus vaccine which was withdrawn after epidemiological studies showed it to cause intussusception in rare cases
Great review. I'll be sure to buy the book. I'm very interested
Yes, I've seen, and fossils are the same age!
I completely agree with you, Noah. What you say explains the current lack of demand for access to the literature. I wonder if science journalism of tomorrow will still be that way? If the current trend of slashing university jobs continues in the face of rising numbers of students, there will be ever increasing competition for the few remaining jobs. In this not very unlikely not-too-distant future scenario of overwhelming pressure to hype any small advance, will journalists still be the willing enablers of hype?
Of course, that scenario doesn't have to materialize, but right now you don't need to be an Einstein to extrapolate the figures...
Hey u I like you. You know?
Anti-vaccers get the fuck real! If you're worried about thimerosal, use those useless fingers of yours, go to Google Scholar, type THIMEROSAL AUTISM and you'll get at least 2-3 studies that show that thimerosal is not responsible for autism.
Have a nice days.
He points out that other fossils of similar age from China, Myanmar, and India have also been proposed as some of the earliest anthropoids. âAt this stage, color me skeptical.â
Very young children will say box B, because that's where the cheese is now. But at around age 4, they'll correctly answer box A, since Mouse has no way of knowing that Cat moved the cheese.
Orac...(although one time I met someone whom I mistakenly thought--just for an instant--was a particularly persistent antivaccinationist who detested me and it momentarily frightened me)
Ouch...I still blush about not being clearer as to who I was, in case this refers to our meeting in NYC.
When a publication like Salon.com endorses bad journalism, what it the best response? Write a letter to the editor? Boycott?
Glad you commented on the structure and in particular the "Mercury Rising" and "Mercury Falling" chapters titles; am planning to write my next (or next after the next) post for the book club on those very chapters.
FWIW, I've met antivaccinationists, been upbraided by one at least, talked to them on the phone, broken bread........
I'm so grateful that Dr. Offit's book got out on the shelves and into the hands of people in power before Jenny McIndigo's promotional JUNKet. I am reminded of:
It is well said in the old proverb, a lie will go round the world while truth is pulling its boots on.
[1859 C. H. Spurgeon Gems from Spurgeon 74]
http://www.answers.com/topic/a-lie-is-halfway-round-the-world-before-th…
Right now big media is running with Jenny's indigo lies and her vaccine lies, but at least the truth has it's "boots" on. People in authority are reading this book. Indigo moms will have their preconceptions reinforced... I wonder if that includes Ariana Huffington?
"but at least the truth has it's "boots" on."
That should be "its 'boots' on." I'm still struggling with it's
and its.
Thanks for the excellent review. I hope this is the end of the antivaccine lunacy.
I think I know what Dr. Offit was trying to do: To show how the steady drumbeat of such studies can give the impression that there is scientific legitimacy to the question fo whether vaccines cause autism, but it was hard to swallow.
As someone far less familiar with the history, when I read those two chapters, I more got the impression that this was a rebuttal to people who think that no one really cared about or looked into a possible vaccine-autism or thimerisol-autism link. It sounded like a lot of scientists really were concerned about these findings of the early studies, leading them to push for or perform the large epidemiological studies that then found no evidence of correlation.
Dr. Offit approvingly quotes Steven Milloy twice
That really jumped out at me, as well. I was wondering if anyone would bring that up.
So....Dr. Offit what causes Autism?
I'm sorry could you repeat that?
Hello? Hello?
Brad Campaigne asked "So....Dr. Offit what causes Autism?"
See Chapter 11, "A Place for Autism", pages 218 through 221.
Just a reminder, this is a book discussion, and in order to discuss the book you should actually read it.
So, Brad, what causes autism. As in, what has been shown to cause autism. As in, don't answer mercury, bacteria, toxins and the rest.
What is better, to admit we don't have the answer or to give the wrong answer? History, including recent history (see Autism's False Prophets) tells us very clearly: the wrong answer is worse than no answer.
Medicine does tell us of one likely candidate for causing autism: maternal rubella infection.
Who solved that? A guy named Stanley Plotkin. He invented a Rubella vaccine.
Stanley Plotkin also worked with Paul Offit on the Rotavirus vaccine. As I recall, one of Dr. Offit's endowed chairs is named for Dr. Plotkin.
A vaccine researcher prevented multiple cases of autism (and death, blindness, intellectual disability...). The argument can be made using real data. This isn't anecdotal. This isn't, someone on the internet claims it. This is data that shows big spikes in autism--with severe or profound intellectual disability--coinciding with large outbreaks of rubella. It ended with the introduction of the rubella vaccine.
This is data, scientific plausibility...everything that the thimerosal and MMR theories lack.
Brad - one thing we know causes autism is Rubella. As in 'Measles Mumps and Rubella'.
You also might want to note you're commenting in a post made by Orac, not Dr. Offit. The easy well to tell is look at the name under the title.
Hope that helps.
i liked the mercury rising/mercury falling structure. my guess was that dr. offit wanted to recreate the feeling of building paranoia that converted so many people to the mercury=autism belief. it especially helped build my sympathy for the parents of autistic children who bought into it. wakefield's (charismatic) assurance, loads of (on the surface) scientific evidence, an answer an therefore a cure, it all must have been so seductive for the parents. if you take the view of the book as an historical account of a movement as much as an explanation of the science behind the movement, it makes more sense.
on another note, as i read autism's false prophets, i was also reading the vaccine book by dr. sears. i have to say, the combination was depressing. on the one hand, dr. offit so skillfully demolishes the mercury/autism link, and on the other, dr. sears helps push the goalposts over to aluminum. sigh...
desiree, you should head over here:
http://mainstreamparenting.wordpress.com/2008/09/05/so-whats-the-deal-w…
The aluminum thing is just moving the goal posts.
Orac, while you are right, er, correct, and press for the right, er, correct cause, you will never be the soul of wit.
I was lucky enough to get one of the free books (thanks!) and so far I am enjoying it. What most surprised me (as Orac mentioned above) was how the application of the precautionary principle, which seems at first like a very cautious, conservative approach to public health, can really backfire, especially once you take into account what's going on in the media and in the legal realm.
Not only does the book make the science accessible, but it's useful (and interesting) to hear someone tell the whole story of how the antivax movement and its cast of characters came to be.
I enjoyed the review and found it informative. Your efforts appear thorough and well researched. Followed Ms Seidel's legal tribulations with great interest. Dr. Offit's generous contribution to autism research is a display of great conviction. Is it beyond the Surgeon General's position to pull together a group to take a public stand against such pseudoscience?
Dave--
I gave a half dozen vaccines today. I gave some reluctantly but respected parents' wishes to vaccinate.
You're turning into a demagogue. Please stop it.
Best,
Jay
Dr. Jay, would you refuse to vaccinate a sexually active teenager who wanted the Gardasil vaccine? Do you keep Gardasil in your office?
What luck for the anti vaccine movement that you 'skeptical' types can't write! What a longwinded and beside the point review . . .
Never once do you mention Offit's clear and documented conflicts of interest . . . Ummm, was it a very emotional moment when those babies DIED because of his Rotavirus vaccine? These are documented cases, I'm not even making this up! Wish I were. An intellectually honest review would mention all the conflicts of interest at work here . . .
Doesn't seem he proves that Ethyl Mercury is safe . . . Would you volunteer your baby for that study?
KK, I think that this relatively new vaccine is causing very severe side effects in a small but significant number of young ladies. I also am worried about the teens and young adults who will assume that the vacine allows them to skip Pap smears and condoms.
On balance, even many "Pro-vaccine" expert are hesitating on this shot. I don't own any and will not give them.
Best,
Jay
Dr. Jay, would you refuse to vaccinate a sexually active teenager who wanted the Gardasil vaccine? Do you keep Gardasil in your office?
Posted by: kkurios | October 2, 2008 3:14 AM
Honeypie,
what bad luck for us 'skeptical' types that the anti vaccine movement cannot read and we have to correct your mistakes.
One baby died and a hundred were sick with intussusception out of 1 million who received Rotashield. This was enough to get the drug withdrawn and, as Dr Offit points out, demonstrates how even very rare adverse effects can be detected by epidemiological methods. Dr Offit's vaccine, Rotateq came after Rotashield. If you have documented evidence of harm from Rotateq I am sure Dr Offit would want you to take it to the CDC.
Even so, what has this to do with Dr Offit's arguments in his book concerning MMR, thiomersal and autism? And how is it a conflict of interest? I would have thought that getting an expert on vaccines to write a book on a vaccine controversy was a good idea, especially one who has already written an honest account of the Cutter Incident.
Read the book. It is not concerned to prove that ethyl mercury is safe ... for whom and at what dose? You did not make that clear. It does summarize the research evidence to prove that thiomersal does not cause autism. Or do you dispute that as well?
So if you know that a teen is going to have sex (is already having sex) and you know that they may very likely end up with genital warts from the human papilloma virus and be at increased risk for some forms of cancer, will you tell them that condoms will prevent the transmission of this disease? Will you tell them that having pap smears will prevent the warts? If a girl ends up with cervical cancer because you discouraged her from getting the vaccine would you feel bad?
This is what wikipedia is saying at the moment:
"Genital HPV is the most common sexually transmitted infection. Estimates suggest that most sexually active men and women acquire genital HPV infection at some point in their lives.[11] The American Social Health Association reported estimates that about 75-80% of sexually active Americans will be infected with HPV at some point in their lifetime.[12][13] According to the Centers for Disease Control (CDC), by the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV.[14]"
Also wondering if Dr. Gordon has read the book? What is your favorite part, Dr. Gordon?
Dear Dr. Gordon:
YOU stop it. Stop spreading the falsehoods of the anti-vaccination "hordes" like the yarns about anti-freeze, etc. that YOU parroted on Respectful Insolence.
When you lie with pigs, you get dirty.
Now, STOP IT!
Wow, Orac. That was verbose even for you.
I'm still working my way through the book and hope to have something substantive to say by tomorrow.
If find your massive hypocracy amazing. You, who speak at rallies designed to convince people to not vaccinate, accuse others of being a demagogue?
Let me remind myself, didn't you recently say there as no need for a Polio vaccine if people avoided eating cheese? Are you sure you're a doctor?
Give me a break, Dr. Gordon. You please stop it with the "wounded puppy dog" routine. You pull that every time you face any significant criticism. In fact, I was far milder this time than I have been in the past, as you well know.
I find it telling that you say you "reluctantly" gave some vaccines today because you "respected parents' wishes to vaccinate." It sounds as though those parents have more sense and medical understanding than their doctor on this issue. Why, if you are not "anti-vaccine" were you "reluctant" to give their child appropriate vaccines? What's to be reluctant about? That's not a quality I look for in a pediatrician. It sounds to me as though you tried to persuade them not to vaccinate. Why, if you're not "anti-vaccine"?
As for me being a "demagogue," let's go for a trip down memory lane all the way back to, oh, July, when I called you out for spewing some of the most embarrassingly easy to refute misinformation about the "toxins" in vaccines that I've seen coming from any pediatrician anywhere. Book club readers not familiar with Dr. Gordon should click on that link and read up about the sorts of misinformation and then go back and check out this link from three years ago to see that Dr. Gordon has been at this at least since 2005.
The July incident was particularly embarrassing for him, as well it should be. There was Dr. Gordon going on about how dangerous the formaldehyde in vaccines is and spouting serious ignorance, all the while telling us that he values his own personal experience over the wealth of studies failing to find a detectable correlation between mercury and autism or vaccines in general and autism. None of that science matters to Dr. Gordon, however. His personal experience does; i.e., anecdotal evidence. Dr. Gordon was forced to admit that he was in serious error about formaldehyde in vaccines, as he had apparently no idea that the human body makes formaldehyde in the process of metabolic pathways or that people are exposed to far more formaldehyde just in the environment. I pointed out that he is exposed to more formaldehyde tooling around L.A. on its famously choked freeways than any vaccine could expose him to. That Dr. Gordon apparently had to be humiliated for him to learn that the amount of formaldehyde in vaccines is trivial and not a danger does not engender confidence in his understanding of other matters related to toxicology.
No, Dr. Gordon, you unthinkingly parroted one of the most noxious and, quite frankly, outright dumb myths about vaccines, the "toxins" myth. Tell me, Dr. Gordon, if you are "not antivaccine," why were you so "reluctant" to give vaccines yesterday and why do you repeat antivaccine talking points in interviews for the media? Why do you hang out with antivaccinationists and give speeches to antivaccine marches? (And, yes, the "Green Our Vaccines" nonsense was clearly antivaccine, not "pro-safe vaccine." The whole "pro-safe vaccine" thing is such an obviously disingenuous and wonderfully Orwellian bit of language manipulation to hide the movement's true orientation that I reluctantly have to doff my hat to whoever thought of it.) Why do you make videos that express "skepticism" about vaccines based on no good evidence?
No, Dr. Gordon. Tell yourself all you want that you are not "antivaccine." Maybe you even are. However, there is no denying that you are exactly as I characterized you: An apologist for the antivaccine movement, someone who gives aid and comfort to it, someone who has indeed become the go-to guy in many media sources for antivaccine quotes. If you're not antivaccine, you sure have a funny way of showing it.
So, I guess my retort to you is: With all the antivaccine talking points that you repeat to the press and in speeches, all the while piously asserting that you are "not antivaccine," you are turning into an antivaccine crank. Please stop it.
I noticed Dr Gordon addressed you by a name other than Orac -- which I would presume to be a not-so-clever attempt at a "semi-outing," yes?
That pretty much seals the deal -- he's not turning into a crank; he *is* one now.
I always thought the box of blinking lights looked more like a 'Ross' personally.
Orac,
Expect to see Dr Jay's "concern" comment next. He's so concerned about your "mean-spirited attack" on him and what it will do to the "dialogue" on the issues.
Talk about being able to dish it out but not able to take it. Just read anything that Dr. Jay has said about Dr. Offit - it makes what you said about Dr. Jay look like high praise.
Here's a bit of the old "concern trolling" right back at Dr. Jay:
Prometheus
I'm concerned that you're concerned. :-)
When is Dr. Jay going to correct his buddies at the clown blog? They make statements that show they are thoroughly antivaccine... 100% antivaccine. They want no child ever to get a measles vaccine. Ever.
Why don't you reason with them on their blog and tell them that they are wrong? Why don't you tell Jenny that she'd be stupid if she had another baby and didn't vaccinate that child at all? I think it's because you are at your heart antivaccine.
Jenny said that babies don't need tetanus shots because they don't crawl around and get stuck on rusty nails. Why didn't you tell her she was wrong!?
And...who paid for all those millions of tetanus vaccines you took (or are taking) to Africa?
This is so interesting. I'm not only learning about the actual science behind the debunking of the vaccine-autism hypotheses but also learning all about the different types of trolling by all these e.g.!
Ms. Clark,
I think that you can expect Dr. Jay to correct his "buddies" in the vaccines-cause-autism movement shortly after they start needing snow plows in Hell.
Seriously, he appears to be desperately trying to currying favor with the celebrity/millionaire crowd he worships - and you can't do that by "speaking truth to power".
You don't get to be Jim Carey's BFF by telling Jenny McCarthy that she's wrong about vaccines.
You don't get to be "Pediatrician to the Stars" by telling them that their latest fad diet, fad therapy or fad fear is "unsupported by science".
No, the way to ingratiate yourself with the rich and famous is to indulge them in all of their idiosyncrasies and to cater to their wishes, no matter how unreasonable, wrong-headed or self-destructive they may be.
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct. They are able to suppress their own conscience and judgment - they let their "boss" be their guide - sort of an reverse Jiminy Cricket.
It's a gift - apparently a gift I don't possess.
Don't expect Dr. Jay to destroy a career built on long hard years of slavishly following the medical fads and fashions of his patrons. He may - on extremely rare occasions - admit that he was wrong (or, at least, misinformed), but he'll never criticize the people who let him reflect a little of their glory.
So, the next time he trots out his "thirty years of experience" story, remember what that "experience" consists of.
Prometheus
Prometheus, I think you are correct. One thing that puzzles me about Dr. Gordon is that he'll shoot his mouth off (or his thoughts off, through a keyboard) and what he says can be totally unprofessional and totally unfounded (like his accusations against Dr. Offit regarding conflicts of interest) and then turn around the next day, even, and apologize for doing that.
I wonder seriously wonder if the guy thinks he can say anything he wants (and please one crowd in doing so) and then sort of wipe the slate clean by apologizing for it. For some reason his fans at the clown blog don't yell at him for this habit of apologizing about making stupid antivax statements. I also wonder if maybe he's had a glass of wine or two when he starts writing mean things on the web. Sometimes he does it at like midnight or later.
Whatever it is, it's totally bizarre. I mean, it's good that he can apologize, but this pattern of insulting and then apologizing (lather, rinse, repeat) is really weird... and unprofessional.
Great review, Orac! Thanks for your thoroughness.
My husband and I are reading the book comparatively slowly, in part because we're reading the same copy, and in part because as parents of a child on the spectrum, it is just so enraging to read about the depredations of Wakefield and the like.
I've been following the events described in this book ever since about 2006, when they were brought to my attention by Respectful Insolence and by Ben Goldacre's "Bad Science" column in the Guardian. Thanks for doing your part to keep the public informed about antivaccinationism, and thanks for not letting up on the enablers of the movement.
Exactly. After Dr. Gordon finally admitted that formaldehyde in vaccines is not a danger because it's such a trivial amount, I tried time and time again to pin him down and ask him if he was going to suggest to Jenny McCarthy that she stop parroting that antivaccine canard. I even told him it would make my job a little more difficult if she did because she would look ever-so-slightly less idiotic if she stopped going on about formaldehyde in vaccines. I asked him to suggest to Generation Rescue, J.B. Handley, et al that using the formaldehyde gambit only made them look incredibly dumb.
I doubt he did it.
I've noticed that too. He said some pretty vile things about Dr. Offit, and now he thinks he can just apologize and it's all OK?
Orac-
I am SO grateful for vaccines. I am a person that had all of the old childhood diseases. Mumps, measles, chicken pox, you name it, I got it - except polio, and small pox. Why didn't I get those horrible diseases? Because we had vaccinations in my public school.
My grandparents used to tell us of the smallpox epidemics that swept through their small town communities, it was horrible. My grandparents siblings died of the small pox in terrible suffering. My mother didn't catch one nasty disease from any of her children, it makes me wonder if her generation got some sort of immunity from their parents, and if we aren't missing one hell of an opportunity to make some vaccines from their blood. If that's how it works.
People that won't vaccinate their children are morons.
@34: I'm reminded of line Tom Lehrer used. He described a fellow who specialized in 'diseases of the rich.'
Terrific review Orac, it certainly increases my interest in the book.
A little off-topic, but my favourite commercial about Gardasil is the one with the teenage girl who says "Why did I get the HPV vaccine? Because I'm smart."
Patricia wrote:
"it makes me wonder if her generation got some sort of immunity from their parents, and if we aren't missing one hell of an opportunity to make some vaccines from their blood. If that's how it works."
That's not how it works. ;) Though there is one thing we're missing that we could get from those generations: the opportunity to remind people who've never had to live through those epidemics just how horrible they were, and how lucky they are to be vaccinated.
Thanks for the excellent review. I hope this is the end of the antivaccine lunacy.
Posted by: Moftasa | October 1, 2008 4:36 PM
About as likely as the deluded evangelicals and catlickers will come to their senses, i.e. - not.
Jay Gordon (doesn't deserve the title Dr., in my opinion, as he is in clear violation of the Hippocratic oath): "I also am worried about the teens and young adults who will assume that the [HPV] vacine (sic) allows them to skip Pap smears and condoms."
They would only assume this if they had been inundated by other forms of pseudoscience (besides the anti-vaccination crap you your ilk have fed them), namely abstinence-only education. This assumption would also indicate that their doctor is doing a dangerously poor job of informing them about necessary medical procedures and precautions. If you are their "doctor," I would not be surprised if this was the case.
You, sir, are a monster.
The irony of the anti-thimersol-in-vaccines people is that thimerosal, in the tiny ammounts used, act to prevent bacteria from getting a foothold in the protein-heavy vaccines. That's why vaccines that shifted away from thimerosal have had to move to individual dosage bottles, and much stricter refrigeration rules. Thimerosal makes vaccines safer. It's roughly analogous to chlorinating water.
Great review. I'll be sure to buy the book. I'm very interested!
Anti-vaccers get the fuck real! If you're worried about thimerosal, use those useless fingers of yours, go to Google Scholar, type THIMEROSAL AUTISM and you'll get at least 2-3 studies that show that thimerosal is not responsible for autism.
That would be step 1. Step 2 - Read the studies. Step 3 - If after reading you still think thimerosal is at fault, go get you name changed to officially include a middle name of "MORON"!
Orac:
What's awful is that I read that and immediately thought of a certain Daily Show running gag.
Hi Dr. Gordon,
As a friendly reminder, you still have unanswered questions at Autism Street in the comments of this article:
What Can Dr. Jay Gordon, Pediatrician, Tell Us About Autism Epidemiology?
Regarding your statement above
Which ones did you give reluctantly?
What science do you have to show that your reluctance is medically valid concern and not an emotional response in regards to those specific vaccines?
Do you respect the science (whether directly understood or not by the parents) that makes those parents' wishes a wise decision?
Would you respect a parent's wishes to have a child (who is not confirmed to be heavy metal toxic by standard tests and diagnositics) chelated?
I read the book, and thought it was great. I don't understand how you could take any college level science course and not understand the case that Dr. Offit laid out for the safety of vaccines. As for Dr. Jay Gorden, well he's about as bright as Dr. Josyln Elders. Out of the millions of doctors trained in this country, statistically, there have to be a few idiots.
Please answer these questions for me. If the parents choose not to vaccinate, how do they register those children for school? What percentage of home schooled children do not receive vaccinations? I ask this because in the states where I have lived, vaccine records are required before children can register for school. Many daycare facilities also have that requirement.
In my opinion, not vaccinating your child is abuse.
To be fair to Honeypie, Dr. Offit's book unfortunately does not name the rotavirus vaccine which was withdrawn after epidemiological studies showed it to cause intussusception in rare cases, and does not make clear that that rotavirus vaccine preceded RotaTeq, the one for which he is responsible.
Of course, Honeypie is still completely mistaken about the two vaccines being the same, even if it's understandable how that mistake could have been made. Less understandable is why she brings up that mistaken belief at all; what does it have to do with conflict of interest??
Update: I thought of another possibility just before pushing the final "Post" button, and did a Google search, and sure enough, here's an Age of Autism post claiming in its headline, that "Paul Offit's Rotateq causes death by intussusception".
... No one there seems to have noticed that absolutely no evidence supports the "caused" part, but then again, if they understood that correlation does not prove causation why would they be going to Age of Autism?
oneypie, what bad luck for us 'skeptical' types that the anti vaccine movement cannot read and we have to correct your mistakes.
Great infomation thanks very much
Very young children will say box B, because that's where the cheese is now. But at around age 4, they'll correctly answer box A, since Mouse has no way of knowing that Cat moved the cheese. Older children have successfully developed an important aspect of theory of mind -- they understand that Mouse falsely believes the cheese is in box A. But does understanding false beliefs of others require language?
48
Orac:
... one particularly deranged antivaccine advocate, who has in the past shown up at least once in the comments on my own blog and is so off the deep end that even antivaccinationists are embarrassed by him, has written posts accusing me of "sodomizing autistic children" and of being a "member of NAMBLA."
Don't expect Dr. Jay to destroy a career built on long hard years of slavishly following the medical fads and fashions of his patrons. He may - on extremely rare occasions - admit that he was wrong (or, at least, misinformed), but he'll never criticize the people who let him reflect a little of their glory.
Anti-vaccers get the fuck real! If you're worried about thimerosal, use those useless fingers of yours, go to Google Scholar, type THIMEROSAL AUTISM and you'll get at least 2-3 studies that show that thimerosal is not responsible for autism.
That would be step 1. Step 2 - Read the studies. Step 3 - If after reading you still think thimerosal is at fault, go get you name changed to officially include a middle name of "MORON"!
thank you admin!
How is the news being anticipated in the scientific community? âI honestly think this is an incredible job of marketing,â says paleontologist K. Christopher Beard of the Carnegie Museum of Natural History in Pittsburgh, Pennsylvania, who has not seen the report but has read the news. He points out that other fossils of similar age from China, Myanmar, and India have also been proposed as some of the earliest anthropoids. âAt this stage, color me skeptical.â
in Pittsburgh, Pennsylvania, who has not seen the report but has read the news. He points out that other fossils of similar age from China, Myanmar, and India have also been proposed as some of the earliest
Very young children will say box B, because that's where the cheese is now. But at around age 4, they'll correctly answer box A, since Mouse has no way of knowing that Cat moved the cheese.
This is a pandering piece of garbage. I wonder how many folks on here actually have autistic children. This book is pollution. Oh and some say I have to read it. I've read enough about this Paul Offit character. He deserves perhaps not hatred, maybe pity for his lost soul.
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
He deserves perhaps not hatred, maybe pity for his lost soul.
This is a pandering piece of garbage. I wonder how many folks on here actually have autistic children. This book is pollution. Oh and some say I have to read it. I've read enough about this Paul Offit character. He deserves perhaps not hatred, maybe pity for his lost soul.
If you're worried about thimerosal, use those useless fingers of yours, go to Google Scholar, type THIMEROSAL AUTISM and you'll get at least 2-3 studies that show that thimerosal is not responsible for autism.
That would be step 1. Step 2 - Read the studies. Step 3 - If after reading you still think thimerosal is at fault, go get you name changed to officially include a middle name of "MORON"!
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
I used to think that wasting time on people who think vaccines are dangerous was just that, a waste of time. I didn't bother arguing with them because there is no real point. If they don't want the vaccines, let them not take it. It's their health at stake, not mind.
Now I think differently because majority of people are just misinformed and arguing and standing up to the lunatics who spread the information is the best way to inform the public of the good the vaccines have brought.
They would only assume this if they had been inundated by other forms of pseudoscience (besides the anti-vaccination crap you your ilk have fed them), namely abstinence-only education. This assumption would also indicate that their doctor is doing a dangerously poor job of informing them about necessary medical procedures and precautions. If you are their "doctor," I would not be surprised if this was the case.
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
As as its resident "vaccine blogger." True, others around here sometimes do posts about vaccines, antivaccine lunacy, and the discredited idea that vaccines somehow cause autism, but with nowhere near the frequency and intensity that I do you have become a natural authority now.
Very young children will say box B, because that's where the cheese is now. But at around age 4, they'll correctly answer box A, since Mouse has no way of knowing that Cat moved the cheese...
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
Right now big media is running with Jenny's indigo lies and her vaccine lies, but at least the truth has it's "boots" on. People in authority are reading this book. Indigo moms will have their preconceptions reinforced... I wonder if that includes Ariana Huffington?
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.
The people who are the best at this sort of sycophancy are able to convince themselves that their patrons' nonsense is actually reasonable and correct.