Dr. Oz: Looking for parents afraid of autism?

I can't believe, in light of all of the debunking of the "vaccine-autism myth" that Dr. Oz would have the temerity to run something like this - god forbid he even invite Wakefield on his show.

Of course, it could just be about Autism & diagnosing the early signs (the earlier the diagnosis, the better the overall outcomes can be), but that's not what will grab ratings.

I was recently at my doctor's and because the Wakefield stuff was so recent, was asking her whether or not it had had any effect on what patients were saying with regard to vaccinations. She said that, for the most part, her patients followed her recommendations, and she had never had anyone really argue with her about vaccines.

Good, so far.

Then she volunteered that she thought kids *were* getting too many vaccines too soon these days, and said that if her (now grown) children (who, to be fair, got all their recommended vaccines when they were small) were young now, she would not give them the full arsenal. She must have noticed my look, because she started justifying particular vaccines, noting that her children were not terribly likely to be exposed to X, Y, or Z under most circumstances. Fortunately, she was knowledgeable enough to understand my two word counter-argument: Herd immunity. As a physician and a mom, she *does* care about other people than just her own children; she just had to be reminded.

It bothers me, though, that the public discussion has moved to the place where my doctor was so quick to dismiss the research, and fall back on the scare claims.

Bullshit alert: Wakefield is going to be speaking to the CBC's The Current in a few minutes.

Then she volunteered that she thought kids *were* getting too many vaccines too soon these days, and said that if her (now grown) children (who, to be fair, got all their recommended vaccines when they were small) were young now, she would not give them the full arsenal. She must have noticed my look, because she started justifying particular vaccines, noting that her children were not terribly likely to be exposed to X, Y, or Z under most circumstances. Fortunately, she was knowledgeable enough to understand my two word counter-argument: Herd immunity. As a physician and a mom, she *does* care about other people than just her own children; she just had to be reminded.

It bothers me, though, that the public discussion has moved to the place where my doctor was so quick to dismiss the research, and fall back on the scare claims.

There are plenty of other reasons why you should vaccinate your kids that actually run counter to this argument. Someone should be able to back me up on this but doesn't the science point that stuff like allergies are possibly a result of not being exposed to enough virus and bacteria at an early age.

noting that her children were not terribly likely to be exposed to X, Y, or Z under most circumstances.

CBC's 'Listen Live' page is at:

http://www.cbc.ca/radio/

... and if you miss it and you want it for fisking it'll be on podcast tomorrow probably beneath:

http://www.cbc.ca/thecurrent/

... if the show does the usual deal with the broadcast.

noting that her children were not terribly likely to be exposed to X, Y, or Z under most circumstances.

Ooo god. I know exactly what she was refering to and she is an ignorant idiot in that regard. Every time I have heard that argument its in reference to Hep B. Hep B is a nasty thing to get as a child to the point where you kids life will be signficantly shortened if they get it. Also, not every single case of Hep B is associated with the risk factors.

Wakefield just denied, in response to Tremonti's (interviewer) question on the subject, that he was developing an alternate vaccine.

@Adam_Y

Yeah, just because it's called a sexually transmitted infection doesn't mean it *only* transmits through having sex.

Wakefield thing is over. Was like 10 min or so, I think.

It was pretty light. Sounded like a standard big pharma are out ta get me/martyrdom spiel. They just had him on because they'd had Mnookin (Panic Virus) on a while earlier, and various Wakefield defenders had written in to protest their hero's depiction therein.

Wakefield just has diaheara of the mouth - he doesn't know when to shut up.

As far as too many, too fast - the combined vaccines that are given now as part of the normal schedule contain less antigens than the older schedule with fewer vaccines. The manufacturing process has also improved over time - so our vaccines today are definitely safer than the ones that were made twenty - thirty or even forty years ago, just from basic improvements in the technology used in the process.

In today's world, where international travel is more than commonplace & vaccination levels/disease vectors vary wildly from place to place, plus the mass migration of individuals (either refugees or just immigarants) means that the opportunity for exposure is actually greater today than it was in the past - you could have a new family move into your neighborhood tomorrow or run into them at the doctor's office, where they might just have come from an area of the world where they don't receive the routine vaccinations.

Quite a number of recent outbreaks, including the large measles outbreak in CA resulted from a family that travelled to Switzerland & had their 7 year old (unvaccinated) exposed and brought the disease back home. Of course, they took their kid to the doctor's office, where many other children, some too young for the MMR, were exposed as well.

This is all common sense, people. One by one, the anti-vaccine tent posts have been knocked down, but the hard core believers won't even begin to re-evaluate their stances, even with all the evidence in the world staring them in the face.

If you were one of the lucky people to already see this episode of Dr Oz, please leave a comment below to fill us in on what was said and if you believe that Dr Neme is really a Faith Healer or not!

Pet peeve here. I'm tired of shows talking about a subject that requires a certain level of knowledge (in science, for e.g.), and then asking for listeners to contact them with their [useless] opinion.

Right. I really need to hear the beliefs on a science topic from someone who has never even opened a science magazine in their life. Sure, someone with knowledge might leave a comment, but mostly it is noise made up of the Dunning-Kruger afflicted.

This week our news program asked people to comment on a court case they would know absolutely nothing about due to a media blackout. Who the f*** cares! Stop asking people to write in about something they can't possibly know. Stop with the man in the street interviews on topics requiring specific knowledge.

If they want comments, ask how x has affected them personally, not how do you fix x.

Related pet peeve are the dumb questions asked--what do you think of the recession/triple murder/disaster?

[/pet peeve, frothing at mouth]
siighhhh.
-dan

I get really annoyed when people who should know better say things like "oh, kids are exposed to so many more toxins today"

Really? I'm 41. I'm old enough to remember leaded gas, acid rain, high VOC paint, diazanon sprayed on the roses by my mom, public smoking EVERYWHERE, etc., etc..

I'm not denying that there are "toxins" out there now that weren't even dreamed of when I was a babe, but still...our air and water and soil are cleaner now than they were 40 years ago...when did we live in the toxin-free utopia Dr Oz is thinking of??

Sorry for the rant, but I had just been reading through my online edition of Nature. One of the most prestigious science journals in the world allows comments from any primate that can operate a keyboard, and judging by the comments, they do--pretty sure the Bonobos at the Heartland Institute have a Pavlovian reaction any time an email alert feeds them key-phrases from a headline, allowing them to regurgitate nonsense without even reading the article.

Ugh. Dr. Oz is so popular. When he says something loony I have a heck of a time convincing family it's not true. Some relatives look at me like I'm a Dalek or something when I criticise stuff he says. This will be bad.

As more details about Mr. Wakefield's "project" spill out into the mainstream media, anti-vax views have become less attractive ( e.g. CNN's various offerings featuring Jenny & Co.) so Oz is merely taking up the slack and the *ratings*( he hopes). The lower woo-esphere is abuzz with tales about Andy being unfairly treated, how Brian Deer is a representative of the nefarious "Medical Industrial Complex"( or is it *Pharmaceutical*I.A.?), and how "most science is corrupt" anyway.( So there!)Oz must get mail and sees a potential audience to cultivate.

Prepare for push-back from the woo-entranced crowd who blame the messengers who delivered the news rather than their beloved Andy, whose value as a figurehead may extend *beyond* the anti-vax movement to other alt-med proponents. In the last six months or so, I have witnessed our esteemed host's nym/name, blogs/ blogging venues, and specific titles of his posts mentioned in several puddles of woo: AoA, NaturalNews, and the Gary Null Show. I wouldn't be shocked if the above companies' reps infiltrate comments( perhaps looking for material for a suit**). Or so my spies tell me.

** "Come see, come sue"- a favorite old movie line.

"I get really annoyed when people who should know better say things like "oh, kids are exposed to so many more toxins today"

Really? I'm 41. I'm old enough to remember leaded gas, acid rain, high VOC paint, diazanon sprayed on the roses by my mom, public smoking EVERYWHERE, etc., etc.."

And for those who believe that we lived in a golden toxin-free age in the early 20th century or previously, consider such healthful things as arsenic compounds used as pesticides, unrestrained industrial pollution of air and water, radium watch dials and parents relying on hazardous patent medicines in the days before the Pure Food and Drug Act of 1906. Or just read "The Jungle" to get an idea what goodies were winding up in the food people ate.

Of course, lots of children were dying of diphtheria, measles and other infectious diseases in those days, but at least they remained unsullied by The Toxins in vaccines.

AJ Milne:

Wakefield just denied, in response to Tremonti's (interviewer) question on the subject, that he was developing an alternate vaccine.

Well, he wasn't developing a vaccine. He was developing an immune therapy to treat and prevent measles.

*rolls eyes*

Wakefield was profiting directly off of lawsuits against vaccine manufacturers, and had prepared a prospectus pertaining to his "transfer factor" that would profit off of both people wanting to avoid measles and people who have actually caught the measles; he wanted the measles rate to go UP, in other words, so that he could profit off of it. The vaccine was clearly an impediment to that.

Why are you so surprised that Dr. Oz decided to not vaccinate his kids for H1N1? Evidence-based medicine shows flu shots to be not very effective (though I believe adults were looked at) and the increase in seizures noted in Australian children is worrying.
You honestly would probably be better off spending your time advocating for better vaccine safety research ( including support for a primate study) rather than drumming up people to contact all these shows to dissuade them to air their views. It kind of reminds me of the little boy plugging his finger in the dam. You can do better than that.

Jen - when has anyone here every said that we weren't in favor of continued research into vaccine safety? As a matter of course, research is done on a daily basis to improve the manufacturing process and increase the overall safety of the vaccine supply - plus find better and improved vaccines as well.

Vaccine research (or just research in general) never stops - at any one time there are tens of thousands of studies going on, related to every branch of medicine you can think of - antivaxxers seem to think that nothing has changed over the last fifty years, when things have changed quite a bit - including the fact that the total number of antigens in the current vaccine schedule is lower than twenty years ago when we gave fewer vaccines.

People complain the drug approval process takes too long - and then complain again when things are rushed & there ends up being a problem. You can't have it both ways.

As the mother of a child with chronic Hep B, the anti-Hep b vaccine attitudes make me crazy. I know I don't have to disclose my child's health status to anyone, but knowing SO many parents who choose not to give their children this vaccine (and are discouraged from doing so by their doctors, or at least not actively encouraged) makes preschool and daycare and playdates very stressful. My family should not have to worry about this on top of worrying about my child's own health.

Jen:

Why are you so surprised that Dr. Oz decided to not vaccinate his kids for H1N1? Evidence-based medicine shows flu shots to be not very effective (though I believe adults were looked at) and the increase in seizures noted in Australian children is worrying.

Context is important. Flu shots in general are not as effective as one would like largely because it's a bit of a crapshoot as to whether or not the immunity achieved will actually be useful. Studies of whether or not they produce the desired immune response have shown them to be very effective -- over 90%. The problem is that influenza mutates very rapidly, so the strain that you vaccinate against may be extinct before the next flu season, rendering the immunity effective but pointless. Over all, statistically it's something like 60% effective. On bad years, it's bupkis. On good years, it's over 80%.

Last season was an exceptionally good one, at least for one flu vaccine: the H1N1 vaccine. The trivalent seasonal flu vaccine in 2009 turned out to be almost worthless; there were some cases of influenzas that it protected against, but very very few. The overwhelmingly most common strain in the 2009/2010 season was 2009 H1N1. And by a stroke of luck, that new strain was discovered in just barely enough time to cook up vaccines against it. The 2009 H1N1 vaccines were consequently among the most effective flu vaccines ever.

For a physician to express concerns specifically about that flu vaccine and not others is for that physician to demonstrate that he doesn't really know what he's talking about. That's what concerns me about Dr Oz's claim.

Does anyone else think it's a little odd that the invitation to parents is to "tell us about your FEARS that your child MIGHT be diagnosed with autism". I'm thinking this isn't about autism (as diagnosed by medical professionals) at all. Jenny McCarthy's kid may not have ever had autism, and look where she's got with her books and treatments and mommy warrior crap.

It seems they are trying to move away from Wakefield and move to a much bigger venue.

"We got exposed to ten vaccines when we were kids. Children today are now getting closer to 30. So there`s a big difference between the exposure amounts and, plus, we have a much purer environment that we grew up in and compared to what kids are exposed to today."

First, I have a problem with Dr. Oz's statement that kids lived in a much purer environment in the past. Is there any evidence to support this? In the past there were no limits on lead, mercury, or other things that we know are harmful. Also, we were much more likely to grow up in a household with smokers than kids today.

Also, I thought the vaccines we got as kids had a lot more "stuff" (for lack of a better word) that anti-vaccine people worry about. ("Toxins", metals, antigens, etc.) Just because we get a higher number of vaccines doesn't necessarily mean we are exposed to more potentially harmful substances.

@Pascale

Agreed. It would seem they're trying to stack the audience/guests with people who are, if not outright anti-vaxers, sympathetic to anti-vax misinformation.

Does anyone else think it's a little odd that the invitation to parents is to "tell us about your FEARS that your child MIGHT be diagnosed with autism". I'm thinking this isn't about autism (as diagnosed by medical professionals) at all.

I think this is asinine. Oz's website says they are looking for parents of children from 0-12 months, it's putting the cart before the horse. It's fear-mongering, I don't see how there could be information of value in talking to parents who are worried that their child might be diagnosed.

It is another case of putting a parent's intuition above evidence. If they are so worried they should be seeking a developmental expert, not going on tv. Worrying about it does no good and giving a stage to that worry only makes more parents fearful.

Plus, I hate how the media makes it sound as if having an autistic child is just the worst fate a parent could possibly face.

@ VT Mom. I grieve for you and all parents of children with chronic diseases and I thank you for your pro-vaccine advocacy on behalf children.

In addition to sites that I and other posters on this site recommend for vaccine-preventable diseases information... I wonder if you are aware of the "PKIDS" (Parents of Kids with Infectious Diseases) site? The site's pages devoted to children chronically infected with Hepatitis B is the portal to all facets of the disease, including parent support blogs, legal issues and development of anti-viral treatments.

Plus, I hate how the media makes it sound as if having an autistic child is just the worst fate a parent could possibly face.

It's been mentioned before, but the way the anti-vax movement dehumanizes children with autism and ASDs is disgusting.

stuff like allergies are possibly a result of not being exposed to enough virus and bacteria at an early age.

You may be thinking of the helminthic theory, in which our immune systems expect a certain amount of exposure to worms & other parasites and go off the rails if that fails to happen:

The central thrust of the theory is, therefore, that correct development of T regulator cells in individuals may depend on exposure to organisms such as lactobacilli, various mycobacterium, and helminths.

I sent in a note to the effect that I hope this show will be a positive one for concerned parents, educating them about ASDs and communicating the message that the fears of mythical 'toxins' in vaccines contributing to autism have no factual basis.

However, since Oz had that idiot Mercola on his show, I'm not optimistic. He's opened up his mind past the brain-loss tipping point.

Speaking of the CBC, this report was on The National last night. Other than the underlying assumption that chiropractors are 'health professionals', it was a pretty decent piece. What, with the CBC also going after homeopathy, they've been doing some good work recently

Oz kills me. I find his show to be inflammatory as well as blatantly hawking products that people probably don't need. My favorite example was the high heel addiction show.
AFRAID of Autism. Fear sells.
Don't solve people's problems - that's too hard. Instead, make them afraid of it and tell them who to blame for it...Works every time. (Autism scary. big pharma...) The formula works rather well here.

http://statgirlskewer.blogspot.com/2010/12/back-from-breakdr-oz-made-me…

@Kristen, #25

Thanks for your astute addition to my comment. At first I thought you were saying my comment was asinine and was alarmed, but a second reading resolved the problem.

And yes, what on earth can be the purpose in seeking such a narrowly defined group of people other than to do a show on people's FEARS of autism (read, vaccinations)? I think it is clear what they have in mind. They are going to "listen to the mommies".

@lilady #26 -- Yes, I love PKIDS. They do amazing work and have great resources. Thanks for your kind words :).

They need to have a show with autistic ADULTS to show that even if your child is diagnosed they aren't always going to end up hideously handicapped, and a lot of us managed to grow up as contributing members of society even without quacky therapy. I think that's behind a lot of this nonsense, equating autism with this supposed terrible future the kid is doomed to.

I would just like to add my voice to the vast numbers of adult autistics and parents of autistic kids who find INEXCUSABLE the antivax movement's demonization of me and my child and people like us. It's phrases like this, in the email from the Oz staffer:

"We are looking for parents-to-be, parents of children up to 4 years old, that are worried their child may be diagnosed with Autism"

Look at the pandering, baseless prejudice. It drips with contempt for the Other. They bully and they stigmatize, they HARM us, and they don't even notice.

Melissa- "demonizing?" "Drips with contempt for the other?" Somebody is being dramatic. What about parents really being worried that autism is being diagnosed more? What about parents hearing of tragic stories of children with autism getting lost and drowning etc.?

Jen, if someone insults something you are, like your race or your brain chemistry or something else that's an integral part of who you are, over which you have no control, is that "being dramatic" to you?

Wow.

O.k. Now I'm just angry. You say a show about parents worried about autism is "demonizing" autism. Well how about -have you ever worked in a school for severe and complex needs? Schools that have the highest staff teacher ratio possible due to behavioural problems and nurses for the many attendant health concerns. Oh yeah, you just pissed me off- by neglecting all those people who live THIS kind of autism. That's right, missy. Not the "my kids a little quirky" kind but severe autism. And you want to know what? In this school, sure there are some kids with Down Syndrome and cerebral palsy but there are also lots of kids diagnosed with autism (sever and complex). So save your "demonizing" crap because many kids with autism are struggling for real. Your whole "insults something you are" characterization is your hang up not Dr. Oz's.

You have no idea of my life experience, Jen.

I have worked for many years with exactly the kids you describe-- the severely autistic, those with Down syndrome, and many many other crippling disabilities-- and I have loved each and every one of them. Of these children and adults, I have learned their complex individual needs, both physical and emotional. I have learned to pick up their physical communication cues where other educators missed them. You say I neglect them in my thinking? On the contrary, I have worked hard for them since my teen years and I have gotten to know many faces of disability.

You know what? They are all human.

Now I ask you-- do you not see that in your very words you are characterizing them as less than human?

You say you're angry. Well, so am I.

Oh my. Warning ahead about the length of this ramble. We are definitely in the category of "parents-to-be afraid of autism," as spectrum tendencies are so common in my family that we think of them not as being markers of "a little bit odd" but as being "definitely a blood relation." I've told my fiance about this tendency in my family, a couple months ago, my mom was reaching out to all of the extended-extended family, to determine the frequency in it, after one of my cousins that she is the guardian of was diagnosed with full-fledged autism. That's when the fiance told me he is officially "la-la-la, gonna-stick-my-fingers-in-my-ears," on the subject. We're both terrified of having a truly special needs child, but based on both of our families, if we had a kid that didn't show some spectrum tendencies, we wouldn't know how to relate to that, either.

So, um, I would love to volunteer as someone who is afraid of having a kid with her fiance, as much as we both want to breed, together, even, because we have such strong genetic risk, esp. on my side. But, my beloved is so afraid of it that it would upset him too much to even consider it, even if it meant we could go visit our friends and family we've been meaning to see in NYC.

Did I mention that my extended family has a history of religious exemption for vaccination, though this obviously goes well back into the family tree far enough that it's clearly irrelevant, since Great Grand-Uncle Cecil was the way he was long before the polio vaccine was invented. My mom had us all fully vaccinated, but I'm sure it's only 50/50 in my cousin set, so yeah, unless he's suddenly on the "genetics plus aging of parents" train, I don't think Dr. Oz's crew would be interested. I feel that our fear is rational, even though women in my family routinely have kids well into their 40s that aren't any more odd than the older siblings. There's enough full-fledged autism in the under-40 mother cousins to be wary.

I believe the experts that don't know for certain that it's genetic, but I swear, anyone who wouldn't make an outsider wonder if the person in question had undiagnosed Aspergers, my family would be wondering if they were switched at birth. Kinda like how brown eyes are recessive to the green that most of us have, in our family, it's definitely genetic, as it's over many generations, multiple states, and even very different countries. We're honestly terrified of having a full-autism child, to the point that I tend to fret we might be better off adopting, esp. as I have blood-clotting issues that make pregnancy extra dangerous to me. If my specialists weren't all on board that it's totally ok for me to get pregnant since my problem is known and the likely cause has been determined, folic acid metabolism gene thing, just have to take some extra and my clotting looks normal, and pre/pregnant women are supposed to take extra folic acid, anyway, right?

So, yeah, we're afraid of autism. But, nothing makes someone more nervous than the fear of having something go wrong with their pregnancy/kid, other than maybe that of there being the possibility of a pregnancy before it's desired. But I seriously doubt anyone as prone to the woo-side as Oz's crew would want us anywhere near a camera, even if it wouldn't so strongly bother my love.

Jen:

What about parents hearing of tragic stories of children with autism getting lost and drowning etc.?

Most normal people react the same to that situation as they would to any child who gets lost, drowns, is in an auto accident, or succumbs to an illness.

Today I was gardening and my new neighbor stopped to talk to me. As we were talking a helicopter circled around us at a fairly low altitude, and then landed nearby. Her face fell with sadness, just like mine does, when I told her that the helicopter was transporting a gravely ill child to the children's hospital* less than ten blocks away.

There is often an increase in helicopter flights overhead in the summer due to drownings.

* The blood mobile was there yesterday, and I walked over to donate blood. My route passes by the Ronald McDonald House, a place where immune compromised children and their families stay during long term treatments. I guess their health is not important to you, since the young cancer patients depend on herd immunity. Something you are fighting hard to erode.

Melissa, I stand with what I said. Fear is fear. Demonizing is demonizing.
No Djinna, don't bother with the show. You more than clearly believe there is a genetic basis in your family. Has anyone bothered to participate in the many genetic studies happening? Why not?

Jen:

Has anyone bothered to participate in the many genetic studies happening? Why not?

Jen, you just made a claim that you need to prove! Show us that families are refusing to participate in genetic studies.

@ Melissa
Dr Oz show..."We are looking for parents-to-be, parents of children up to 4 years old, that are worried their child may be diagnosed with Autism"

Melissa...'Look at the pandering, baseless prejudice. It drips with contempt for the Other. They bully and they stigmatize, they HARM us, and they don't even notice.'

I dont feel contempt from the statement. I think any new parent is worried about anything their child could be diagnosed with. It doesnt harm me. As a parent I think you worry about every single thing, but that doesnt mean you demonize those things. If I had a choice ahead of time, would I choose a diagnosis that could make my child's life harder, possibly even have severe health problems. Nobody would choose that, but after it happens you adapt because the love is the same. That part doesnt change, but the whole plan of what you thought your life would be may change. I think most parents never stop worrying. Dont let it feel like a stigma or like harm from someone else. I remember the fears I used to have and now, the diagnosis just adds many more. Take care.

@antro

Thanks for your astute addition to my comment. At first I thought you were saying my comment was asinine and was alarmed, but a second reading resolved the problem.

Thank you for re-reading. It is hard for me to get my point across sometimes. I have difficulty expressing in words what I am thinking.

I just get sick of all the distractions. There is real research being done, and real questions being answered. This kind of crap does nothing to improve awareness or improve education.

Perhaps Dr. Oz could do a show about the deplorable state of special education in this country, or about the difficulty of making sure ones autistic child isn't institutionalized after they die or the daily struggle to get people to understand and accept our children.

He's sold his integrity for fame and I lost my respect for him some time ago.

Chris, stay the hell out of it. Save your helicopter, blood mobile and Ronald McDonald House stories, too. Guess what? News flash. You aren't the only caring human in the world.
I asked Djinna a logical question about seeking genetic testing when she states that she has such a strong genetic risk. I'm pretty sure she doesn't need you to answer for her.

jen, you are so far out of line. Your lack of empathy for Melissa is difficult to fathom. I say this as a mother of a child who is Autistic.
Secondly the flu killed three children in 2 weeks where I live In Western Australia a few years back. That is why health authorities take it so seriously.

Why isn't Dr. Oz seeking to talk to adults with autism? (As much as I admire Ari Ne'eman and Temple Grandin, I would exclude them from this group -- they aren't the only adults with autism).

Why isn't Dr. Oz seeking to talk to parents of children with autism, who do not blame vaccines? (As much as I admire Ken Riebel, Kristina Chew, and Shannon Rosa, I would exclude them from this group as they aren't the only parents who do not blame vaccines).

Jen, I can tell you that I have and do spend much of my free time working with the most severely autistic children. It is not my career, nor do I receive any kind of compensation aside from helping to aid these neurodiverse children into teens. I have seen some advance far enough to move off of the spectrum. I have not been doing it long enough to see any turn into full-fledged adults yet, but I will say that I share my actual name with one young man who reacts almost violently to any touch, cannot meet his mother's eyes, and who at the age of 22 has never spoken an actual word.

It is this experience, along with my own exposure to the progress of autism research, that makes me so unspeakably, hand-shakingly enraged at people like you. There is literally nothing redeeming about your anti-vaccine crusade. There are legitimate issues to be raised with certain vaccines, and few here would disagree, but rather than do the difficult work of discovering these weaknesses and pushing to address the reality of the medicine, you continue to attack them baselessly.

Your actions have manifold consequences, none of which are good, starting with the fact you and your ilk are responsible for an increase in brutal diseases and their disfiguring consequences. Children are quite seriously dead because of your misinformed, baseless slander of vaccines. A minimum of seven in California, dead from pertussis. What is ironic is that infection with rubella is actually one thing that has been conclusively shown to be linked to an increase in autism, thus by your activism you are actually aiding the very disease you claim to despise.

Secondly, you are forcing the diversion of millions of dollars of research money that could be going to finding the actual cause of or treatments for autism. The one thing that has been conclusively studied and ruled out as a cause is your raison d'etre. Why?

Thirdly, and perhaps most damning in the long-term, your groups' rantings about vaccines and autism creates an environment where parents or groups trying to bring attention to legitimate vaccine problems are forced into an uphill battle for credibility, meaning that if there really are problems that require intervention the damage continues for far longer than necessary.

I wish I could believe you have rational, reasonable answers here, but overall I believe I spent the last ten minutes writing into a howling void.

"It might even be rather interesting to see what sort of response Dr. Oz's producers would have if neurodiversity advocates were to contact them."

Orac, are you promoting the neurodiversity ideology which says that autism is not a medical disorder that should be cured?

@Harold: Yes, I do believe that Orac is aware that autism is not a medical disorder. It is a condition of DEVELOPMENTAL DELAY (as you have been told many, many times before). It is not a medical disorder, it is most probably a genetics issue.

It cannot be cured. You can't cure Down's Syndrome, and it ranges from very mild to severe. You can't cure Rett's Syndrome and it, too, ranges from very mild to severe.

Go away, Harold. You don't understand true neurodiversity.

Left a long comment that the system is waiting for release. Short version: Harold, you're not intelligent. (I won't insult the idiots and morons, which had specific medical meaning.)

O.k. Now I'm just angry.

Angry and stupid is no way to go through life.

Link to the CBC program segment of Wakefield's interview. Good thing I haven't had breakfast yet, because I'd be tossing it.

If Simon Singh can be charged with libel for calling chiropractic 'bogus', there ought to be a lot of actionable statements in Wakefield's response. Overall, I'd say the interview was OK but not hard hitting.

Brad

Triskelethecat thank you for my daily chuckle.

The Pervasive Development DISORDERS are all listed in the DSM-IV and will soon all be catergorized as Autism Spectrum DISORDER in the DSM-5.

DSM, in case you were unaware, is the short form for the Diagnostic and Statistical Manual of Mental Disorders.

The autism that ND promotes, and that Orac appears to embrace, with the comment I quoted, is in fact a Mental Disorder.

Sorry to have to break the news to you.

Is it true that there was a time when homosexuality was listed as a mental disorder?

@Harold: I'm so sorry to disappoint you. I'm well aware of the DSM, having used it since back when it was DSM-II changing over to DSM-III. I am also aware, unlike you apparently are, that many things are listed in the DSM that are not true mental disorders.

Perhaps, though, you consider alcoholism, cigarette addiction, ADHD, homosexuality and other things mental disorders? How about bereavement? They are/were all part of the DSM. Many of those things have no cure. They may have treatments but few of them are ever "cured". (Tell someone who has lost their loved one that you can cure their grief. Time eases it, but it is never "cured".)

The DSM is not static, and changes as we learn more. If you had a bit more medical knowledge you would understand these things.

@Gray Falcon: yes. IIRC, it wasn't until the DSM-IIIR came out that homosexuality was removed from the DSM.

I just remembered: I'm on the Internet. I don't need to ask rhetorical questions, I can get rhetorical answers:

http://ajp.psychiatryonline.org/cgi/content/abstract/138/2/210

Damien, I am not responsible for discovering weaknesses in certain vaccines, and I have every right as a citizen to be outraged that more hasn't been done to ensure vaccine safety for our children. Baseless, my ass.
Funny, Njinna, who seemed so interested in the genetic explanation for autism never answered my question.

@Gray Falcon: yes. IIRC, it wasn't until the DSM-IIIR came out that homosexuality was removed from the DSM.

Sorry for the massive postings. They would not go through- and then they did in droves.

@ Gray Falcon : it was listed *and* my gay and lesbian classmates in grad school never let any. single. one. of us EVER forget it!(of course, they were right).

Damien - peace and thanks for your work.

Harold - bitchslapped as usual. Go back under your rock of hatred. I used to feel sorry for you, now you're just a distraction from adults having a conversation.

Jen - some tylenol will help with your headache.

Ouch! Hey Zeus' Homeboy has just won the thread. I award three internets.

The autism that ND promotes, and that Orac appears to embrace, with the comment I quoted, is in fact a Mental Disorder.

So what if it is? Does that make the people who have it any less human or any less deserving of the same social support you and I take for granted?

Orac's point (and the point of neurodiversity) is not that autism is something to be embraced but that it is an essential part of who some people are. Some people have diabetes. Some people have asthma. Some people have porphyria. And some people have autism. These are all lifelong conditions which are not generally curable and which can greatly affect a person's life. The best that can usually be done is to manage them, preferably without drugs, but with drugs if necessary.

You don't have to embrace autism, any more than you have to embrace lactose intolerance (which is an odd thing to call a disease, given that the majority of humans have some degree of it -- lactose tolerance seems to be the abnormal condition.) What ND proponents want is for you to embrace autistic *people*. There's a difference.

"Angry and stupid is no way to go through life."

Angry, ignorant and confused is the altie trifecta.

CanadianChick, that's a great point you make. Has anyone seen a good blog or any research that actually compares the amount of 'toxins' during the 20th century, from one decade to another? Lead, DDT, aerosols, caustic cleaning agents--am thinking of all the things that were common when I was a kid. But what's the actual evidence on 'toxic load'. Would like to know more to help counter this common conception. Any references?

CanadianChick, that's a great point you make. Has anyone seen a good blog or any research that actually compares the amount of 'toxins' during the 20th century, from one decade to another? Lead, DDT, aerosols, caustic cleaning agents--am thinking of all the things that were common when I was a kid. But what's the actual evidence on 'toxic load'. Would like to know more to help counter this common conception. Any references?

On a side note, back to our friend Wakefield, anyone spotted this yet?

http://www.naturalnews.com/031116_Dr_Andrew_Wakefield_British_Medical_J…

http://www.naturalnews.com/031117_BMJ_Dr_Andrew_Wakefield.html

Apparently, some months after the GMC hearings ended, all of a sudden another study has come to light that Walker-Sith had done with 7 of the children, 14 months before the MMR paper, with 7 of the same children, which chronicles their reaction to the MMR jab and diagnosis with autism.

Leaving aside all the problems -- like, Walker-Smith should have remembered the existence of this paper during the hearings, maybe, or that it contradicts the timelines of how and when the children were contacted anyway -- Wakefield is using it as "proof" that he is innocent and is (according to NaturalNews, our bastion of accurate medical info :-/) demanding that the BMJ retract its accusations of fraud.

THIS should be fun to watch, except that it really is turning into the undead zombie "controversy" from hell. I have to wonder how Wakefield sleeps at night.

Wonderfully articulate Damien, thank you so much. Very. Well. Put.

Triskelethecat The words Mental DISORDERS mean what they say.

The CDC fact sheet says:

What are autism spectrum disorders?
Autism spectrum disorders (ASDs) are a group of developmental disabilities CAUSED BY A PROBLEM WITH THE BRAIN [caps added]. Scientists do not know yet exactly what causes this problem. ASDs can impact a personâs functioning at different levels, from very mildly to severely....The thinking and learning abilities of people with ASDs can vary â from gifted to severely challenged

http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/AutismFactSheet.pdf

Ditto to Damien. Especially by ending with:

I wish I could believe you have rational, reasonable answers here, but overall I believe I spent the last ten minutes writing into a howling void.

Because this Jen, who thinks she cares so much told me:

Chris, stay the hell out of it.

Is what I get for reminding that other children drown, and that there are other hazards to children other than autism.

Too bad for her that this is not AoA where voices like mine are deleted immediately. Nor her responses.

Which is something I

Oop, I forgot to edit out the last sentence completely.

Harold,

There is a major difference between "This is a disorder" and "This child would be better off dead" or "This person has nothing to contribute to society" (though both of those are all too commonly said, and thought, of people with all sorts of disabilities).

Maybe neither you nor anyone you're close to has any sort of brain disorder: nobody with chronic depression, OCD, or any other mental illness, nobody with an autism spectrum disorder, epilepsy, or multiple sclerosis, no stroke survivors, nobody with brain damage from multiple concussions.

That's possible, certainly. It's even possible by random chance. But there are a lot of people in those categories, and they are people. Yes, it would be great to cure a lot of those things. (Asperger's may or may not be a disorder, but the people with MS, epilepsy, severe depression, and brain damage from strokes and car crashes would like those problems cured.) But in the meantime, would you tell the person with a seizure disorder, not that he shouldn't drive a car, but that he shouldn't be part of society at all? Do you think the stroke survivor shouldn't be calling the paratransit people to get him to a concert, because he should be hidden away in a nursing home somewhere, and listen to music only on the radio or maybe his iPod?

@Vicki: Bravo!

@Harold: change a few words...

What is mental retardation?
Mental retardation is CAUSED BY A PROBLEM WITH THE BRAIN [caps added]. Scientists do not know yet exactly what causes this problem. Mental retardation can impact a personâs functioning at different levels, from very mildly to severely....The thinking and learning abilities of people with mental retardation can vary â from mildly to severely challenged

Do you see how offensive your attitude is? Besides the fact that many children today with a diagnosis of ASD or autism would have been diagnosed as mentally retarded 40-50 years ago, your attitude that they are not worthy to be recognized as people, just differently-minded people, is awful.

Chris:

Today I was gardening and my new neighbor stopped to talk to me. As we were talking a helicopter circled around us at a fairly low altitude, and then landed nearby. Her face fell with sadness, just like mine does, when I told her that the helicopter was transporting a gravely ill child to the children's hospital* less than ten blocks away.

There is often an increase in helicopter flights overhead in the summer due to drownings.

* The blood mobile was there yesterday, and I walked over to donate blood. My route passes by the Ronald McDonald House, a place where immune compromised children and their families stay during long term treatments.

Everywhere you go, Death, Disease, Dysfunction, and Drama follows. Where do you live? A war zone?

Little Augie, I live in reality. You should try it sometime.

Kids get sick and get hurt. When one lives in a rural area you cannot spend four hours driving to the emergency room, hence there are these things called Air Ambulances. The hospital I live near serves the needs of five western states.

It makes up for having Bastyr just across the lake.

Wait, it has been revised to four states. Still the largest region of any children's hospital in the country.

ugh troll, in the real world, where most of us reside, bad things happen to real people (and not just 'bad' people), in many cases for no particular reason at all (like, say, infectious diseases spread by people before they express symptoms).

Maybe in your fantasy world, Chris' documenting of the health concerns and realities in her neighbourhood are signs of some disturbing trend. In the real world, they're normal (if unfortunate) occurences.

One cannot expect to live within a few blocks of a any hospital and not expect to hear sirens.

Jen, you are certainly free in this country to be angry about whatever strikes your fancy. However, your attacks against vaccines are indeed baseless. Vaccines are perhaps the most safety tested products on the market today, and there are multiple redundant systems in place to ensure their continued safety. The first rotavirus vaccine is an excellent example, because there were scientifically validated, specific ill effects which precipitated its removal from market.

The operative word in this story is "specific," because while you are indeed free to rage against vaccines, or homeopathy, or space aliens, or illegal immigrants, your concerns are treated with much more respect when you are able to provide details about what in particular you're angry about; respect that is further compounded if your concerns reflect the reality of a situation.

As an example of what I mean, consider two different perspectives in the illegal immigration issue: on the one hand, I could argue that illegal immigrants are coming to steal our jobs, shoot our wives, rape our cattle, etc. and so we should deport them all. This general, unfocused rampage, which does not comport with the reality of illegal immigration, is useless and eventually becomes the white noise that gets ignored.

Now, if I come and I say that illegal immigration is bad for all involved because it brutalizes a subset of vulnerable people and helps drive down wages and benefits for all low-income workers, that's a specific concern. The specific reaction is to advocate removing the incentives for businesses to hire illegal workers, as well as making it easier to get temporary legal permission to work for lower-income people.

Do you see the difference here? The first is unhelpful and actually hinders the solution of the issue as politicians must pander and businesses are free to continue their ways; the second has a particular, reality-based viewpoint and the idea of deincentivizing businesses is a well-known and successful technique for changing practices. Therefore the second is more reasoned and reasonable.

I am honestly willing to listen to your solution, jen, without judgment. While I have previously stated the reasons that I believe you are wrong in your position, I am a reasonable person and I want to hear you out.

However, merely advocating for vaccine safety is a meaningless phrase. What, specifically, are you concerned about?

Relentless scientific testing of vaccines has shown that they have no role in autism; if you are concerned about toxins, what toxins are there? Keep in mind that the dose makes the poison, and I'll want to see your evidence that whichever toxin you're concerned about has caused damage in its vaccine-level amounts.

If you're concerned about there being too many vaccines being given at once, why do you think that? There are fewer immunological components in all vaccines given today than in a single smallpox vaccine given in 1971. Are you worried about a baby's immune system being unable to cope? Why would it be able to fight off the dozens of infections children experience in the first few years of life (infections involving billions if not trillions of immunological challenges, incidentally), but cower before the 100-ish challenges presented by vaccines?

Are you of the opinion that natural exposure is better? Why would that be, when it necessitates a larger, longer and more bitterly contested war between the immune system and the invader than a vaccine could ever hope to create?

Again, I am sincere in wanting to hear your point of view and your concerns. I'm not saying you need to specify a particular vaccine, but I would like to hear you bring forth a particular aspect of vaccine safety that concerns you.

One final thing, just something I've always wondered: if it weren't private industry making these vaccines, but rather the government, would that relieve some of your concern about big business cutting corners?

I look forward to your reasoned response.

@72...You're wrong.

It's not "angry, ignorant and confused."

It's angry, ignorant, and completely confident that they're right despite the mountains and mountains of evidence stacked up against them, every shred of history, and all logic and reason.

@Harold -- Dude, you need to STFU about things you know nothing about. I'm a bit "miswired", myself, and function just fine DESPITE my disabilities. I have to work twice as hard as a "properly wired" individual to accomplish the same amount of work, because I have to consciously filter out irrelevant sensory stimuli. My brain does not have a "spam filter", and cannot automatically shut out or ignore things like, oh... the feeling of my clothes on my skin, or the noises of people in the hallway. It is exhausting. This is on top of Cerebral Palsy, Depression, ADHD, Anxiety, and a mild case of OCD.

NONE OF THOSE CONDITIONS MAKE ME ANY LESS OF A PERSON.

Here's hoping you're never on my side of the disability divide -- you'd never be able to handle it.

Everywhere you go, Death, Disease, Dysfunction, and Drama follows.

Gotta be better than Stoopid, Stoopid, Stoopid and Stoopid.

@Harold L Doherty:
My 17 year old PDD-NOS daughter has stated repeatedly that she would NOT like to be 'cured' even if it were possible. Temple Grandin has said the same.
My daughter is working to 'fit it' but not to be 'normal'.

Damien, I am going to get back to you, what with such a polite, genuine request. I am battling a bad cold and some neck pain but will respond shortly. I struggle with responding in a way, though, because I am not a scientist. I do k now my limitations and I am really aware that there would be so many more scientifically literate people to respond to the important issues of vaccination. I am really not the best spokesperson in that regard. I do have university courses in statistics, research methods, physiology, nutrition within my Child Studies degree, though.
My anger was more specifically about someone *seeming* to minimize what autism is. It sure isn't just being "quirky" in many cases. It actually is something to be worried about. "Demonized", no; of course not.
Where I can see that you and I disagree is the point regarding vaccines and their role in autism. I don't feel it's been relentlessly or exhaustively studied. I do understand your point about the "dose making the poison." My problem is that I wonder if the dose is (and this is where I am sure someone like a doctor could do better with terminology) different in it's effect for different people. People have very widely varying physiognomies?/biological realities ( weight, nutritional status, absorption rates, cholesterol levels, immune processes etc. etc.) so maybe what x amount of say mercury would do to person 1 is a lot different to what x amount would do to person 2 or 3. Do you know what I mean? I know the typical line of "comparing a pack a day smoker to a two pack a day smoker", and it not one that you guys are fond of, but it makes sense to me in light of what I said about people being different in their response to a toxin.
With respect to the safety studies done ( and I think it's fair to look at the ones that the autism
science foundation recommends, I think that YOU have to remember that the methodology makes the results. One of the studies has such a low prevalence that they must have screened for very healthy subjects which does bias results and limits what you can extrapolate about the results and inMadsen's study, my God, counting in the outpatient people with autism AFTER the mercury amount went down is just beyond poor methodology. Fombonne's autism rate in one city and vaccine uptake in another is crazy bad. And those points are all irrespective of control groups.
Really, I think that a primate study would go a long way to answer the question as to vaccine safety. I don't even know what all measures would be taken at various points in the vaccinated VS unvaccinated primates but I assume you could look at blood levels of things, brain changes and behavioral changes, without necessarily noting "autism" since, as someone pointed out, we wouldn't know what primates with autism looked like. You might be able to notice (potentially) lots of behavioural differences, though. Someone also mentioned something about an extended phase 4? animal study after vaccines which might be good, too. So not just killing them after 90 days or whatever but observing them for longer.
On the other hand, a simple comparison of overall health outcomes between vaccinated and unvaccinated ( maybe not so randomized) would show something in terms of effects.
To your point about which "ingredients" (couldn't think of a better word) I find the most worrisome, I don't even know where to start on that. I wonder about many of them. That's partly why I wonder if a different delivery method (nasal) would be better. That may be a better way for the body to deal with things (blood/brain barrier issues, mini stroke potentials) but I am not sure. Finally, as to it being perhaps better to get the real disease vs a vaccine, I do think it's possible that some might be better to just get (chicken pox is one, maybe mumps. If boys get it older that can be problematic). I do understand that for some areas/people, hep b to babies may be worth it but not for all kids. I think the chances of my kids getting rheumatoid arthritis, seizures, diabetes or GB would outweigh
any potential benefit.
Finally, I really can understand the risk VS benefit concept you guys espouse, but to me, to say the safety studies show no link between vaccines and autism (esp the mercury studies) is just not true. They are too poorly done.

Jen @ 92:

They are too poorly done reach conclusions that I personally dislike.

FIFY.

Jen@ 92:
"Finally, as to it being perhaps better to get the real disease vs a vaccine, I do think it's possible that some might be better to just get (chicken pox is one, maybe mumps."

I've never known anyone to become deaf from the mumps vaccine, however one of my best friends (female) is deaf as a side-effect of her childhood mumps infection.

@Jen, physiology maybe, not physiognomy.

Melissa, I believe you. I know certain diseases have certain side effects potentially. What I don't know about, conversely, are the risks from the vaccines.
NJ, if you are a scientist and can sincerely not have a problem, methodologically, with the studies I mentioned, then no wonder there is doubt for the vaccine program!

Jen:

Finally, I really can understand the risk VS benefit concept you guys espouse, but to me, to say the safety studies show no link between vaccines and autism (esp the mercury studies) is just not true. They are too poorly done.

And you know this because...? What special qualities do you have over the scientists, doctors, technicians and statisticians in the USA, Europe and Japan? Come on, tell us what makes you a better judge of vaccine safety than the FDA, CDC, NHS, the public health departments of Japan, UK, Denmark, Sweden, German, Canada and the World Health Organization. Where did you get your PhD in microbiology and immunology to add to your degree in Child Studies? Please, we really want to know how you are the expert.

Chris, I in fact stated that there were many more qualified people to address the lack of good quality safety studies to supposedly exhonerate the role of vaccines in autism than me. But even I can see, with my background, how the methodology in many of the studies Autism Science Foundation holds up are not methodologically sound. There are many Scientists, doctors who have that same opinion and your argument as to judging vaccine safety becomes a little trickier when you ask those people.

So link to those studies that find real fault with the almost twenty studies done around the world that show no real association of vaccines to autism. Go and show us who those "scientists" are, and be aware that Handley is not one.

Point to us the particular ASF studies that are faulty and the papers that criticize them by a qualified scientist.

You are proposing a complete waste of money that would be better used providing services to our adult children.

I appreciate your response, Jen. This is the kind of dialogue that I would like to have, reasonable and civil. Yes, I know, what am I doing on the internet?

I understand your concern about vaccines and autism having not been conclusively studied, but after the IOM has done eight reports, studying the entire extant literature (both published and not) that the MMR vaccine has no connection, it's somewhat difficult for me to assume that they are purposely ignoring the strong studies in favor the vaccine-autism link or, conversely, the weak studies decrying it. I must also confess to not having heard of the studies you're mentioning, do you have links? I'd love to take a look at them.

I am interested, however, as to what standard of research would be sufficient to convince you that vaccines and autism have no connection. Seeing as I haven't heard you disagree that vaccines are a life-saving tool, we must agree that the large-sample, randomized vax/unvax study would be hugely unethical. The only way to do something remotely similar would be either a case series or an unblinded study where the parents choose which group they want, which would be equally as unethical, as no solid conclusions would be able to be drawn.

A primate study would be intriguing, and I would love to have one of the other denizens here explain why it would or wouldn't be feasible, as it is outside my realm of expertise.

As to the dose being the poison, I think that much of this discussion may be moot, being as no vaccine that I have ever heard of any ingredient of statistically-significant quantity above what the body encounters or produces on a daily basis. If I'm wrong on this point, I would very much like to be corrected, so if you can point out an ingredient that is present at a significant level, I would be appreciative.

Yes, people do have different reactions to certain chemicals, but there needs to be a necessary amount in the body before the reaction can kick off at all. For the chemicals that I've read about being in vaccines, they would have to be present in far, far greater quantities to initiate a response. Otherwise, since they're nearly all things we encounter on a daily basis, the people sensitive to them would be having reactions non-stop.

I would like to finally address the idea that natural infection is better than the vaccine. I'm interested in why you think this would be so? Melissa G makes the point, which is central to my own to follow, that the side-effects of the actual disease are far more prevalent and damaging than the effects of the vaccines. Mumps deafen people, sterilize some; chicken pox can cause scarring and blindness; measles causes brain damage, deafness, blindness, and rubella (as I mentioned) is directly tied to increased incidence of autism. These are horrifying side effects, not to mention the thousands of deaths.

The best analogy I can make is to the zoo. Your immune system and disease is like a child who has never seen a lion. Would you rather they see it at the zoo from afar or on the Serengeti? Admittedly, some kids fall into the lion pit, other kids trip on their way out of the zoo, but overall millions of kids come through just fine; on the Serengeti, on the other hand, the kids who've never seen a lion go in and overwhelmingly get mauled and eaten. This is not a facetious comparison, though it may sound that way, the purpose of vaccines is to show the immune system's antibody response what different diseases look like in a safe, controlled way.

I'm legitimately interested in why you think natural exposure would be better?

Chris, my making a list of other scientists ( big or small) means nothing, really. I know. Dr. Miranda critiqued Tozzi's study and you know darned well that other scientists have been critical of some of the vaccine safety studies (Cochrane didn't like Fombonne's much). Even Kumanen Wilson, who has been part of some vaccine research stated once that there needs to be more transparency with respect to the risks of vaccines. I am not going to bust my ass looking for more scientists/doctors which we both know are out there. I give up. You don't want to admit there is a problem so I guess there's no problem.
Damien, thanks for your response. I honestly don't KNOW (I know people hate caps use but sometimes I feel they help) that getting the natural disease is better in all cases. For example, with chicken pox the complications rate tends not to be too bad (I know I'm not citing) and you have to compare natural chicken pox disease and subsequent immunity thereafter to chicken pox vaccine and its immunity protection (how much boostering do you need? Is real chicken pox immunity better/longer?) On the other hand, hep b would not be a good disease to have. You would really have to weigh the risks because the side effects from the vaccine don't seem so good, either. I certainly don't think most newborns need it.
You haven't seen the studies the Autism Science Foundation cites as proof of vaccines having no connection to autism? You can go to their website where they are posted under something like evidence-based vaccine research. You can also read JB Handley's critique of those same studies where he does more than just talk about control groups or conflict of interest (pharma-shill gambit in Orac's terms). And you have to remember that just because it's JB Handley critiquing, doesn't mean the critiques aren't valid. You can read his article (he actually invited scientists to critique his points-not just the control group or conflict of interest points!). "Dissecting the Autism Science Foundation's Use of the Hungry Lie."
Lastly, I honestly just assumed that they had done vaccinated VS unvaccinated type primate studies when I gave my children some (but not all) of the recommended vaccines. Or "extended phase 4 toxicology studies." something. I really did.

But even I can see, with my background, how the methodology in many of the studies Autism Science Foundation holds up are not methodologically sound.

That's rather more of a problem than you are acknowledging, though. If someone who is acknowledged worldwide as an expert says "The methodology is sound," and you say "I'm not an expert, but in this case I know that I'm right and the expert is wrong!" then I'm really still more inclined to think that the expert is right. A significant part of that is that in my own fields of expertise I know of a great many things where a non-expert would definitely say "Oh, sure, that'd work!" or "Oh, that can't possibly work!" and would be completely certain and completely incorrect. (A prime example would be the utility of Monte Carlo algorithms.)

There are many Scientists, doctors who have that same opinion and your argument as to judging vaccine safety becomes a little trickier when you ask those people.

There are also many scientists and doctors who refuse to accept germ theory. That does not mean that the validity of germ theory is really in doubt.

My objection to the viewpoint "we should devote time and money to investigate the hypothesis that vaccines can cause autism" is not, as you might think it is, "the hypothesis has been studied enough to absolutely disprove all forms of it." My objection is, "the hypothesis has been studied enough that the only reason we ever suspected the hypothesis has been disproved."

Remember, the only reason vaccines were ever considered to be a possible trigger of autism was a perception that there were too many cases of children developing their first autistic symptoms shortly after a vaccination to be explained by coincidence. That perception, even though it became an article of faith for many people, turned out to be illusory. But now people are saying "How can we be sure that vaccines aren't causing autism in some very small subpopulation in children?" They're missing the point that the only reason we ever had to suspect that they ever caused autism is gone!

If you don't follow why that's so completely wrong, think about the following analogy: One night in a hypothetical city, a warehouse burns to the ground. It's not completely clear why it burned, and many people suspect that it might have been arson. Soon there's stories in the newspaper linking John Jones to the fire, claiming that he was seen near the warehouse shortly before the fire and hinting darkly that since he's from out of town and no one really knows him, who knows but what he's a firebug who's been responsible for fires everywhere he goes?? Everyone's giving John Jones the stink-eye because everyone's muttering the same thing, that it can't be a coincidence that John Jones was near the warehouse and it just happened to catch fire!

... Then two things happen. Surveillance footage is found showing the warehouse being hit by a bolt of lightning at the time the fire started; eyewitnesses also come forward who can establish without a doubt that John Jones was in a completely different part of town at the time people thought they saw him near the warehouse. It becomes clear that John Jones was not responsible for the warehouse fire.

Now, if someone comes forward and says "Can you prove that John Jones didn't commit any crimes that night?? Can you prove that he didn't mug anyone? That he didn't rob any stores? There were other crimes that night, you know! Can you prove John Jones didn't do them??" they might be correct that John Jones has not been disproven as the culprit in those other crimes -- but they're misguidedly assuming that there's a reason to start a search for "possible perpetrators of crime" with John Jones!

Antaeus, I am left still wondering how poorly done studies answer ANY question to do with vaccine safety. Have you read Handley's critiques? Kids in the USA get hep b at birth, so timing of autism development is really kind of moot in a sense. I would still say primate studies or "extended phase 4 toxicological studies" are needed to address differences (if any) in vaccinated VS unvaccinated.

Jen:

Chris, my making a list of other scientists ( big or small) means nothing, really. I know. Dr. Miranda critiqued Tozzi's study and you know darned well that other scientists have been critical of some of the vaccine safety studies (Cochrane didn't like Fombonne's much). Even Kumanen Wilson, who has been part of some vaccine research stated once that there needs to be more transparency with respect to the risks of vaccines.

Actually, yes, since you made the claim it is up to you to post the journal, title, authors and dates of those critiques. Because you have a habit of not actually reading them, but only going on what is spoon fed to you from AoA and JB Handley. And I specifically said nothing from Handley is acceptible, who is the personification of the Dunning-Krueger effect. I even linked to a critique of Handley's latest silly bit on the studies (oh, and tell him that the reason one study was listed first is because they were in reverse chronological order).

Prove to us that there are real legitimate reasons to distrust the dozens of studies done over the past two decades that show that there is no casual relationship between vaccines and autism.

Jen, you need to learn how to think for yourself and not rely on Handley, as noted by Dr. Novella at Some Nonsense from J.B. Handley:

Handley, however, is not an honest and competent broker of scientific information. He is, in my opinion, an incompetent thug.

Chris, I did just read the Skepacabra link and wasn't't too impressed. Lots on Bernadine Healy, so what about the Japanese study of MMR AND even that guy didn't dare to challenge Handley's points about Tozzi, Madsens or Fombonnes (those guys just come to mind most) research being methodologically unsound. He repeats the tired control group/pharma-shill gambit stuff. That's all and that ain't no videotaped lightening strike! Maybe there would/should be more public critiques of poor studies like those. I don't think the journals tend to publish much critique of that nature, though.
What I have uncovered from this is that people like you seem to be terrified of scrutinizing the studies held up by ASF for any reasons other than the more easily defendable control group issue or conflict of interest issues. Sample bias, methodology sleights of hand are something you just want to ignore. I have mentioned the studies and problems but none of you are willing to defend/critique say, Madsen's methodology of counting children with autism. I give up. I see it's hopeless. Everything is fine in science land.

Jen:

What I have uncovered from this is that people like you seem to be terrified of scrutinizing the studies held up by ASF for any reasons other than the more easily defendable control group issue or conflict of interest issues.

Which studies? Give the journal, title, authors and dates of those specific studies.

Where is your evidence that the studies you don't like are worthless? Give the journal, title, authors and dates of the papers where you, yourself, got the information to tell you to ignore the Madsen and Fombonne papers.

Then do the same for every single paper listed here and here.

You have continued to make the claim that all of the research since 1998 showing that there is no association between is vaccines and autism is fatally flawed. But the only "proof" you offer is some whining about two to four authors and Handley's silly ignorant essays, you need to do better.

Prove that qualified persons have actually found sufficient flaws in those several dozen papers that funding should be done for yet another study that you will ultimately ignore.

In my "silly whining"I mentioned Fombonne, Madsen and Tozzi and their methodological mistakes. You clearly don't want to scrutinize them for yourself so now I understand even better why we don't see printed critiques of these poor studies when you are afraid to express your own opinions of these on a science blog. I think you could look in the mirror when you talk about thinking for yourself.
By the way, you indirectly involved the Japanese study in one of your links and that study has also been shown to be very misleading. The "un-vaccinated" were actually given separate single rubella and measles vaccines as well as J. Encephalitis. "When Honda/Rutter is compared to Terada, it can be seen that ASD numbers rose and fell in direct proportion to the total number of children vaccinated in any year." Tough luck and big surprise if you don't like that my source isn't a medical journal.

If Dr Oz makes a show that aims to make a vaccine-autism connection I think we should all create a campaign to complain to the AMA. Doing so would be a serious violation of many of the ethical responsibilities that physicians have.

So, Jen, you cannot support your claims on the quality of the studies done since 1998 with any real educated critiques. Remember, until you can post a qualified critique of any of those studies, you will be considered a Handley fan girl lapping up his nonsense without question.

So, Chris, and until you can resist swooping in to save people like djinna from a simple question and actually think for yourself about the methodological problems with some of these safety studies so widely touted by the ASF and not hijack conversations, I will assume that you are a paid blogger; a silly Scienceblog fan girl lapping up...

Gah, you are such a tool. Yes, I am a fan of Scienceblogs, but I also question some things. Unlike you I actually post evidence to support my claims. Example: there are two Japanese studies on the fact that autism went up even after they stopped using their version of the MMR vaccine (care to tell us what component was the issue? Do you even know?). So your comment on "the Japanese study" showed how you never looked at (oh, and what was that link? Did you check it?). They are:

MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan
Authors: Uchiyama T, Kurosawa M, Inaba Y
Source: J Autism Dev Disord, February 2007; 37(2):210-217

No Effect of MMR Withdrawal on the Incidence of Autism: A Total Population Study
Authors: Honda H, Shimizu Y, Rutter M
Source: J Child Psychol Psychiatry. 2005 Jun;46(6):572-9

Which if you had done any research yourself, you would have known. I know you will just say that one, without specifying if it was the one with a bit over 900 children or the entire 300000 population of a city, had flaws but will continue to fail to tell who did the qualified analysis.

Possibly because they do not exist. Just like all the other papers you claim are flawed, there is no real reason to discount them. Unlike the infamous paper Autism: a novel form of mercury poisoning, which was reviewed here, that concluded:

On the basis of current evidence, we consider it improbable that thimerosal and autism are linked.

Plus the reviews that included the Geiers' VAERS mining research and some Danish studies, like Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data. One telling comment on the Geiers' papers was:

We identified multiple methodologic concerns regarding this article.

The Danes that you often malign, fared much better.

Unlike you, I actually did the work myself. Something you should learn how to do sometime.

Jen, I hope that what I'm about to say will not be taken with offense, as it is not meant in a spirit of cruelty. You yourself have mentioned that you are not an expert in this field, correct? I rush to point out that I make no claims as to my own vaccine science expertise, either; I do, however, lay claim to some knowledge in the realm of science generally.

I think that perhaps the problem that we're facing in our quest to understand each other (at least that's my quest), is that some of your views on science are distorted. Again, I'm sure that certain of my views on topics of your expertise would be similarly distorted.

Few scientists that I have met are so wedded to a particular notion that they would ignore or minimize the overwhelming weight of evidence if it contradicted their idea. The great Albert Einstein himself was forced to reject his own long-cherished theory of a static-state universe when the weight of evidence and experimentation tilted toward the idea of an expanding universe. Similarly, I have no doubt that if the vaccine-autism hypothesis had produced positive results (whether via thimerosal, the intestine-brain link, or mercury), they would be published and an entirely new field of science would be opened up to research.

However, science is conducted in a very specific, if utterly brutal, manner. Ideas or presented at conferences, discussed and debated in meetings, and published in journals. Disagreements over the actual science, or methodological issues, are hashed out in these same locations.

All of the science and experiments attempting to tie vaccines to autism is public, and the experts who pass judgment on the bases for the conclusions have pronounced them good. Science, moreover, is not an exclusive club, but instead welcomes outsiders with interesting ideas. See, for example, the ultimately unsuccessful attempt of a Malibu surfer to provide a grand unified theory a couple of years ago. He challenged the conventional theories and scientists reacted with joy, testing his theory until it, unfortunately, was discovered to be flawed.

I have stated this to point out that I think the perception that you have which is distorted is the idea that science or scientists revere specific ideas enough to purposely bias their research or bond together in order to protect them. I can't think of anything further from what I've observed and read. If the experts were to disagree with their evidence, conclusions or methods, there would be a war of words declared and waged publicly until one side was vindicated. This could take a long time, but the ship of science rarely makes a sharp turn, but it does turn. As an example, Simon Flexner was the grand old man of polio research, and one of the single most revered scientific figures in medicine. He had the world's foremost polio lab, and he ran the entire world of polio research like his personal fiefdom at Johns Hopkins; he believed that polio spread in the nasal passage and missed the bloodstream completely, and his mistake shut down polio vaccine research for almost 20 years, long enough for FDR to be paralyzed.

However, he was wrong, and other scientists challenged him and his theories, eventually shredding them to bits just before Flexner's death in 1949. If scientists revered particular ideas or people, they would have ignored Flexner's wrong notions instead of challenging and destroying them.

I state all of this to contrast the science, which really has been thoroughly studied, with the anti-vaccination process. Eight reviews of all literature on vaccines and autism, whether published or not, by an expert panel (here's a PubMed LINK) concluded that there was no link between vaccines and autism. This was reported by the NAS, published by the National Academy Press, and was the most thorough meta-analysis of the current state of the science that I have found thus far. I welcome you to prove me wrong, Jen, I really honestly do, I just need more than JB Handley's essay (I'll explain why in a moment) and some non-scientific analysis.

I hope that the preceding didn't come off insulting or trite, because it really wasn't my intent. However, that previous paragraph brings me to the central difference between the world of science and the world of opposition. I have yet to see a scientific paper that used language and attacks as vicious and nauseating as JB Handley has used so casually in the past. There can be no disagreement between us that it is disgusting to insinuate that respected vaccine researchers were dining on baby, which just happened this past Thanksgiving (or was it the one previous? Time flies.), and this something that Handley has not only done, but defended.

Not only that, but the ascription of devious or diabolical motives to their opponents is routine. Conspiracy, greed, murderousness, these are supposedly the central characteristics of those who support vaccination, according to Mr. Handley and others, some of whom post on this forum. I'm sure you can understand the difference here: I have yet to hear anyone here state that anti-vaccine parents are intentionally colluding in a conspiracy to murder children, while that is a routine allegation flung about at AoA for example (a site that I left long ago after being told in no uncertain terms that I was viewed as supporting child murder).

I don't begrudge you that your opposition to vaccines is sincerely based on your opinion that they are unsafe. However, I have not yet heard you explain why. I also have not yet heard an answer to my question about what would convince you that they are safe? Or, more to point, that they are safer than the diseases they were designed to prevent?

Specifically talking about Hep B, which you mentioned by name previously: before the vaccine came out, Hep B was directly responsible for shortening lives. Many, many children were infected in early childhood, or even at birth, with little immediate effect; as the children aged, however, their Hep B infections began to damage their livers, kidneys, and eventually their hearts. Cirrhosis and diabetes in later life could be directly attributed to the Hep B, and it took an average of 7-10 years of life from the adults who had been so infected as children.

That said, why would you oppose vaccinating babies in order to give them 7-10 years of quality life on the other end? I'm not trying to accuse you, I'm honestly curious.

I'd really like to hear your thoughts, Jen. But I must stand with Chris on one particular issue: if you're going to cite information, please make them from journals, or at least websites citing journals. It's important for us to be able to view the actual source information.

I'm enjoying this dialogue, Jen. I just wanted you to know that.

Jen,

Chris, I did just read the Skepacabra link and wasn't't too impressed.

Chris linked to Neuorologica, written by Steve Novella, not Skeptacabra, written by Michael Rosch. I read both regularly and I can tell the difference. Yes, Dr. Novella inlcuded a link to Skeptacabra, but if Chris wanted to refer you to Skeptacabra's analysis, I'm pretty sure she would have done so directly.

Please, go back to Neurologica and re-read Dr. Novella's post. And think about it. And also please, please, please think about whether you or anyone else should be looking to J. B. Handley for advice on scientific matters.

Seriously, Jen - think about it.

Damien, I have enjoyed talking with you as well. I honestly can't give a simple answer as to why I don't think vaccines are safe but I do know that my nana developed GB after her flu shot many years ago. I find it quite plausible that some people are particularily vulnerable to side effects (people with allergy histories, auto-immune problems). Of course I'm not sure though, because there are no studies to say. Mostly why I can't feel that they are safe is because of the lack of studies comparing vaccinated to unvaccinated. Re. hep b, by all means if the child is in a high risk group then vaccinating at birth may outweigh the possible negative side effects. For my kids, though, I would oppose giving them something at birth that they are not at high risk for and may have negative side effects (not that we know for sure, because there is no objective comparison). And, by the time they may actually need the protection it would have waned anyways since their
"birth series."

At the risk of sounding really redundant, whether Handley suggests it or not, I still find it troubling that scientists defend/condone Fombonne's study (looking at prevalence in one city and vaccination rate in another, Tozzi, where autism incidence was 15-20times less than the US rate in his sample and Madsen's where autism outpatient's were added after the mercury was removed.
I hope that you're right about scientists bot being wedded to particular ideas and I hope that one day there will be some kind of vaccinated vs unvacc study or more prolonged toxicology studies to reassure people. The kids deserve that.

Chemmomo, Chris's 99 post linked to skepcabra.
Gotta get to bed as I have a cold. Night all. I have enjoyed the discussion.
Damien, what idea/scientific principle was it that the surfer guy challenged?

One last thing, Damien. ..." the most thorough meta-analysis of the science so far"
"Meta-analysis of badly designed studies will still result in bad statistics." (wikipedia).

Chemmono, I linked to both in separate comments.

Jen, responding with just the author's name is not just being redundant, but still failing to provide enough information for me to find the papers. You need to provide either a link, or the PubMed identification number or the journal, title, author and date of the paper with the unfavorable review.

So you have not supported your claim that some of the studies in the list of dozens are fatally flawed.

Which is funny, considering how much Wakefield's retracted fraudulent study is still cited.

Jen:

Dr. Miranda critiqued Tozzi's study

Now I know why you don't link to the critiques, they are rubbish. I found that while Miranda is a doctor, he is not qualified from his letter with no references: "doctor and father of a child with neurodevelopmental disorder"

His letter is about as valid as John Stone's.

Searching for "Kumanan Wilson vaccine dtap" finds a note on a presentation, and then a comment on AoA from a "jen".

Searching for qualified critiques of any of several Madsen papers (other than the review I actually linked to) brings up mostly AoA and other anti-vax sites. I assume it would be the same for Fombonne.

Chris, I don't need to "provide a paper with an unfavorable review of Tozzi' Madsen's or Fombonne's research. I can do that all by myself. You can just go to ASF's website and find them.

Sorry, you made the claim you provide the evidence. There are several pages at ASF, much of them the same list of studies I gave you earlier.

Searching google using "madsen" and site for the page finds one page:
http://www.autismsciencefoundation.org/autismandvaccines.html

The one instance of "Madsen" is this cite:
"Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data"
â Pediatrics, Kreesten M. Madsen, MD (September 2003)

Do the same, only use "fombonne" and I get the same page as before with these cites:
"Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations"
-Pediatrics, Eric Fombonne, MD (Volume 118, Number 1, July 2006)

"No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism"
â Pediatrics, Eric Fombonne, FRCPsych (Volume 108, Number 4, October 2001)

Also there is this page:
http://www.autismsciencefoundation.org/2007-08research.html

With this cite:
âThimerosal Disappears but Autism RemainsââArchives of General Psychiatry, Fombonne (2008)

I do the same for Tozzi, and I get the same first page as before with this cite:
Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines. --Pediatrics, Tozzi AE, Bisiacchi P, Tarantino V, De Mei B, D'Elia L, Chariotti F, Salmaso S. (January 2009)

And another page (out of links) on the latest research. And it just cites:
"Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines".
--Pediatrics, Tozzi AE, Bisiacchi P, Tarantino V, De Mei B, D'Elia L, Chariotti F, Salmaso S. (January 2009)

I would think if there was an unfavorable review on that site I would be able to find it with a simple search, and if they did not like those authors they would not be listed on their research pages. Try again, Jen.

Jen and Chris,
sorry - I didn't click on Chris's link @99 because I've read enough of J. B. Handley's pontifications to form my own opinion about his knowledge base.

That said, Jen, seriously - read what Steve Novella has to say. He's brief, and to the point.

And, again, please, please, please think about it.

And ask yourself: why exactly do you think that J. B. Handley is credible about science?

Damien, thank you. That was very clear. Jen won't be swayed because her feelings about vaccination outweigh any evidence or reasoning (though at least she's honest enough to admit that), but perhaps some lurkers will.

I think Jen is the perfect example of a person who is completely swayed by an incident from her own life and is clinging to this as proof. I refer to her report of her grandmother contracting Guillain Barre. I can imagine how afraid her family were when the matriarch became paralyzed or partially so. If Jen is in her 40s (I'm guessing here) then she would have been a young child when this happened. You can imagine the echoes of that when talking about vaccine. There is little chance she can see how this is coloring her opinion and also means that all the criticisms she reads (Handley or not) reinforces this fear.
All this to say, she will not ever be persuaded otherwise because the childhood trauma of a sick grandmother outweighs all the science you can throw at her.

Agashem, it wasn't great that my grandmother had that happen to her, and yes, it does make me think that vaccines can have ill-effects. Indeed Kumanen Wilson did say (during preparations for H1N1 in Canada) that Canada should have a vaccine-court similar to the US to address the very reAl possibilities that vaccines can cause harm. Honestly, I saw it yesterday. He said the court system in Canada is not a very good way to deal with that (vaccine complications) problem. I am open to reading Novella's synopsis of the studies (particularly if he addresses issues like sample bias, methodology, not just conflict of interest or control groups).
Bottom line for me is if they do a studies that compare vaccinated VS unvaccinated (primates or humans) or extended phase 4 tox studies using lots of bio-markers I would pay attention to those results.
I think they have also crossed a line vaccinating for not just "contagious" diseases (hep b and Gardasil would be examples). Of course thAt isn't to say that hese are minimal diseases. I'm just saying that there is a difference between say chicken pox transsmition and hep b. That's another whole discussion, though.
Novella, interestingly, is quite vocal against support for the new CCSVI theory for MS. My friend just had the surgery (in California-which kind of goes aginst my argument for "universal health care" but anyways, that too is another story). Her legs are not purple, cold and swollen anymore and she is walking. She thinks "MS" really wasn't what she had all along. She had a 5.5 cm hi grade stenosis and it was corrected (not just by ballooning the veins, but making the valve bigger).

A person might start off a bit nervous about vaccines( due to an incident like my grandmother's GB) but I also completely assumed that there were more safety studies such as a vaccinated VS unvaccinated, or extended tox studies when I gave my kids the vaccines that I gave them (back in the early-mid nineties). I mean there was none of this Internet searching, really. I can't really stress that point enough. I really assumed those kind of studies were in place. My friend had told me all about BLF's book but I don't remember BLF saying anything specifically about vaccinated VS unvaccinated studies not having been done. Maybe she did, not sure.

Jen, Dr. Novella's criticism of CCSVI and MS are quite well founded. Several studies (done by researchers independent of Dr. Zamboni) have not been able to replicate his initial research. See Florian Doepp, Annals of Neurology 2010;68: 173-183, Mike Wattjes, Journal of Neurology, Neurosurgery and Physchiatry 10.1136/jnnp.2010.223479. Also Dr. Robert Zivadinov (an early advocate of the CCSVI theory) recently published a study in Radiology (PMID 21177394) titled " No Significant Differences in the Extracranial Venous Systems Between MS patients and Healthy Controls were Detected by Using MS Venography."
Colin Rose on his blog "Panacea or Hygenia" has a very good exposure of the flaws and fallacies in Dr. Zamboni's theory and his possible financial motivation for advocating treating a non-existent pathology. Almost sounds like Zamboni took a page from Dr. Wakefield's play book.

Jen,
exactly what do you want studied via a vaccinated vs unvaccinated study? What kind of outcomes do you think need to be compared?

And how long do you think "extend tox studies" should run? I know you don't study pharmacokinetics or metabolism, so I'm not asking for specific numbers - just give us a rough idea of what kind of information you think needs to go into deciding how long to run the study.

Cuttlefish's Dr.: "Then she volunteered that she thought kids *were* getting too many vaccines too soon these days..."

Dr. Oz: "We got exposed to ten vaccines when we were kids. Children today are now getting closer to 30. So there`s a big difference between the exposure amounts ..."

Am I the only one to be struck (and worried) by the profound stupidity of these comments? Kids may be getting more vaccines these days, but do to technical advances and vaccines improvements, they are actually receiving FEWER antigens.

Neither of these doctors has a clue... (Cuttlefish, if I were you, I'd already be doctor-shopping).

Jen--

What exactly is "crossing a line" about a vaccine against cancer?

What is wrong with vaccinating against a serious disease that can be transmitted by, among other things,
# getting an accidental needle stick with a needle that was used on an infected person
# using an infected personâs razor or toothbrush

Maybe your children are never going to work in a hospital or other medical facility, but a lot of people are. And sharing toothbrushes may not be a good idea, but it is a thing people do. Sometimes accidentally, because two brushes can look very similar (especially given how many people brush their teeth just before bed or first thing in the morning, while not very awake).

For that matter, have you taught your children to quiz potential spouses or other sex partners about their infection status, and demand test results if the person thinks they are uninfected?

A vaccine against Hep B or HPV may do less for herd immunity than the DPT or flu shot, but it's not a vaccine against something that you can count on never being exposed to.

Jen:
With children required to receive an increasing number of vaccines, Canada should institute a national no-fault compensation system for people who suffer serious side effects from immunization, a leading public health expert says.

Vaccine adverse events are rare and far outweighed by the benefits, but the unlucky few who experience them have no recourse for financial redress, Dr. Kumanan Wilson of the University of Ottawa told a major immunization conference.

A compensation system -- like one already in place in Quebec -- would also help counter a growing anti-vaccination movement that is exploiting the Internet to spread often ill-informed views, he said.

"It seems unjust that we don't have one," said Dr. Wilson after addressing the annual Canadian Immunization Conference. "As we're moving to more and more 'coercive-type policies' ... and with more and more vaccines, and HPV vaccine coming out, I think it's really a need."

Read more: http://www.nationalpost.com/related/topics/Expert+urges+fault+vaccine+c…
He is not advocating the need for vaccine compensation in the way you are portraying it, he wants to make sure people who THINK they have a claim to have a process to follow. No one here thinks that is a bad idea, but to make it sound like he is advocating this because he thinks vaccines are unsafe is clearly not true.

With regard to the comments about hepatitis B vaccine; testing of individuals for efficacy of the vaccine is recommended for individuals who are at occupational risk for needle sticks, babies whose mothers are hepatitis b carriers and other individuals who are "risk". People who are at risk are those whose partners are hepatitis B carriers, who live in congregate residences for the developmentally disabled, those who have sexual relations with multiple partners, IV drug users, men who have sex with men, and those whose immune system is impaired...including dialysis patient. (Not a complete list...see Immunize.org website, "vaccination information for health care providers" header)

Research on that site indicates that once post vaccination testing confirms a positive hepatitis b surface antibody, that the immunity lasts for at least 23 years. It is a very effective vaccine and research indicates that re-testing for hepatitis b surface antibody is not required for those who have healthy intact immune systems.

Agashem:

He is not advocating the need for vaccine compensation in the way you are portraying it, he wants to make sure people who THINK they have a claim to have a process to follow. No one here thinks that is a bad idea, but to make it sound like he is advocating this because he thinks vaccines are unsafe is clearly not true.

So it is similar to the National Vaccine Injury Compensation Program (VICP) that has been in the USA for over twenty years.

Agashem: thanks for the quote. I believe Dr. Wison's quote speaks for itself. i don"t think I mischaracterized his words.
Vicki- you bet I teach them about condoms. They have to worry about all kinds of things when they get sexually active. ( pregnancy,AIDS, chlamydia, hep C, etc. etc.)
Chemmomo- I really leave that to the scientist(s) to figure out as to the particulars of extended tox studies or primate vacc VS unvacc studies. Like I said, I assumed stuff like that had been done but it's definitely time to get going on it.

Let Steven Novella be one of the doctors!

one caveat: scientists who have minimal conflict of interest. Probably a multi-disciplinary type team to help with input.

Okay, jen. You don't like the studies already done for reasons you can't define. You want more studies that you can't come up with a premise for.

That's not very reassuring.

Jen - why exactly are you complaining about Canada wanting to streamline the process so parents of children that may have a legitimate claim because of a vaccine-related injury would have an easier time filing for compensation?

We've had this process in the US for about two decades now, and quite a number of parents have filed suit and been justifiably compensated - as the system was designed to - and each legitimate claim gives the industry as a whole another area in which to focus its efforts to improve safety - since no one here is claiming 100% safety of all vaccines. It would seem to me, that this is a good thing - as with any sort of medical intervention, it is impossible to guarantee, with 100% certainty, that all patients will react exactly the same way, with the same results - they can only do their best to address the majority of the concerns, and be in the position to take care of those that fall outside.

None of this is done with malicious intent - instead, a process was put in place, outside of the normal, extremely expensive litigious environment to make sure those families were given a fair shake.

It really peeves me that the very people to whom the system was designed to help, are its worst critics - who, for whatever reason, blame the fact that the system exists in the first place, as a reason for demanding that vaccines be blamed for a whole host of maladies that there would be otherwise no reason in the world to equate them to.

Jen,

Chemmomo- I really leave that to the scientist(s) to figure out as to the particulars of extended tox studies or primate vacc VS unvacc studies. Like I said, I assumed stuff like that had been done but it's definitely time to get going on it.

Perhaps I wasn't clear with my question. I'm asking you to tell us what you think is missing. Exactly what kind of studies did you assume were done, but weren't?

I know you're not a scientist, and I respect the fact that you do understand that the details should be worked out by those with expertise. But I'm just looking for your opinion here, as a non-scientist, not the details for the study.

Please be more specific.

And for "extended tox": how far do you think this should be extended? And why?

Handwaving and saying "more needs to be done" just doesn't give us enough information. We need a little direction here.
More what?

Hi Damein -

I noted your responses to Jenn and thought I might hop in with some thoughts of my own. Your civil tone is definitely welcomed and I appreciate the effort you put into your posts. I might add, I'm not sure of all of Jenn's positions, or indeed, if I agree with them, but I do have some concerns about the possibility of vaccination having effects we don't understand, and indeedd, have some specific thoughts on how we might learn more about vaccine safety.

However, merely advocating for vaccine safety is a meaningless phrase. What, specifically, are you concerned about?

My concerns are along the lines that it is possible that the act of vaccination itself may be modifying the immune system in ways other than the generation of immunological memory of specific pathogens. There happen to be a great number of animal studies that show there are difficult to predict consequences of early life activation, a classification that I think (?) we can agree a vaccine falls within. Please understand, I believe that vaccines work, I'm just not sure that protection from specific pathogens is the only thing they might be doing.

Before we start discussing that kind of thing in detail, (if you'd like), however, I would like to address some things in some of your posts that I've seen people argue before, but seem to fail some very simple logical tests when evaluated with much detail. The fact that the types of simplications tend to dominate the 'pro-vax' side of these discussions bothers me a lot; I really feel like the foundation of a national health policy ought to have stronger support than it seems to. Ultimately, what I have found is that when pressed on the failings of some fo the arguments you have made, there just isn't any good research behind them, and some research to suggest exactly the opposite.

Relentless scientific testing of vaccines has shown that they have no role in autism; if you are concerned about toxins, what toxins are there?

Let be clear about something here. One vaccine has been tested relentlessly regarding autism, the MMR. One vaccine ingredient, thimerosal, has also been tested relentlesslyl regarding autism. There is a persistent, and to my mind inexplicable, conflation from these two types of studies to studying 'vaccines in general' on the Internet that I've never been able to figure out. Imagine a study wherein one group smoked Camels, Pall Malls, and clove cigarettes, and the other group only smoked Pall Mall and cloves. Does this tell us about smoking, or smoking Camels? Similarly, a study wherein one group smoked tar free cigarettes, and the other did not tells us nothing about smoking, it only tells us about smoking cigarettes with tar in them. Imagine the absurdity of proclaiming that these types of studies told us anything about the effect of smoking. And yet, again and again, people insist that vaccines have been tested in relationship to autism, but all of the studies on autism were designed to test either thimerosal, or the MMR.

The fact is, this leaves the overwhelming majority of vaccines, those given at the earliest stages of life, unevaluated for a potential role in autism. If you think that other vaccines have been studied relentlessly regarding an autism diagnosis, could you provide a link or PMID to those studies so we could discuss them?

There are fewer immunological components in all vaccines given today than in a single smallpox vaccine given in 1971.

I'd be curious if you would be willing to source this statement before we discuss it futher? I guess the big question for you would be what has given you the idea that we can (or should) just count up "immunological components" to arrive at a meaningful answer? My position is that I think the idea that we can understand a stystem as complicated as the immune system by subtracting or adding antigens is extremely naieve, and prone to lead us to false conclusions.

Are you worried about a baby's immune system being unable to cope? Why would it be able to fight off the dozens of infections children experience in the first few years of life (infections involving billions if not trillions of immunological challenges, incidentally), but cower before the 100-ish challenges presented by vaccines?

To start with, I'm not worried about the "overwhelming the immune system" canard; that's a bogus argument. [I don't know how Jenn feels]. I am concerned about the possibility of vaccines modifying the immune system in ways that we can't understand because we haven't tested for them; mostly because the idea that an immune challenge without pathogenic effects of the microbes having persistent effects is largely a novel concept.

Unfortunately, saying that, I think that there are some confusing pieces here.

In the first place, the overwhelming majority of vaccines are given within the first six months of a child's life; diptheria, pertussis, tetanus, hib, rotavirus, hep b, polio, and pneumococcus, are given at two, four, and six months of age. We do ourselves a disservice by starting any discussion with inadequate measurements, equating the infections a child may get during their childhood years (until when, they are teenagers) with their infancy; remember that autism's signs are visible as early as the first year (some say, maybe even earlier). Given that, widening our criteria out to all of childhood seems like a poor analogy.

Secondly, I guess I'd wonder what you mean by "infections involving billions if not trillions of immune challenges". Or for that matter, how you have arrived at "100-ish challenges presented by vaccines"? I'm hesitant to provide my thoughts on this until I understand your position better, Would you be willing to clarify how you arrived at these values, and perhaps provide some references?

Here is a paper that gives an example of the kind of finding that worries me:

Modulation of the infant immune responses by the first pertussis vaccine administrations [PMID: 17116347 / not linking to avoid spam filter]

Many efforts are currently made to prepare combined vaccines against most infectious pathogens, that may be administered early in life to protect infants against infectious diseases as early as possible. However, little is known about the general immune modulation induced by early vaccination. Here, we have analyzed the cytokine secretion profiles of two groups of 6-month-old infants having received as primary immunization either a whole-cell (Pw) or an acellular (Pa) pertussis vaccine in a tetravalent formulation of pertussis-tetanus-diphtheria-poliomyelitis vaccines. Both groups of infants secreted IFN-gamma in response to the Bordetella pertussis antigens filamentous haemagglutinin and pertussis toxin, and this response was correlated with antigen-specific IL-12p70 secretion, indicating that both pertussis vaccines induced Th1 cytokines. However, Pa recipients also developed a strong Th2-type cytokine response to the B. pertussis antigens, as noted previously. In addition, they induced Th2-type cytokines to the co-administrated antigen tetanus toxoïd, as well as to the food antigen beta-lactoglobulin. Furthermore, the general cytokine profile of the Pa recipients was strongly Th2-skewed at 6 months, as indicated by the cytokines induced by the mitogen phytohaemagglutinin. These data demonstrate that the cytokine profile of 6-month-old infants is influenced by the type of formulation of the pertussis vaccine they received at 2, 3 and 4 months of life. Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants.

Lets think about this for a minute. Two full months after the last vaccination, researchers were able to discern which children got DTP and which children got DTAP through cytokine profile alone. I'd like you to consider how it is possible that the type of vaccine received was able to cause distinct patterns within the context of 'billions if not trillions of immune challenges'? How is this possible?

Furthermore, take a look at this study, it was published in 2007, a full decade after DTAP was licensed, published in the journal Vaccine. And yet, the second sentence in the abstract refers to the large unknowns involving the capacity of vaccination to affect the immune system in ways other than antibody generation. However, little is known about the general immune modulation induced by early vaccination. How does this make you feel about the state of our knowledge regarding what else might be happening as a result of vaccination besides pathogen protection?

I do not believe we understand for a single second we understand the impact of changing our infants immune system like this; it might be nothing, but I think we are starting to learn that it is a dangerous proposition to tinker around with complicated, and highly interwoven systems like the immune system and assume that there is no change because we cannot envision a way in which the change might occur. We aren't nearly smart enough.

Finally, you might consider taking a look at this study as a sample of the kind of thing we are learning in the realm of animal study regarding the effect of early life immune challenges:

Early Life Activation of Toll-Like Receptor 4 Reprograms Neural Anti-Inflammatory Pathways

http://www.jneurosci.org/cgi/reprint/30/23/7975

[The full version is available online.]

In it, the authors report that a single challenge to the immune system during early postnatal life can has persistent effects in modifying the neuroimmune response in challenged animals into adulthood. Not only was the immune system of the brain modified, but the HPA-Axis, substances with large participation in the stress response were also permenantly changed in the treatment group. It is important to note here that the animals in question never got sick, they were just fooled into thinking they were under pathogen attack; and even more importantly, their immune system was not 'overwhelmed', it was altered. If you take a look at the references inside Early Life Activation of Toll-Like Receptor 4 Reprograms Neural Anti-Inflammatory Pathways you will see that it is built upon more than a dozen other studies probing the result of early life immune insults.

Those are some of my thoughts; I have many more, including a lot about the specific findings of the altered immune response in autism that we can discuss if you'd like.

Take care.

- pD

You know, pD, there have been numerous studies that cut straight to the chase -- looking for correlations between vaccination and autism. And the issue has been pretty solidly settled -- there doesn't seem to be a connection.

As for your other points, isn't the whole idea of a vaccine to alter the immune system?

Lawrence, I never complained about Canada wanting to offer compensation for victims of vaccine damage! I know some people still feel the manufacturers should be responsible directly, but however it is done people who have been harmed by vaccines should be compensated. I believe Quebec is our only province to have some kind of no-fault compensation system.
Dedicated lurker and chemmomo, listen up because I'm only going to say this again once. I'm not a frickin' toxicologist (I have a Child Studies and an Art History degree). Believe it or not it isn't too hard to spot that a lot (though not all) of the safety studies are poorly done or they are just not enough for many consumers to feel safe- but as I have already told you it would really be up to experts to figure out better, longer more revealing toxicology studies looking at certain bio-markers after vaccination or to figure out a reasonable way to do a vaccinated VS unvaccinated primate study.

Jen:

Believe it or not it isn't too hard to spot that a lot (though not all) of the safety studies are poorly done

If this is true, please explain why. You did just tell me that it's not hard to spot. Tell me about it. Educate me. I'm listening.

listen up because I'm only going to say this again once

You haven't actually said anything yet.

I'm not a frickin' toxicologist (I have a Child Studies and an Art History degree)

I acknowledged your lack of expertise back @140. But if you truly think there are studies that should be done, surely you can express what needs to be studied.

It's not that hard, Jen. Tell us what you think is missing.

By the way, Jen - I do actually see gaps in the literature and studies I'd like to see done. But this isn't about what I think - it's about you putting your thoughts into actual words.

The bottom line is that the immune system is integral to the behavior of an individual. This has been well documented throughout the literature and at this point there are even college level textbooks written on this subject. The primary mode of behavioral modification is through the generation of specific cytokines, which can affect the brain both directly and indirectly through the peripheral nervous system. The best example of this is the induction of âsickness behaviorâ a subset of behaviors which become apparent as an individual becomes ill, Iâm sure you are all aware of the behavioral changes associated with getting sick. Well, these happen to be adaptive in the sense that they confer a survival advantage to the individual. These also happen to be directed by the generation of various cytokines, which is the result of PRR (pathogen recognition receptor)activation.

This actually all make a hell of a lot of sense since the the immune system is just another sense organ. But unlike eyesight or hearing or other senses the immune system senses the microbial world and the metabolic state of the individual, relaying this information to the brain so that the organism can make concerted behavioral changes to adjust to its environment and enhance survival.

I donât think anyone here would argue that the sensory information received by the retina which is subsequently integrated within the eye and then transmitted to the brain could have long lasting effects on brain structrure, function and ultimately behavior. But I would bet a lot of money that most people have no idea that, similarly, the sensory information received by the immune system is also integrated by the brain resulting in structural, functional , and behavioral changes. Why is that? Well the most obvious reason to me is that neurimmunology is a relatively nascent field of science that hasnât gained mainstream traction. But it will, certainly as researchers all over the world are discovering that Major depressive disorder is highly correlated to certain levels of cytokines and further research has raised this from simply correlation to causation, as the specific neural substrates which cytokines effect are discovered.

Now, why is it so crazy to think that tinkering with the immune system during development can have no effect on brain and behavior. As a medical microbiology and immunology major from a prestigious university with an interest and education in neurobiology, it seems awfully messed up to me that scienceblogs, a bastion for science base medicine, is not more interested in discussing and elucidating the important connections of brain-immunology-and behavior. Why is that? The only answer I can come up with is arrogance of ignorance. Seriously, have none of you with a background in science explored these concepts? To me, it seems the most fundamental place to start. On the other hand, pD, a non-scientist (pD I mean absolutely no disrespect by this designation) is far far more educated on these matters than the god damn surgical oncologist that writes this blog (as well as the rest of the regulars that write here). Hello, red flag much, arrogance of ignorance knockin at your door.

Anyway, back to the subject. We have the following evidence:

1) Autism has very well documented immunological component.

2)The developmental period of an organism is a specifically sensitive period when sensory information is integrated and the organism makes long lasting predictive-adaptive responses (epigenetic changes)

3)Immunological information is integral in forming the behavioral patterns of an organism.

4)Vaccines affect the immune system both qualitatively and quantitatively (that is what they are supposed to do)

So based on this evidence wouldnât it be important to explore these concepts? Iâm certainly not suggesting that vaccines are the number one contributor to the development of autism, this claim is quite easily debunked. I am suggesting that a shit ton more research into this field must be done pronto. Specifically, I would suggest:

1)that we profile the cytokines generated from the normal childhood vaccines both quantitatively and qualitatively.

2)That we examine the timeline of immune activation from each and every childhood vaccine.

3)That we observe the effect of these cytokines on neural activity and behavior.

4)That we start to look at how these above items may differ between individuals taking into account specific immunogenetic parameters.

I personally donât even know anyone who has autism. I donât feel there is any conspiracy going on within the pharmaceutical and medical industry. I have absolutely no stake in this whatsoever.

I do however see a dogmatic approach riddled with arrogance of ignorance towards understanding the potential of childhood vaccines contributing to behavioral dysfunction. Please donât take this the wrong way, I am a not trying to say autism is a dysfunction, to me it is simply another way the the human brain develops and can result in dysfunctional behavior (according to our social standards) but not always.

BTW pD, great recent posts(on your blog and of course this one), I had written a nice long response to your latest post and went to submit and somehow I didnât fill in the name, so it ate it alive never to return it to me. damn, I had some good stuff to say.

That sounds OK sq, until we ask "Compared to what?"

Developmental issues in children - any developmental issues - have very different protocols for research depending on the topic. How would you ascertain a baseline or a control group for the various things you want tested?

And we are talking testing here, not just observations. Because observations alone won't tell you anything about whether the phenomenon in question is or isn't affected, unaffected, enhanced or detracted from by immunisation, all the usual SES issues, geographical - all those things.

The idea might be worthwhile, but I doubt it'd get funding ahead of many, many other more specific / important / urgent matters. And I really don't see how you could come up with a good design for this research that didn't raise the what-about-an-unvaccinated-control-group wails from the sidelines.

@skeptiquette -- it's a shame your "prestigious university" and exceptional education have not equipped you with better research skills. Or, perhaps, powers of interpersonal communication and persuasion.

Just out of curiosity,

1. to what extent are you familiar with the extensive literature on autism and immune response, including mapping atypical cytokine levels?
and
2. given that as far as I can tell the vast majority of said literature implicates autoimmune issues, why do you think we should divert the massive amount of resources which would be needed to stage studies such as you suggest (and this is assuming you would get them approved) away from more likely genetic/environmental causes, to the rather unlikely (given the fact that we cannot find any statistical link at all) cause of "vaccines"? What exactly is your justification for this massive diversion of limited resource?

Has it ever occurred to you, in your wonderfully self-righteous "come in swinging" approach, that maybe, just maybe, someone out there HAS looked at immune system links to brain development, and it just doesn't point in the direction of vaccinations?

passionlessDrone at 141:
I am concerned about the possibility of vaccines modifying the immune system in ways that we can't understand because we haven't tested for them; mostly because the idea that an immune challenge without pathogenic effects of the microbes having persistent effects is largely a novel concept.

On the contrary, I imagine that the vast majority of the immune challenges to which we are exposed during childhood result in no pathogenic effect, yet provide protection in the future. Avoiding life-threatening disease is what the immune system is designed to do, and with most viruses and bacteria and parasites it succeeds.

At any rate, the suggestion that vaccination could be more hazardous than childhood disease because it causes fewer pathogenic effects is new to me.

passionlessDrone, here is the problem I have always had with your argument "about the possibility of vaccines modifying the immune system in ways that we can't understand".

The children in these studies are undoubtedly the product of the late-20th or early-21st Century developed world. As such, their mothers were adequately nourished during pregnancy; they were delivered in an environment as sterile as possible; they were attended in their first hours or days by people gloved, gowned, and masked to protect them from infection; they have been adequately nourished throughout their young lives; they have been protected from fleas, ticks, lice, bedbugs, and mosquitoes; they have lived among people who themselves are very healthy by any historical standard and thus unlikely to spread disease to them.

In other words, these children have lived their entire lives with abnormally few serious immunological challenges. The very way we live our lives undoubtedly modifies the immune system -- ours as adults and theirs as children -- in ways that we can't understand. So detecting that there is a difference caused by an immunological challenge is interesting (and not unexpected since the whole point is to make a difference), but if it has no discernible harmful effect -- an effect on the macro level of school performance, social interactions, and the like -- scarce research funds probably shouldn't be devoted to it. Of course, if you want to raise funds yourself to study it, that's great.

So is there a discernible harmful effect? That's really the initial question. Given that autism is not new (studies have found the same prevalence of autism -- albeit undiagnosed -- among adults fifty and up as among young people), given that diagnoses of mental retardation plus autism have not increased, though the proportions have changed, despite the increased vaccinations, what harmful effects do you think are visible among the vaccinated population?

The human species evolved in an environment of constant immunological challenge, beginning at birth and even before. If brain development could be completely disrupted by a single mild challenge in childhood, none of us would have escaped disruption.

Hi Idelmind -

You know, pD, there have been numerous studies that cut straight to the chase -- looking for correlations between vaccination and autism. And the issue has been pretty solidly settled -- there doesn't seem to be a connection.

I wonder if you could post one of these "numerous" studies; one that measures vaccination, as opposed to thimerosal or one particular vaccination (the MMR). There's a difference you know.

Thanks.

- pD

Jen:

Believe it or not it isn't too hard to spot that a lot (though not all) of the safety studies are poorly done

You should really stop saying this until you can come up with a qualified reference to support your claim.

All someone has to do is look up thread to see you bob and weave avoiding supporting your claim that the studies are poorly done. So support this claim, or stop using it.

And we say a "qualified" reference, it does not mean a letter from some random doctor whose credentials cannot be verified or Handley and friends. They must be like the examples I gave before, or like this old class on some Geier research: Study Fails to Show a Connection Between Thimerosal and Autism.

I feel that you need to be reminded that every time you make a claim, that you need to support it with a real reference.

Hi Skeptiquette -

Your words are too kind. I am largely in agreement with you regarding ways we might learn more, why it might be important, a disbelief in an epidemic caused solely by vaccination, and the lack of curiosity that seems to perpetuate these discussions. I would welcome your thoughts on the mitochondria papers that came out recently.

- pD

Chris, believe it or not, I think it's more important on a Science Blog to see discussion on details of immunology etc. than me for the umpteenth time saying I think there is something left to be desired in terms of vaccine safety research. There may or may not be supporting documents to this effect and that doesn't change a thing about what I think (that there should be more extended toxicology studies or vacc/unvacc studies). I'm done. I do thank you guys (and Damien) for being civil and, really, pD and skeptiquette are asking interesting questions to which I hope people like yourself or Promethius etc. will answer, considering that it would take a fairly high level of science to really discuss.

Hi Luna the Cat -

I can't speak for skeptiquette, but I am largely in agreement with him/her on ways we might be able to move forward, and indeed, the startling lack of curiousity based on our findings in the autism domain and the recent increase in our vaccination schedule. Can I hop in?

1. to what extent are you familiar with the extensive literature on autism and immune response, including mapping atypical cytokine levels?

I'd like to think of myself as pretty familiar with them, in fact, they are in large part what makes me think that the autism population could be a sucsceptible subgroup for the modifications I am proposing as possible. There are two questions to be addressed, firstly could there be an immune mediated mechanism of action for what is observed in autism, and secondly, could the act of vaccination participate in this? For the first question, my thoughts are that we have three related, but three distinct lines of evidence that points us towards the reason the immune system may be playing a part.

1) We have no less than five studies that tell us that as indices of the innate immune response increase, so too, do behavioral severity. Those studies are:

a) Macrophage Migration Inhibitory Factor in Autism Spectrum Disorders [Grigorenko / PMID: 18676531]

RESULTS: There were genetic associations between known functional polymorphisms in the promoter for MIF and autism spectrum disorder-related behaviors. Also, probands with autism spectrum disorder exhibited higher circulating MIF levels than did their unaffected siblings, and plasma MIF concentrations correlated with the severity of multiple autism spectrum disorder symptoms.

b) Increased serum levels of high mobility group box 1 protein in patients with autistic disorder [Enzo / 20302902]

RESULTS: Compared with healthy subjects, serum levels of HMGB1 were significantly higher in patients with autistic disorder (10.8+/-2.6 ng/mL versus 5.6+/-2.5 ng/mL, respectively, P<0.001). After adjustment for potential confounders, serum HMGB1 levels were independently associated with their domain A scores in the Autism Diagnostic Interview-Revised, which reflects their impairments in social interaction.

c) Associations of impaired behaviors with elevated plasma chemokines in autism spectrum disorders [Ashwood / 21095018]

Increased MCP-1, RANTES and eotaxin levels were observed in ASD children compared with both control groups (p<0.03), and increased chemokine production was associated with higher aberrant behavior scores and more impaired developmental and adaptive function

d) Elevated plasma cytokines in autism spectrum disorders provide evidence of immune dysfunction and are associated with impaired behavioral outcome [Ashwood / 20705131]

In addition, increasing cytokine levels were associated with more impaired communication and aberrant behaviors.

e) Altered T cell responses in children with autism [Ashwood / 20833247]

Induced cytokine production was associated with altered behaviors in ASD children such that increased pro-inflammatory or T(H)1 cytokines were associated with greater impairments in core features of ASD as well as aberrant behaviors

2) We have several studies that suggest that children with autism might have problems regulating the immune response. Specifically:

a) Immune transcriptome alterations in the temporal cortex of subjects with autism [Garbett / 18378158]

The deregulation of these gene pathways might indicate that the profound molecular differences observed in the temporal cortex of autistic subjects possibly originate from an inability to attenuate a cytokine activation signal.

b) Global methylation profiling of lymphoblastoid cell lines reveals epigenetic contributions to autism spectrum disorders and a novel autism candidate gene, RORA, whose protein product is reduced in autistic brain [Nguyen / 20375269]

RORA is a member of the NR1 subfamily of nuclear hormone receptors and is involved in transcriptional regulation of many genes (34, 43, 44). Among its many relevant functions are regulation of the circadian clock by activation of BMAL1 (35), neuroprotection in the face of oxidative stress and inflammation (36), survival and differentiation of Purkinje cells (33), and cerebellar development (34)

c) Decreased transforming growth factor beta1 in autism: a potential link between immune dysregulation and impairment in clinical behavioral outcomes [Ashwood / 18762342]

In addition, there were significant correlations between psychological measures and TGF beta 1 levels, such that lower TGF beta 1 levels were associated with lower adaptive behaviors and worse behavioral symptoms

3) Our findings that direct stimulation of the immune system in autism results in increases in inflammatory cytokines when compared to people without a diagnosis.

a) Altered T cell responses in children with autism [Ashwood / 20833247]
b) Differential monocyte responses to TLR ligands in children with autism spectrum disorders [Enstrom / 19666104]

While all of these findings could be spurious, and there are conceivably mechanisms by which something else is causing a relationship between the propensity of a heightened immune response, or problems with its regulation, and an autism diagnosis, sooner or later it will be incumbent on someone to provide some evidence or reasoning for this, as opposed to simply declaring that it might be so and trotting out the problems with correlation and causation. To my mind, it is especially problematic in that both ends of the immune response, either increased response, or impaired regulation, appear to be risk factors; any explanation of these findings without invoking their potential falseness will need to incorporate an mechanism external to the immune system which can modify both ends of the immune response. That is a tall order; especially considering the frailty of the arguments I've had submitted to me previously.

As towards the second question, could vaccination be playing a part,the animal studies I've seen indicate this might be possible, especially considering our findings in the autism population.

For example, this study came out the other day: Dopaminergic neuronal injury in the adult rat brain following neonatal exposure to lipopolysaccharide and the silent neurotoxicity which found that neonatal administration of LPS resulted in long term microglial activation, stereotyped tasks, and impaired mitochondrial dysfunction in the treatment group (!). Going from rodent to human is a very tricky business, species and timing wise, but ultimately they are useful models for a variety of purposes. The fact is, there is a large body of evidence from the animal realm suggesting that immune stimulation during development is not effect free, even if there is no actual pathogen involved. We have good evidence that immune disturbances in the gestational period can cause problems, but there seems to have been a sacred line drawn between that environment, and the postnatal/neonatal environment, but I can't seem to figure out what evidence people have used to come to this conclusion. I am personally open to a complicated system that can and does involve inputs with varied time, dose, and individual specific components.

In the meantime, we have a population that seems to react more vigorously to immune challenges, whose behaviors correlate with the degree of immune dysregulation, and show evidence of an ongoing immune response in the CNS. Given that, I seriously have to wonder, what has happened to intellectual curiousity? It has been pointed out repeatedly that there just aren't any studies of vaccination and autism, just thimerosal, and one vaccine given at a year, or eighteen months of age. Is the concept of a time dependent effect really lost on everyone here?

2. given that as far as I can tell the vast majority of said literature implicates autoimmune issues, why do you think we should divert the massive amount of resources which would be needed to stage studies such as you suggest (and this is assuming you would get them approved) away from more likely genetic/environmental causes, to the rather unlikely (given the fact that we cannot find any statistical link at all) cause of "vaccines"? What exactly is your justification for this massive diversion of limited resource?

I don't know why you think that 'autoimmune issues' is necessarily a deal breaker here; I'd submit that the dysregulated immune response observed in the brain classifies as an autoimmune issue; perhaps you are referring to the antibody studies? Do you think that the findings of Vargas, Garbet, or Morgan are do not classify as autoimmune?

Has it ever occurred to you, in your wonderfully self-righteous "come in swinging" approach, that maybe, just maybe, someone out there HAS looked at immune system links to brain development, and it just doesn't point in the direction of vaccinations?

I've read a lot of the neuroimmune studies in autism (I think, maybe all of them), and I must say that I think you are overstating the conclusions if you think the arrow of causality is being pointed anywhere, vaccination or not; except with the broadest possible strokes. Would you be willing to post a neuroimmune study in the autism realm that does more than give a variety of scenarios which might be responsible? For the most part, my takeaway from these studies is along the lines of 'we are observing an ongoing immune response in the CNS in autism, but can't be sure of the cause, but it seems likely to be playing a pathogenic role.". Maybe you have a different take on the discussion sections from these papers; would you like to discuss any of them in particular?

That's long enough, or too long. [sorry]

I like your handle and have always found your posts to be well constructed.

- pD

Hi LW -

The children in these studies are undoubtedly the product of the late-20th or early-21st Century developed world. As such, their mothers were adequately nourished during pregnancy; they were delivered in an environment as sterile as possible; they were attended in their first hours or days by people gloved, gowned, and masked to protect them from infection; they have been adequately nourished throughout their young lives; they have been protected from fleas, ticks, lice, bedbugs, and mosquitoes; they have lived among people who themselves are very healthy by any historical standard and thus unlikely to spread disease to them.

I agree with you. In the past, I'd say that a lot of the infants that got pertussis, or the flu, or tetanus, or whatever at two months of age likely had a very low survival rate. I'd also say, however, that other things in our modern world might be contributing on the other end. As I tried to state above, I don't have a particular problem with a complicated system.

So is there a discernible harmful effect? That's really the initial question. Given that autism is not new (studies have found the same prevalence of autism -- albeit undiagnosed -- among adults fifty and up as among young people), given that diagnoses of mental retardation plus autism have not increased, though the proportions have changed, despite the increased vaccinations, what harmful effects do you think are visible among the vaccinated population?

Indeed that is the sixty four thousand dollar question. I don't know. (?) I won't argue the benefits of vaccination, that's for sure.

Unfortunately, the 'study' that you raise involving adults is pretty much a joke if you start poking around the details.

Here's a link to it:

http://www.ic.nhs.uk/webfiles/publications/mental%20health/mental%20hea…

For starters, their findings were along the lines of a staggering 9:1 male to female ratio!

Using this recommended threshold score on the ADOS, 1.0%of the adult population had ASD. The rate was higher in men (1.8%) than women (0.2%), which ï¬ts with the proï¬le found in childhood population studies

There aren't any childhood studies that show anything close to this value! At most, you'll see 5:1. Should we take this to mean that all of our childhood studies, and I do mean all of them, are missing lots of boys with autism and incorrectly assigning almost all of the girls into this category? What evidence do we have to support this?

But if we don't change our childhood studies, we've got to accept that a new phenomena is indeed occurring, something is causing the shift from an exceedingly high male dominated disorder in adults to one that is only mostly rules by males in children. Should we really do this based on this study?

Or, if this study actually missed a ton of females, a more likely scenario, then the rates in adults go through the roof! Remember, this study excluded anyone who wasn't in jail, or in an institution, and already had landed at 1%! If we start adding in a lot of females, and the incarcerated population, we start getting to 2% pretty quickly. We might start to ask ourselves, what is happening such that our children exhibit so little ASD?

Of course, once we realize that the NHS study had a grand total of 19 people that were given a diagnosis of ASD, we don't have to take any such drastic steps, we can realize that the findings are highly preliminary and should be extrapolated out to the general population with extreme caution. It just seems that no one seems interested in doing that because it is such a convenient stick to shake around if we need to have calmness about the idea of a true increase in ASD.

If brain development could be completely disrupted by a single mild challenge in childhood, none of us would have escaped disruption.

Remember, our population of interest has been shown to respond more vigorously to immune stimulation than their peers; we make the two equivalent between the two at great risk to our conclusions.

I appreciate your criticism.

- pD

It seems to me that you're missing an opportunity here. I am inclined to doubt that there are two completely distinct populations with completely different responses to immune stimulation -- the fact that autism is a spectrum suggests otherwise, assuming there is any validity to your theory -- and therefore there will be a range of responses: extremely vigorous, vigorous, somewhat vigorous, normal.

Fifty years ago, there were fewer childhood vaccines and many more childhood infections with severe diseases. Therefore, children would have many more opportunities to suffer immune stimulation, and those with vigorous and somewhat vigorous responses would also be likely to be driven over into autism. So the autism rate should have been higher fifty years ago, much higher a hundred years ago, and indeed higher now in less developed countries.

Hi LW -

I am inclined to doubt that there are two completely distinct populations with completely different responses to immune stimulation -- the fact that autism is a spectrum suggests otherwise, assuming there is any validity to your theory -- and therefore there will be a range of responses: extremely vigorous, vigorous, somewhat vigorous, normal.

Sure there is a range of immunological response, but the salient thing is that when you measure the response from children with autism versus children without autism, those with autism cluster at the high end of range. I was suffering from quote fatigue in my resopnse to Luna the Cat and didn't include them, but I should be clear; you can't just be inclined to doubt my statements, you need, instead, to be able to develop alternate theories, preferably with sources, as to why the published data from a variety of sources is wrong. Also, I should point out that my thoughts on potential autism causation are not limited to immune mediated mechanisms by any stretch, I've got a big tent approach towards a condition with such a heterogeneous manifestation. That being said, I do get bothered a lot when the reasons we get that a vaccinated / unvaccinated study is not necessary hinge on simplistic heuristics such as counting antigens between vaccination generations, or the crudest of observational methods; i.e., kids got sick in childhood in the past.

Our immune system has components, which are responsible for detecting non self protein structures (i.e., cell structures from different types of bacteria, viral dna strands, molecular patterns associated with fungus, ect) and marshalling the initial immune response, the innate immune response. These components, called toll like receptors, or TLRs, could be considered the first line of alert for our immune system. [There are other, related structures, some of which detect endogenous signals of infection. Most of the autism literature involves direct toggling of TLRs, though there is (at least) one study indicating other pattern receptors are also being triggered at increased rates in autism.]

That being said, if we want to see a measurement of the robustness of the immune response in autism, you can stimulate the toll like receptors (TLRs) in blood from children with autism with a variety of stimulants and see what happens: [snipping for length purposes / any emphasis mine]

Altered T cell responses in children with autism. [Ashwood / 20833247]

In vitro stimulation of peripheral blood mononuclear cells with PHA and tetanus was used to compare group-associated cellular responses. The production of GM-CSF, TNFa, and IL-13 were significantly increased whereas IL-12p40 was decreased following PHA stimulation in ASD relative to TD controls. Induced cytokine production was associated with altered behaviors in ASD children such that increased pro-inflammatory or T(H)1 cytokines were associated with greater impairments in core features of ASD as well as aberrant behaviors.

Differential monocyte responses to TLR ligands in children with autism spectrum disorders [Enstrom / 19666104]

After in vitro challenge with TLR ligands, differential cytokine responses were observed in monocyte cultures from children with ASD compared with TD control children. In particular, there was a marked increase in pro-inflammatory IL-1beta, IL-6, and TNFalpha responses following TLR 2, and IL-1beta response following TLR 4 stimulation in monocyte cultures from children with ASD (p<0.04). Conversely, following TLR 9 stimulation there was a decrease in IL-1beta, IL-6, GM-CSF, and TNFalpha responses in monocyte cell cultures from children with ASD compared with controls (p .05). These data indicate that, monocyte cultures from children with ASD are more responsive to signaling via select TLRs.

Preliminary evidence of the in vitro effects of BDE-47 on innate immune responses in children with autism spectrum disorders

In contrast, cells cultured from subjects with ASD demonstrated an increased IL-1beta response to LPS (p=0.033) when pretreated with 100 nM BDE-47 compared with vehicle control. Preincubation with 500 nM BDE-47 significantly increased the stimulated release of the inflammatory chemokine IL-8 (p .04) in cells cultured from subjects with ASD but not in cells from TD controls.

Innate immunity associated with inflammatory responses and cytokine production against common dietary proteins in patients with autism spectrum disorder [Jyonouchi / 12378124]

ASD PBMCs produced elevated IFN-gamma and TNF-alpha, but not IL-5 with common DPs at high frequency as observed in DPI PBMCs. ASD PBMCs revealed increased proinflammatory cytokine responses with LPS at high frequency with positive correlation between proinflammatory cytokine production with LPS and IFN-gamma and TNF-alpha production against DPs.

[DP == dietary proteins; i.e., gliadin / cow milk protein]

There shouldn't be any question that the immune response in autism is abnormal, and in these instances, stimulation clearly displayed a more robust immune response. But we, also have studies telling us that baseline levels of inflammatory cytokines are higher in autism (see my previous post for some), and that known promoters of the immune response, MIF and HMGB1 are also higher in the autism population. (See Grigorenko and Enzo in my previous post). If you want to doubt the findings in Grigorenko, or Enzo, or the rest of what I've posted here (and others), that's fine, but this is a forum where evidence is supposed to trump doubt; so far, I haven't seen any.

Fifty years ago, there were fewer childhood vaccines and many more childhood infections with severe diseases.

We don't vaccinate against all that many pathogens; just the relatively easy ones that have a big impact; but we do it globally. Do you really think that 90+% of infants in the past had pertussis at two months, or polio, or Hib? These diseases, while very dangerous at young ages, were relatively rare at the earliest stages of life; especially in contrast to our vaccination rates. Also, the animal studies I've been referring to involve the neonatal period; timeframes very close after birth. "Childhood" is a lot different than early infancy, and indeed, the neonatal period.

Therefore, children would have many more opportunities to suffer immune stimulation, and those with vigorous and somewhat vigorous responses would also be likely to be driven over into autism.

You are assuming this subset of infants survived.

So the autism rate should have been higher fifty years ago, much higher a hundred years ago, and indeed higher now in less developed countries.

But you are using the most primitive tool, your guesses as to how frequently infants got sick fifty years ago, or one hundred years ago, and performed a back of the cocktail napkin analysis to reach your end game. This site, and it's underlying theme, skepticism, is that we should strive to use good information on which to make conclusions, but in this instance, in this one particular instance, the opposite seems to be true.

My biggest concern, as I think I've stated, is that I just don't think we are smart enough to understand the consequences of our actions without quality analysis; analysis that everyone will admit doesn't exist when pressed on the issue. For example, take the relatively recent finding that paracetamol in infancy is associated with asthma and related disorders.

http://anthro-therapie.de/forschung/ergebnisse/lancet-paracetamol_24090…

205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the fi rst year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1·46 [95% CI 1·36-1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46-1·77] and 3·23 [2·91 - 3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the fi rst year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema.

The risk of this was always present, we just didn't think to look for it until 2008. Unfortunately, our toolset didn't allow us to understand the relationship between paracetamol and decreases in glutathione until relatively recently. This isn't a slam on the failings of the scientific method, just the opposite; but once we understood how a particular insult might contribute to a subsequent condition in a biologically plausible way, tests were designed to evaluate for a relationship. That's all that I am suggesting here; a cautionary approach to a health policy that affects nearly every infant. The animal paper I referenced above, Early Life Activation of Toll-Like Receptor 4 Reprograms Neural Anti-Inflammatory Pathways was published in June 2010; it wasn't until 2008 that we started to understand exactly how adjuvants included in vaccines actually work to induce a robust immune response; and yet, when someone suggests this might be cause for detailed studies, the quality of the responses involves either misconceptions about the types studies that have been performed 'relentlessly', gross over simplifications of complex systems (i.e., counting 'immunological components'), or common sense, but ultimately evidence free tales that try to go back a hundred years and substitute a single variable, i.e., kids used to get sick a lot. That isn't approaching the problem by leveraging the force of the scientific method, but rather, with an mix of grade school approximations and faith. It is the opposite of skepticism.

- pD

@ VT Mom & @lilady -- Thank you so much for mentioning and loving PKIDs. We have loads of great information about Hepatitis C and other infectious diseases on our website. So glad to be part of the conversation in protecting kids' health.

passionlessDrone, I believe we may be talking at cross purposes to some extent. "I am inclined to doubt that there are two completely distinct populations with completely different responses to immune stimulation" -- perhaps that is ill-phrased, but I certainly was not disputing that "those with autism cluster at the high end of range".

I was describing the nature of the distribution: one possibility would be a discontinuous distribution with one population way over there on the right with extremely vigorous responses and everyone else way over there on the left with responses that have a narrow distribution around the mean response, and no one at all in between; the other possibility would be a continuous distribution with some people way over here on the right (those would include the autistic group) but many people at various positions between that extreme point and the mean. Since few traits look like the discontinuous distribution described, you would need some evidence to overcome the null hypothesis that there is a continuous distribution. I assume, therefore, that there is a continuous distribution, but that people with autism cluster at one end.

You seem to suggest that people with autism cluster at that end because their extremely vigorous response to immunological insults alters their developing brains, as opposed to the possibility that they cluster at that end because their extremely vigorous response and their altered brain development are simply linked manifestations of their genetic traits.

What I am suggesting is that (1) if there is a continuous distribution of response to immunological insults and (2) if an extremely vigorous response to such insults alters the developing brain so as to produce autism, then the more immunological insults infants in a population suffer for any reason, the more autism we should expect to see in that population.

You observe that in the absence of modern medicine, those on the extremely vigorous end of the response spectrum will simply die from their own over-reaction (or at least that's what I understand you to say), but my comment was intended to convey that those who react strongly but not quite so strongly as the current (surviving) most extreme reactors will have a net response to the greater challenges that is equal to the response that the most extreme reactors have to the trivial challenges of today. Thus they should develop autism just as the most extreme reactors do today. And given the probable distribution, those who are closer to the norm will also be more numerous that those further away, and therefore there should be more autism and not less in environments with more immunological challenges.

You keep pointing out studies that the immune system is abnormally reactive in people with autism, but I'm not disputing that. I'm pointing out that you don't need to know every jot and tittle of the immune response in order to formulate an hypothesis as to the effect of a much greater immune assault in infancy -- which we know did and does occur.

Fifty years ago, there were fewer childhood vaccines and many more childhood infections with severe diseases.

We don't vaccinate against all that many pathogens; just the relatively easy ones that have a big impact; but we do it globally.

I think this was another case where I expressed myself poorly. I didn't mean that there were many more childhood diseases; I meant that there were many more cases of children who were infected with the severe diseases for which we now vaccinate.

Do you really think that 90+% of infants in the past had pertussis at two months, or polio, or Hib?

No, of course not. We've been through this before. Vaccination, especially vaccination with antigens -- not even entire bacteria or viruses -- is not remotely similar to infection with a disease. Infection gives rise to a desperate race between the bodily defenses and the bacteria or virus: the immune system mobilizes and throws ever increasing resources into the fight as more and more enemies are produced and more and more tissues are attacked. In vaccination, the immune system mobilizes, it attacks the antigen, and ... that's it. No additional enemies appear and tissues are not under attack. In a patient with a defective immune system, an infection can be deadly; a vaccination will merely be ineffective. Vaccination and infection are not the same thing.

I do think -- it is completely obvious to anyone interested in, say, the Middle Ages -- that infants used to be exposed to enormous immunological challenges. Sterile surroundings for childbirth, in the days when germs were undreamt of? Of course not. Fleas, ticks, lice, bedbugs, and mosquitoes attacking neonates? Those vermin were attacking the adults; how could the neonates possibly have been protected? And every bite by an insect injected all sorts of antigens into the neonate's body.

In the United States fifty years ago, I agree that conditions were far better (though not so good as today). But they weren't, and aren't, much better in the poorest regions of the world today. Do those areas have higher rates of autism?

Come to think of it, in the United States fifty years ago, infants were much more likely to be exposed to the actual diseases pertussis and Hib, and about as likely to survive as they would be today if unvaccinated and exposed. So all of those with extremely vigorous responses to immunological insults should have developed autism upon recovery (if they recovered), along with all those with somewhat less vigorous responses who would have responses to the greater challenge which are equal to or even greater than the responses of the extremely vigorous responders today.

Ugh, that's hard to read. To put it in mathematical terms, say the maximum response is 100%, the challenge from a vaccine is 1, and the challenge from exposure to the disease itself is 100. Then an extreme responder challenged with a vaccine would have a response of 100% * 1 = 1, whereas a lesser responder (50%) exposed to the disease would have the greater response of 50% * 100 = 50. Therefore the lesser responder exposed to the disease would be even more likely to become autistic than the extremely vigorous responder exposed to the vaccine.

Are survivors of Hib, pertussis, or any other disease in infancy more likely to be autistic than those who were never exposed to those diseases?

I repeat, (1) if there is a continuous distribution of response to immunological insults and (2) if an extremely vigorous response to such insults alters the developing brain so as to produce autism, then the more immunological insults infants in a population suffer for any reason, the more autism we should expect to see in that population. Is this hypothesis confirmed?

@PKIDs No need to thank me. PKIDs was always one of my favorite sites, when I worked in public health. I had the opportunity of seeing first hand, as a case manager in the Perinatal Hepatitis B Prevention Program, the benefits of testing all pregnant women for the presence of hepatitis B surface antigen and the use of Hepatitis B vaccine and hepatitis B immune globulin to protect vulnerable neonates. It was, and remains, a very intensive program to education women, their household contacts and practitioners about the importance of blood testing for hepatitis B status and vulnerability, the importance of completing the hepatitis B series and post immunization testing.

VT Mom and I aren't the only ones in our community that promote education about infectious diseases. In my area of the country that has large groups of people born in areas of the world that have very high incidences of chronic carriage of the hepatitis B virus, organizations in those communities have wonderful programs to educate, provide blood testing and medical resources for people.

Thank you, PKIDs for providing the public, practitioners and parents with a wonderful resource.

Hi LW -

I have often found that even after very verbose, and seemingly at the time, well thought out posts, that I'd wished I'd expressed more clarity, or more fully
fleshed out my thoughts. I'm getting the feeling that this post might be the gold medal winner in that regard. I do appreciate the time you are taking with this discussion, the potential problem of cross talking is there.

You seem to suggest that people with autism cluster at that end because their extremely vigorous response to immunological insults alters their developing brains, as opposed to the possibility that they cluster at that end because their extremely vigorous response and their altered brain development are simply linked manifestations of their genetic traits.

I'm suggesting that it is biologically plausible that the situation could occur. I'm not opposed to genetic participation at all, but I think I do would argue that the idea that "simple" linked manifestations of the same genetic jigsaw has some huge barricades to overcome, and even if it can overcome those problems, it doesn't really help your position much.

In the first place, a purely genetic foundation that creates both autistic behaviors, and coincidentally creates the immunological profiles we seem to observe in autism mandates some very difficult to envision changes. For example, I referenced a few studies in 154 that indicated not a propensity for exaggerated immune response, but inversely, problems regulating the immune response. This means that our genetic base must be able to do (at least) three things:

1) Create autistic behaviors.
2) Create a propensity for an exaggerated immune response.
3) Create a propensity for problems regulating an immune response.

We aren't going to find a single, large impact genetic change ala Fragile-X that can be responsible for this. We've done enough looking; if there was another
heavy hitter in the genetic realm capable of delivering this variety of changes, we'd have found it by now; much in the same way that large scale genomic scans for other diseases with known genetic components have missed the mark.

While I do recognize pleiotropic and / or low penetrance genes as meaningful, the MET findings seem to fit nicely here, we must acknowledge that we have thrown thousands, or tens of thousands of entire genomes at sequencers and consistently are only able to find changes sufficient to explain no more than a tiny fraction of autism. Given that, I find idea that there is a genetic based, dose relationship such that behaviors are coincidentally linked to increased immune response, and impairments in regulating that same response is possible, but far from "simple". Sooner or later we might consider asking ourselves if we are ignoring an actually simple answers in order to insist on a complicated one that rests within the genome. If you think such a genetic premise for these seemingly disparate conditions is simple, I'd argue that the animal models are a lot simpler; for they do not mandate a mix of genetic changes which, in large part, twenty years of research has failed to identify; and they seem to be reproducible.

For example, in Dopaminergic neuronal injury in the adult rat brain following neonatal exposure to lipopolysaccharide and the silent neurotoxicity we
didn't have to breed knock out mice, or have hundreds of mice in order to get the right mix of genes such that the animals displayed stereotyped behaviors, chronically activated microglia, and impaired mitochondrial function in the CNS. The effect of the early life immune challenge were able to supercede individual genetic differences among the animals. Similarly, none of the animals in Postnatal Inflammation Increases Seizure Susceptibility in Adult Rats had specific genetic makeups other than what chance determined, yet the treatment group consistently showed alterations in neural excitability. That isn't to say underlying genetic differences aren't important, just that they do not appear to be necessary.

Furthermore, as suggested earlier by skeptiquette, our findings in the field of the neuroimmunology and neurological conditions suggest that the neuroimmune
response is participating in lots of things, including schizophrenia, depression, bi-polar disorder. Here's a small sampling of some recent data in
this regard:

Dysregulation of chemo-cytokine production in schizophrenic patients versus healthy controls

CONCLUSION: The observation that in schizophrenic patients the PBMC production of selected chemo-cytokines are disregulated reinforces the
hypothesis that the peripheral cyto-chemokine network is involved in the pathophysiology of schizophrenia.

Understanding the role of inflammatory-related pathways in the pathophysiology and treatment of psychiatric disorders: evidence from human peripheral studies and CNS studies

Many lines of evidence now support the hypothesis that inflammation-related pathways are involved in the pathophysiology of psychiatric disorders. Much of the data underpinning this hypothesis has come from the study of inflammation-related proteins in blood of individuals with mood disorders and schizophrenia. Significantly, recent data have emerged to suggest that changes in inflammation-related pathways are present in the CNS of subjects with psychiatric disorders.

Check this out, a positive, double blind, placebo controlled trial of anti-inflammatories in schizophrenia!

Adjuvant aspirin therapy reduces symptoms of schizophrenia spectrum disorders: results from a randomized, double-blind, placebo-controlled
trial.

CONCLUSION: Aspirin given as adjuvant therapy to regular antipsychotic treatment reduces the symptoms of schizophrenia spectrum disorders. The reduction is more pronounced in those with the more altered immune function. Inflammation may constitute a potential new target for
antipsychotic drug development

Here's a similar one.

Celecoxib as adjunctive therapy in schizophrenia: a double-blind, randomized and placebo-controlled trial.

The purpose of the present investigation was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of chronic schizophrenia in an eight-week, double-blind and placebo-controlled trial. Eligible participants in this study were 60 patients with chronic schizophrenia. All patients were inpatients and were in the active phase of the illness, and met DSM-IV criteria
for schizophrenia. Patients were allocated in a random fashion, 30 to risperidone 6 mg/day plus celecoxib 400 mg/day (200 mg bid) (morning and evening) and 30 to risperidone 6 mg/day plus placebo. Although both protocols
significantly decreased the score of the positive, negative and general psychopathological symptoms over the trial period, the combination of risperidone and celecoxib showed a significant superiority over risperidone alone in the treatment of positive symptoms, general psychopathology symptoms as well as PANSS total scores.

There are tons and tons more; as skeptiquette noted, for example, studies that show that medications already shown effective in depression have anti-inflammatory effects, Even within a framework of genetic predisposition, I think there are a couple of tough questions that need to be asked if we want to believe that our immunune findings in autism genetically based, and spurious to behavioral pathology. We don't need to just find (as of yet unidentified) gene clusters that can produce autistic behaviors alongside immune changes, but we also need to find other gene clusters that can explain very similar results in schizophrenia, depression, bi-polar disorder and others.

While such findings are possible in the future, I'd say that an alternative solution is that a dysregulated neuroimmune response can manifest behaviorally, and we need not rely on genetic changes to arrive at a state of
a dysregulated neuroimmune environment. For evidence of this, I would provide any of the animal studies I've mentioned here or on other threads.

If, we wanted to discuss whether the genetic changes could result in neuroimmune disturbances, and ultimately, autism in a causal fashion, that's fine, but it doesn't do much to support the notion that we shouldn't be concerned about toggling the immune system during early infancy. Most people acknolwedge a critical nexus of gene products and environmental forces; given that, if we assume that genetics can drive towards an altered immune response,we must contend with the fact that vaccines are interacting with the end products of those genes. And once we do that, we have to contend with the animal studies.

You observe that in the absence of modern medicine, those on the extremely vigorous end of the response spectrum will simply die from their own over-reaction (or at least that's what I understand you to say), but my comment was intended to convey that those who react strongly but not quite so strongly as the current (surviving) most extreme reactors will have a net response to the greater challenges that is equal to the response that the most extreme reactors have to the trivial challenges of today.

My thoughts were more along the line that any neonate with a serious infection before modern sanitation and medicine would be at a much greater risk of not surviving; degree of immune response not withstanding. Sanitation and nutrition were a lot different back then.

You keep pointing out studies that the immune system is abnormally reactive in people with autism, but I'm not disputing that. I'm pointing out that you don't need to know every jot and tittle of the immune response in order to formulate an hypothesis as to the effect of a much greater immune assault in infancy -- which we know did and does occur.

But the research I keep posting in the animal realm is all about the nuts and bolts specifics of the immune response that appears to be causing persistent effects. Furthermore, our knowledge of exactly how the immune response is generated from vaccination (of infection) is still very much in its infancy (so to speak). I think maybe we have different ideas on the importance of how detailed our knowledge of this process ought to be before declaring that we understand it.

No, of course not. We've been through this before. Vaccination, especially vaccination with antigens -- not even entire bacteria or viruses -- is not remotely similar to infection with a disease. Infection gives rise to a
desperate race between the bodily defenses and the bacteria or virus: the immune system mobilizes and throws ever increasing resources into the fight as more and
more enemies are produced and more and more tissues are attacked. In vaccination, the immune system mobilizes, it attacks the antigen, and ... that's it. No additional enemies appear and tissues are not under attack. In a patient with a defective immune system, an infection can be deadly; a vaccination will merely be ineffective. Vaccination and infection are not the same thing.

None of the animals in the studies I've posted actually got infected. There was no 'ever increasing resources thrown into the fight', there were no 'more and more enemies produced'. There was no infection! And yet, persistent changes were still observed. [There are some other similar studies that used actual infection in perinatal rats with similar findings; see work by Bilbo or Bland for more.]

But I'd also like to discuss "Vaccination, especially vaccination with antigens -- not even entire bacteria or viruses -- is not remotely similar to infection with a disease.", I may be in agreement with you, but not in the way that you'd think. You are making the assumption that the immune response is qualitatively similar, and quantitatively reduced, in vaccination compared to actual infection. To the second point, we might reach some level of agreement, at least if we were going to discuss individual vaccines, but to the first point, qualitative differences in the immune response, I'm not sure you can back that statement up. There is a broad mix of signals released upon activation of PRRs, some inflammatory, some anti-inflammatory, some chemotaxic, some that induce b cell maturation, and some that do combinations of these things; and those signals vary by pathogen classification, type, and other environment specific factors. You are making a big, and I assert, unsupportable, claim if you think that we understand the qualities of the immune response from vaccination; especially from multiple vaccinations at once. Furthermore, you are making assumption that adjuvants are not participating; we have more than just antigens in there, we also have aluminum salts; could you demonstrate for me what the effect of these salts is on the composition of the immune response? The specifics of how we craft vaccines may also be playing a part; as you said, we aren't even putting in all of the vaccine, just the special parts that we want the body to identify (i.e., the antigens). That's a nifty move on our part, but it presumes that the only thing of interest is that we present the specific components we want the adaptive immune system to remember, and ignores the possibility that other protein structures on the bacteria, structures we are intentionally leaving out because they do not comprise the epitope we are trying to memorize, contribute to the mosaic of the immune response. This is one reason we need adjuvants, we aren't including the entire bacterial structure, just pieces parts, but our immune system didn't evolve responding to pieces parts; it evolved responding to bacteria and memorizing the unique chunks. We cannot over simplify.

For example, could you demonstrate with a study the amount of IL-10 that gets released as a result of vaccination by DTAP, or Hib vaccine, or flu vaccine?

Ugh, that's hard to read. To put it in mathematical terms, say the maximum response is 100%, the challenge from a vaccine is 1, and the challenge from exposure to the disease itself is 100. Then an extreme responder challenged with a vaccine would have a response of 100% * 1 = 1, whereas a lesser responder (50%) exposed to the disease would have the greater response of 50% * 100 = 50.
Therefore the lesser responder exposed to the disease would be even more likely to become autistic than the extremely vigorous responder exposed to the vaccine.

Unfortunately, if I were to ask you for actual measurements of the innate immune response from the pediatric schedule, on how you arrived at 1:100, you couldn't give them to me. What is to keep me from arguing that the real ratio ought to be 1:10 or 1:1.5 or 1:1000? We'd both have said things, but neither of us could back it up with any meaningful data. Tell you what, show me something that indicates that empirical rise in inflammatory cytokines from the vaccine schedule is 1%, or any percent, from an infection, and you've got a point at which we can start talking. But right now, you can't do anything like that. In any case, I will again submit that we are at great risk of faulty conclusions if we try to understand the immune system by multiplication. The DTAP vaccine has 5 antigens in it, but the varicella vaccine has 70; does it follow that the immune response is thirteen times higher to varicella vaccination? We cannot apply simple rules unless we
want simple answers!

Are survivors of Hib, pertussis, or any other disease in infancy more likely to be autistic than those who were never exposed to those diseases?

Well, if they got them during infancy, maybe, if the pathway I am proposing is feasible. By the way, we do have some evidence to this effect, this study found that children with autism are more likely to have infections during their first thirty days of life. Infection in the first 2 years of life and autism spectrum disorders

Data suggest that children with autism may have modestly elevated rates of infection in the first 30 days and that, during the first 2 years, children with autism may be at higher risk for certain types of infections and lower risk for others.

Another, much larger, study from Denmark showed higher rates of infectious hospitlization across longer timeframes in the autism group: Association of
hospitalization for infection in childhood with diagnosis of autism spectrum disorders: a Danish cohort study

Children admitted to the hospital for any infectious disease displayed an increased rate of ASD diagnoses (HR, 1.38 [95% confidence interval, 1.31-1.45]).
This association was found to be similar for infectious diseases of bacterial and viral origin.

Funny enough, the authors submit that because infections were both viral and bacterial in nature, it argued against a causal mechanism. Ho ho.

OK. This might be my longest response ever. Whew!

- pD

I don't think this discussion is going to get anywhere, since I think you're missing the forest for the trees and you think I'm missing the trees for the forest. You keep arguing that immunological insults in infancy could have wide-ranging effects on the development of the brain. I am pointing out the obvious implication if you are right. I have not been saying that you are wrong, so it's kind of pointless to keep citing studies at me.

Ugh, that's hard to read. To put it in mathematical terms, say the maximum response is 100%, the challenge from a vaccine is 1, and the challenge from exposure to the disease itself is 100. Then an extreme responder challenged with a vaccine would have a response of 100% * 1 = 1, whereas a lesser responder (50%) exposed to the disease would have the greater response of 50% * 100 = 50. Therefore the lesser responder exposed to the disease would be even more likely to become autistic than the extremely vigorous responder exposed to the vaccine.

Unfortunately, if I were to ask you for actual measurements of the innate immune response from the pediatric schedule, on how you arrived at 1:100, you couldn't give them to me.

Of course I couldn't give them to you. I made these numbers up because I was trying to illustrate a point that I didn't think I had adequately explained in words how the lesser responder, by actually getting the disease, suffers the same harm as the extreme responder suffered by getting vaccinated, or even more. I didn't even name a disease because I wasn't describing any real disease, just trying to describe the concept.

I drafted an extremely long response explaining my point with algebra rather than made-up numbers, but I don't think I should abuse Orac's hospitality. So I will let this drop.

Hi Luna,

In regard to your first paragraph, How have you come to the conclusion that I have poor research skills (I think you mean literature reviewing skills), and that I lack powers of interpersonal communication and persuasion?

Or are these just simply baseless attacks against my character?

You may be surprised but I actually have exceptional interpersonal communication skills. Sometimes these get lost on the internet, I admit. I have tried different approaches over the internet, sometimes very polite and patient, sometimes snarky or rude, lately I have tried the middle roadâa little snark interspersed with a lot of facts. I realize I canât win with everybody, some people respond better to getting slapped up side the face with snark, some donât. I am just trying to offer my knowledge to raise the bar of discussion and to ultimately help people that are in need of help. I am confident that those who are genuinely dedicated to critical logical thinking appreciate what I have to say.

Can you honestly say that what pD and I have to say doesnât make you think a little deeper about the issue?
Here are the answers to your questions:

1. I am very familiar with the literature relating the immune system to autism, if I could rate myself on a scale of 1-10 I would have to say in the neighborhood of 8-9. In other words, I feel that I have probably read 90% of the literature(in this specific domain) that is extant. Furthermore, I am well versed in the literature that relates immunology to neurobiology. I am also up to date on the literature which focuses on the genetics of autism as well as the neurobiology and neuranatomy of autism. I also am highly interested in the existing literature which looks at oxidative stress(mitochondrial dysfunction) and autism.

Can I ask the same of you? To what extent are you familiar with autism lit.?

2.The main reason that I am interested in vaccines relating to autism is quite simply there is a level of biological plausibility that warrants further research. Moreover, I have yet to see a compelling argument against this plausibility. Do you happen to have a compelling argument against the biological plausibility of vaccines contributing to autism?

It is interesting that you see my approach as self righteous , considering I genuinely can say âI donât know for sureâ and that there are many avenues that may lead to the behaviors which typify autism. I personally, based on my education and extensive familiarity of the extant literature, believe that there is reason to look deeper into the question of vaccines contributing to autism. In fact, I find it a bit self righteous that others with far less familiarity with the literature and/or education in the field of immunology microbiology and neurobiology can say with certainty that there is no link. Seriously, isnât that the definition of self righteousness?

As to the comment that have âI considered that others may just have looked at the immune system link to brain developmentâ, this one seriously has me befuddled. I just got done saying that there is a growing body of research to this end. Yes, others are looking at it and no they are not ruling out, a priori, vaccinations. I know that you know that good science takes a long time, any neuroimmunologist worth their weight is not going to preclude an Idea or hypothesis without the appropriate research. This may just take a long time(which doesnât fit with the current societal âwe want it hot we want it nowâ attitude, but, shit be patient, as Damien said(I like this) the ship of science takes a long time to turn. On the other hand, sub-par scientist will rule out ideas a priori, without the necessary knowledge or research (or in this case, in the face of biological plausibility), and to be honest this is a much better example of self righteousness.

I personally, want to see a more informed dialogue, and ultimately less incidence of developmental disorders amongst our children, as well as, increased confidence in the vaccination schedule. The only way to achieve this is to think critically, have an open dialogue and continue to perform top notch research.

Months ago the report by "The Genome Project" came out. In my mind it would be used to further the lie that there is no vaccine-autism connection. Oddly, they stated that children labelled autistic had genetic mutation that didn't originate with their parents. It reminded me of an SV40 story that ARI had in a newsletter. A toddler died of brain cancer. Parents heard about SV40. Baby and parents checked for it, but only baby had SV40. Where did it come from? Contaminated polio vaccine. Genome project had me asking, "what happens to babies between birth and 3 years that could cause genetic mutation? Could it be breast feeding? Pablum, diaper change, being held lovingly, being shown to relatives, baptized, bottle fed, sleeping a lot, and I just couldn't imagine these normal things causing autism or genetic mutation. So what else? How about something "UNNATURAL"? Like injecting a bunch of chemicals, viral entities, MSG, peanut oil, fish oil, stealth virus like SV40, or neuro- toxins like aluminum, mercury, formaldehyde and much more? How about I search aluminum and mercury and find out they can cause spontaneous genetic mutation? Well thats what I found..case closed.

Everyone who thinks that vaccines are not causing developmental problems need to do more research! There has not been one test on cumulative impact! LET ME REPEAT THERE HAS NOT BEEN ONE TEST ON CUMULATIVE IMPACT!

READ THE VACCINE INSERTS! ALSO I WOULD ENCOURAGE THOSE WHO THINK VACCINES ARE HARMLESS TO READ HOW VACCINES ARE PRODUCE AND TESTED. YOU WILL BE AMAZED AT THE KINDERGARTEN SCIENCE LEVEL WE ALLOW PHARMA TO GET AWAY WITH.

faith, did it take you a whole year to come up with that fact free comment? Did you bother to read the articles posted this month, January of 2012? Or did you miss it like you missed that you hit your Caps lock key?