In which I break a rule and call out Dr. Bob Sears

Dr. Bob Sears, famed pediatrician who seems to live to write books, wrote the following on his Facebook page:

“New Study in Journal of Pediatrics Shows Number of Vaccine Antigens Not Associated with Autism Risk… Another waste of money in another attempt to pretend to do research on vaccines and autism.”

Because we haven’t wasted enough money and resources chasing that windmill? He continues:

“Now, if I were to do a study (and have several million bucks to fund it), here’s how I would look at the question of whether or not an increased number of vaccines relates to an increased risk of autism: I would take a bunch of kids who had all the vaccines on the regular schedule and look at the rate of autism in that group. We know that it’s about 1 in 50 kids. Then I’d take a whole bunch of kids who were only partially vaccinated and look at the rate of autism. I would subdivide the partially vaccinated group into subgroups based on the total number of vaccines given during infancy. I would perhaps have a group that delayed vaccines. And hey, while we’re at it, let’s really go crazy and find a few totally unvaccinated kids just for fun. On the other hand, no. Let’s not. It would be totally unethical to subject a group of totally unvaccinated children to any type of medical research. Ok, back to my study. These data would then give us a true look at autism rates compared to number of vaccines given and the age at which they were given.
Now THAT would be an interesting study. Unfortunately, it’s just too logical. It’s much better to study things in a confusing and illogical manner so you can get some results that the press can really sink their teeth into.”

Really? IF you had the money? You haven’t made enough from your books, Dr. Bob Sears?

And when the heck did you become an epidemiologist? Oh, you didn’t. I can tell from your study “design.” The study you’re criticizing (PDF) is a case-control study. The researchers started with cases (kids with autism) and controls (kids who were neurotypical). They then assessed if there was a difference in the number of antigens and vaccines they received. That is, was there a difference in the odds of getting a vaccine as it relates to autism? There wasn’t. Kids with autism were just as likely to be exposed to vaccines as kids without autism. We do case-control studies when the cases are too few in number. We do it to get a good idea of causality. We do it because it’s the right study to do, Dr. Bob Sears.

That’s not what the anti-vaccine people, like Dr. Bob Sears seems to be, want to hear.

Dr. Bob Sears wants a retrospective cohort study, where you take kids with different levels of exposure and then go back through medical records to see if they are autistic, or how autistic they are. It sounds reasonable, right? The problem with that study design is that autism is rare, even at a 1 in 50 prevalence rate. To get a significant number of autistic and non-autistic kids for comparison, you’d have to enroll thousands and thousands and thousands of kids. If you don’t do that, you run the risk of having too small a sample, screwing up the statistics. Further, it’s really hard to assess temporal (chicken or egg) associations. And there are all sorts of biases, including selection and recall bias that can affect your results.

And we couldn’t possibly do a prospective cohort study because, well, it would never go through an IRB. Never. Never ever.

But it’s not like Dr. Bob Sears has a mastery of vaccine science. He doesn’t. So why assume he knows anything about epidemiology?

He does know about straw men arguments and pharma shill gambits, though:

“So, is anyone really surprised to see the Journal of Pediatrics study? What were you expecting? CDC researchers to publish as study that actually showed an increased risk of autism related to vaccines? The CDC would NEVER simply publish such a study. I doubt anyone would. Anyone at the CDC who published such a study would be fired faster than they could sell their Pharma stock.”

Dr. Bob Sears has revealed his true anti-vaccine nature. Can’t wait for the next measles outbreak from one his patients and for him to deny it.

Now, for a list of studies that have found no association between vaccines and autism, check out the Autism Science Foundation’s page on the subject. But Dr. Bob Sears is right on one thing, how much more should we waste?

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11 thoughts on “In which I break a rule and call out Dr. Bob Sears

  1. I read Dr. Bob’s post and a number of the comments. It is clear that Dr. Bob and his most devoted followers see this as an intensely and essentially political issue. A question of fact might hope to be resolved by examination and analysis of the evidence, but not a question of politics. For that reason, I have no interest in trying to convert the true believers — a mug’s game if ever there was one — but in bringing science education to the more reasonable population. How do we do that?

    • We all have our ways of doing it. I try to be reasonable but find myself losing my cool. Others just copy and paste facts, which is hard to do with “news” like the most recent vaccine-autism study. And then there are the silent people who notify the more active of us to take action.

  2. Poor Dr. Bob. When I went after him on the Ho-Po and he yelled at me…I continued to post at him. I also linked to the MMWR issue, that reported on the San Diego measles outbreak and identified the 7-year-old deliberately unvaccinated “index case” (Dr. Bob’s patient), who infected 11 additional unvaccinated children, including the index case’s siblings.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm

    “…In January 2008, measles was identified in an unvaccinated boy from San Diego, California, who had recently traveled to Europe with his family. After his case was confirmed, an outbreak investigation and response were initiated by local and state health departments in coordination with CDC, using standard measles surveillance case definitions and classifications.* This report summarizes the preliminary results of that investigation, which has identified 11 additional cases of measles in unvaccinated children† in San Diego that are linked epidemiologically to the index case and include two generations of secondary transmission. Recommendations for preventing further measles transmission from importations in this and other U.S. settings include reminding health-care providers to 1) consider a diagnosis of measles in ill persons who have traveled overseas, 2) use appropriate infection-control practices to prevent transmission in health-care settings, and 3) maintain high coverage with measles, mumps, and rubella (MMR) vaccine among children.

    The index patient was an unvaccinated boy aged 7 years who had visited Switzerland with his family, returning to the United States on January 13, 2008. He had fever and sore throat on January 21, followed by cough, coryza, and conjunctivitis. On January 24, he attended school. On January 25, the date of his rash onset, he visited the offices of his family physician and his pediatrician. A diagnosis of scarlet fever was ruled out on the basis of a negative rapid test for streptococcus. When the boy’s condition became worse on January 26, he visited a children’s hospital inpatient laboratory, where blood specimens were collected for measles antibody testing; later that day, he was taken to the same hospital’s emergency department because of high fever 104°F (40°C) and generalized rash. No isolation precautions were instituted at the doctors’ offices or hospital facilities…”

    (I think it has been determined that the 7-year old child did not visit Dr. Bob’s office)

    BTW Reuben, another anti-vaccine crank (R.S.), has posted on Dr. Bob’s Facebook page. That person has his own blog http://www.thevaccinemachine.com/ and he has posted under his ‘nym Sid Offit on Respectful Insolence (I refer to him as “Offal”). Boob hasn’t been posting recently on RI (sigh, I miss him), but he has his own Facebook page…which is loaded with his idiotic posts.
    Boob isn’t an epidemiologist, but he did graduate from a fourth-tier college with a degree in “Fire Science”. He’s also a libertarian, who hates little brown babies, who succumbed to pertussis in California.

  3. He’s completely ignoring the mountain ranges of data from Denmark, where Every chid has been followed medically for decades now, and the rates of autism were HIGHER in the NONvaccinated than in the vaccinated. That in itself disproves any link pretty conclusively.

  4. The problem is simple. Any study that disparages his gravy train will be unwelcome and be disparaged by him.
    Science matters not to him, money does. Money from books and money from his quackery practice patients.

    I can conditionally say that I agree with Doctor Boob on one thing, one should always feel free to question one’s medical professional. Indeed, this very week, I questioned my father’s physician over a prescription that doctor wished to prescribe. Then, I gently suggested doctor check his allergy list.
    Said physician looked, agreed that it was a bad idea and thanked me for my observation.
    I question immunization in one conditional case that the majority of the populace will never be exposed to, the military immunization method. I’ve yet to see a study verifying effective antibody levels on all or even most agents immunized against. Anyone who knows of such studies, please let me know. That’s about the only immunization problem I have, save for smallpox vaccine, we can do far, far better in safety. But, for that, again, the populace is not exposed to it, only DoD personnel are.

    For those who promote non-vaccination, they literally sentence those unable to be vaccinated or suffer immune deficiency to death.
    To be blunt, I firmly believe those people should be summarily executed. Just as they summarily deny life to others randomly.
    But then, I’ve been in villages ravaged by polio and watched children and elders die. I’ve been in villages ravaged by all manner of preventable communicable disease. It’s damned ugly.
    Even war is prettier than witnessing an epidemic of high morbidity and mortality communicable disease.
    And both I know far too well. Two things wake me up on bad nights. One five year old kid that wandered into the middle of a firefight and had his skull shattered by a bullet. Village after village of sick and dying people that suffered from diseases that could have been immunized against.
    I’d have far preferred only one bad dream/memory.
    Add to that the fact that I’m now a grandfather, who had to suggest to one antivax mother what would happen if she exposed my too young at the time grandson to a potentially lethal disease…
    Well, I went to a different school of diplomacy. The George S. Patton school of diplomacy.
    She kept her unvaccinated kids away from my grandkids.

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