Autism is not death, unless you want it to be

The latest scandal to rock the anti-vaccine crowd has done nothing to sway the opinions of the True Believers® about vaccines and autism. If anything, they think that they have a smoking gun and all the evidence in the world to point their fingers at vaccines as the causative agent of autism. At best (for them), they have evidence that giving the MMR vaccine before 36 months increases the risk of autism for African American boys. That is a big assumption because the DeStefano paper that has been so widely criticized as of late dealt with a case-control study and odds ratios. Thinking that you can reanalyze it as a cohort study with relative risks is poor judgment and horrible reasoning.

I’m not here to talk about all that. Others are doing a fine job in peeling the layers of the ineptitude of Andrew Jeremy Wakefield and BS Hooker in trying to scam the American public about vaccines and autism again:

• Orac tells us here, here, here and here about the whole goddamned thing. In fact, his latest post wraps it all up very neatly with a message to the “CDC whistleblower” and how the whistleblower’s scientific career is pretty much done.
• Todd W. tells us here about Andrew Jeremy Wakefield confusion about history, here about anti-vaccine activists on Twitter not understanding Twitter, and here about the whistleblower telling us all about being betrayed by Andrew Jeremy Wakefield and BS Hooker.
• Phil Plait tells us how, no, there is no connection between the MMR vaccine and autism, yet again, here.
• Liz Ditz tells us about the whistleblower statement here, about Andrew Jeremy Wakefield and BS Hooker implicating an African American researcher in an alleged scheme against African Americans here, and she gives us the overall backstory here.
• Finally, Ren tells us why the whistleblower’s and BS Hooker’s epidemiological and statistical reasoning is unsound here, and how everything came undone for Andrew Jeremy Wakefield and BS Hooker yesterday here.

That right there should be essential reading for you to get caught up. Now, let me tell you about a special group of people…

There is a special group of people who are, for the most part, parents of autistic children (or children with other developmental delays). These people are special because, although their child is right there in front of them, they are under the impression that the child is dead. They refer to their “lost” child, or how their child was “taken” from them, all the while the child is breathing in front of them. In many cases, the child is not just breathing but trying to interact with them. I write “trying” because the amount of online activity these people have makes me wonder if they have any time for their living, breathing, interacting child in front of them.

I’ve told you before why I believe that these people need to walk away from their children, and I even got a rabid anti-vaccine and conspiracy theorist threatening to kill me if he ever saw me in person for it. (Some people react in the weirdest ways to being told the truth.) The joke is on him, though. Ideas are bulletproof.

With so many anti-vaccine activists “hooked” on the “BS” over the “whistleblower”, I started to notice something about how they were presenting themselves online. During their “twitter party,” many of them had a black ribbon as an avatar. Why? Because these “non-sheeple” were told to:

While the black ribbon can mean different things to different people, it’s main use is for grieving or remembering the fallen, the dead. The way that these people have used it is to try to bring attention to their cause by equating autism with a death or a loss.

I call on these parents who think hours-long “parties” on Twitter are the best way to advocate for their children to walk away from their children immediately. Those children deserve love, caring, understanding, and acceptance. Why not go fight for them at school meetings to get them more inclusive curricula in public schools? Why not go to your elected representatives and demand laws to protect your children from scam non-medical treatments like bleach enemas and chemical castration? Why not write letters to the editors of your communities’ newspapers to advocate for acceptance in the community of your children with special needs so that they will not be shunned from your society and, instead, be integrated into it?

But to display black ribbons and say that your child is no more because he or she is autistic? How in any reasonable terms is that the best way for you to do something for your child? Again, walk away, because there are thousands more caring and loving people out there to take care of them than you, based on your brand of advocacy on line and in person.

Even the bottom-feeding journals seem to have some sense

Thanks to a reader by the moniker of “Lawrence,” I’ve come to find out that “Translational Neurodegeneration” has taken down the article by BS Hooker on MMR and autism. Now, we have this:

http://www.translationalneurodegeneration.com/content/3/1/16/abstract

The page where the article used to be now links to a PDF version of it with this message:

“This article has been removed from the public domain because of serious concerns about the validity of its conclusions. The journal and publisher believe that its continued availability may not be in the public interest. Definitive editorial action will be pending further investigation.”

I call this journal a “bottom feeder” because, in my humble opinion, it has a lot of questionable articles in it and the impact factor of the journal is lacking. But the editorial board has done the right thing in wanting to take another look at the article.

I’m still left wondering how this paper got through peer review, or who did the peer review. They seem to not have bothered with checking the biostatistics or with looking back at the DeStefano paper.

How to end a scientist’s career with some fancy editing

I’ve been taking extra strength exedrin today, all day. I have this nagging headache. See, I get these headaches when I hear people lying. It’s like a superpower, except that it hurts worse as I hear more stupidity. The “Thinking Moms” decided that they were going to have a “Twitter Party.” Well, they don’t know how twitter works. They thought that creating an echo chamber of anti-vaccine people repeating the same hashtag (#CDCwhistleblower) would make said hashtag trend and attract regular Twitter users to their message of anti-vaccine madness. That’s not how it works. For something to trend and be featured on Twitter, you need to have a lot of individual people using that hashtag in their conversation. A dozen people writing it a thousand times has an impact factor of 12, whereas twelve-thousand people tweeting it just once has an impact factor of 12,000.

My headache only got stronger when I was directed to this video from who else but the “Autism Media Channel”:

(I wonder how many autistics work at the Autism Media Channel?)

Anyway, the video is more fancy editing from Andrew Jeremy Wakefield and his team. This time, we get to hear more snips and soundbites attributed to one Dr. William Thompson. As much as the anti-vaccine activists have been demanding that Dr. Thompson come out into the open and make some sort of a statement, no one seems to demand that Andrew Jeremy Wakefield and his team publish the entire recorded conversation between Brian Hooker and Dr. Thompson. All we get are lies and innuendo. We have operatives like Ginger Taylor writing on Twitter that CDC deliberately didn’t look at birth certificates for African-American babies in the DeStefano study. Others keep repeating that the DeStefano study is like the Tuskegee study, where African-American men were deliberately denied penicillin when they had syphilis. It’s not.

Still others are saying that this is yet another form of abuse of African-Americans by the government, then they compare it to the unrest happening in Missouri. The even use imagery from the riots and of the teenager killed in Ferguson by a police officer. Again, autism to the anti-vaccine crowd is just like murder, just like death.

Yet none of them demand that Andrew Jeremy Wakefield release all the tapes. If I were running his public relations machine, I would probably do the same. Release little bits, edited ones, ones taken out of context, all to feed the masses who clamor for evidence where there is none, all to keep them worshipping their god. And it wouldn’t matter to me if I destroyed a scientist’s career, as long as the donations kept coming in and the sheeple kept up their deification and sanctification of Andrew Jeremy Wakefield, the godhead, and Brian S. Hooker, the priest.

Andrew Jeremy Wakefield plays video director while African-American Babies die, or something

Let’s say that I have a secret. Well, not that I have the secret but more like I discovered a secret. Let’s say that it is a secret so heinous that telling it to the world may change the world or, at the very least, save a lot of lives. And let’s say that I’ve vetted the information contained in that secret and I have found it to be true. Do I…

1. Go to the media with the secret and the evidence and make the news?
2. Bury the secret in a bunch of convoluted science-speak in a paper that I want to publish in a bottom-feeding journal that no one with any real credentials has heard about while I make a video, edit the video, narrate the video, edit some more and post the video online only to take it down, edit some more, and then post it again?

Me? I’d go to the media immediately. I’d take all the money I’ve been given by fearful parents and call a press conference ASAP. What Andrew Jeremy Wakefield decided to do is, well, you’ll see.

If you remember correctly, there’s a PhD biochemist by the name of Brian Hooker. Dr. Hooker has actively sought legal relief for his son’s autism. In his mind — as that of others — it was the vaccines his child received that caused the autism. So Dr. Hooker has time and again tried to play epidemiologist and biostatistician and try to debunk studies that have debunked the autism-vaccine myth.

Hooker’s latest “research” dealt with a study by CDC epidemiologists where children with autism and children without autism were compared to see when they got the MMR (measles, mumps, rubella) vaccine. That study (DeStefano et al) found no difference in the odds of receiving the MMR shot between groups of autistic and neurotypical children of the same age all living in the Atlanta, Georgia, metropolitan area. Hooker has come along and claims that data left out from the DeStefano paper shows that there is an increased risk of autism in African-American children receiving the vaccine at 36 months.

I read Hooker’s paper, and it is rife with problems. First, he uses as his references papers written by the Geier father-and-son team. The Geiers were involved in some shady treatment of autistic children by using chemicals typically used to chemically castrate people. They contended that, because mercury binds with testosterone in a petri dish at high temperatures, then the same must be true in a human being. In their mind, mercury in thimerosal binds with testosterone and triggers autism. Their solution? Chemically castrate male children by giving them chemicals that reduce their testosterone. For that, the father lost his medical license in just about every state he had one. The son faced charges for practicing medicine without a license.

Next, Hooker cites Andrew Jeremy Wakefield’s paper, a paper that has been retracted for being an “elaborate fraud.” So, right off the bat, the Hooker paper is not looking too good. Next come the statistics. Hooker uses Pearson’s chi squared test to see if there is a significant association between MMR and autism in children at different ages. DeStefano et al used conditional logistic regression. For the non-biostatisticians out there, the technique that DeStefano et al used accounts for confounders and effect modifiers, different traits in their population that could skew the results. Hooker’s technique doesn’t really do that, unless you stratify results and use very, very large datasets. Hooker’s approach is more “conservative,” meaning that it will detect small effects and amplify them, and those effects can come from anything.

Even with that approach, Hooker found that the risk of autism associated with getting the MMR vaccine was not there or it was negligible, except in one population: African-American male babies. He found that African-American male babies at 36 months had a higher than 3-fold risk of autism if they had received the MMR vaccine. Pretty damning, right?

Well, as is the case with most anti-vaccine activities, there is more than meets the eye. I’ll explain that in a second. First, I want to show you what Andrew Jeremy Wakefield and Hooker did with this information:

Yes, instead of calling a press conference or otherwise going to the media with this information, thereby maybe halting all MMR vaccination of African American babies at 36 months, Andrew Jeremy Wakefield decided to create a video, edit it, narrate it, edit it some more, and then post it online. This is not the first version of the video, mind you. There is another version where the “whistleblower” is not named by name. If you want to believe another anti-vaccine activist (The Kid), Hooker never wanted to reveal the identity of the whistleblower. I guess Andrew Jeremy Wakefield just did it because the internet, or something.

So, just so we’re clear before I go into why Hooker is wrong in his assertions, we have Wakefield admitting he was wrong (as we all knew) and we have Hooker on the phone with a researcher of a well-known paper, on video, but the whistleblower’s identity was supposed to be kept secret. Right.

Hooker is wrong in his assertions because the DeStefano paper did not leave out African-American children on purpose. Children were excluded from the analysis because of very legitimate and scientific reasons. They either were not the right age, did not have autism but some other neurodevelopment disorder, or were born outside of Georgia. Even if they were tossed into the analysis, DeStefano et al used a statistical analysis that took into account things like birth weight and mother’s age when analysing the data. They wanted to make sure that what they were seeing was most likely because of the MMR vaccine and not because of some other factor associated with autism.

The nail in the coffin for the Hooker paper is that autism is usually diagnosed by the time a child is three years old. There was no increased risk at 18 months, higher but not by a whole lot at 24, and then the three-fold increase at 36 months. Gee, was it the MMR vaccine, mister? No, the effect is being modified by age. It’s as if I asked you if your shoe size was bigger at 36 months because you drank milk vs because you were 36 months. It’s age. It’s the way that autism is diagnosed. You’re going to have more children diagnosed as autistic at 36 months than you will at 18 months or at 24 months. Using the chi square test doesn’t tease this out, Dr. Hooker! That’s more than likely why DeStefano et al used conditional logistic regression, to take age into account in the analysis.

So why did we not see this in the other ethnic groups or in girls? The answer here is simple, again. Hooker had a limited dataset to work with when he boiled it down to African-American baby boys. In this table, for example, he tells us that he had to modify the analysis to 31 months instead of 36 because he had less than 5 children in that group. It’s the same goddamned mistake that Andrew Jeremy Wakefield wanted to pass off as legitimate science. You cannot, and must not use small numbers to make big assertions… Big, racially-charged assertions:

“Dr. Hooker stated “The CDC knew about the relationship between the age of first MMR vaccine and autism incidence in African-American boys as early as 2003, but chose to cover it up.” The whistleblower confirmed this.

When asked if there could be any scientific basis for excluding children born outside of Georgia, Hooker responded, “I know of none, and none has been provided by the authors of the DeStefano study.” He added, “The exclusion is reminiscent of tactics historically used to deprive African-Americans of the vote by requiring valid birth certificates.””

That is pure race-baiting right there. With the situation in Ferguson, MO, as it is, I am wondering if Hooker and Wakefield didn’t try to capitalize on that and bring even more racial tension into the mix. I mean, Tuskegee and autism, really?

Autism is not syphilis. It cannot be cured with a shot. It cannot be cured, period. It is also not like the Holocaust or genocide, like Wakefield claims toward the end of his little video montage. Autism is not a death sentence. It’s time that parents of autistic children and autistic adults put an end to Andrew Jeremy Wakefield’s lies and his propaganda machine by speaking out against him and by convincing his devout followers not to fund him anymore. After all, if the paper by Hooker and the assertions of the video are true, Wakefield and his “Autism Media Channel” chose to sit on the information in order to make a good video (and maybe even a good buck) while thousands upon thousands of African-American babies continued to receive the MMR vaccine the world over.

Then we’ll just have to fight, won’t we?

There’s a scene in “The Dark Knight Rises” where Selina Kyle, aka Catwoman, tells Bruce Wayne, aka Batman, that “there’s a storm coming.” The scene starts off innocently enough with the aged Bruce Wayne showing up at a high-society party. There, he ends up seeing Ms. Kyle and asking her to dance. He deduces that she is there to swindle some rich guy out of money, but she is part of a bigger plot, a more sinister plot.

I was stupid enough to email an anti-vaxxer a snarky message asking her when they were going to give up, when evidence would be enough that vaccines are perfectly safe and effective, especially when compared to what the natural diseases that they prevent can cause. She told me that I didn’t even know what was coming and that a storm would take us scientists all out to sea, signing her email with X’s and O’s, internet speak for “hugs and kisses.” It seemed odd. Realizing my stupidity and that most everything I write or say to them can be used against me, I left it alone.

Last night, a friend emailed me a link to a video where Andrew Jeremy Wakefield compares the alleged MMR-autism link to the Tuskegee syphilis experiments, where African-American men were purposefully held back from receiving penicillin in order to study the natural history of syphilis. To Andrew Jeremy Wakefield, autism is like syphilis, I gather; a disease that is curable and whose cure is being held back by the government.

I’m not going to share the video with you because it’s ten minutes of your life you’ll never get back. I don’t want to do that to you. Suffice it to say that the accusations him and others make in that video would mean the downfall of a lot of epidemiologists if it were true. I have the sneaking suspicion, based on Andrew Jeremy Wakefield’s “elaborate fraud” from 1998 that not everything in his video is true.

However, I do know this… A storm is coming, and we better batten down the hatches.

When that happens, we’ll just have to fight, won’t we? Like we always do. Like we’re have to do.

What’s the harm, really?

One thing that anti-vaccine types keep asking over and over is the following:

“If your kid is vaccinated, and if vaccines work as well as you say they do… Why is my kid a threat to your kid?”

It’s an interesting mental game to play with them if you’re so inclined. It probably won’t get you anywhere with the hardcore anti-vaccine activists, the ones that blame everything and anything on vaccines. But the “softer” ones may still be reachable. Here’s how you play the game:

Utilitarianism, Science, and Public Policy

One of the things that you hear over and over again from the anti-science crowd is that public policy should not “sacrifice” the life of one person for the good of the population. In the case of vaccines, many of the people who are convinced that vaccines cause autism will tell you that we should not “sacrifice” a child to autism even if it means preventing a whole lot of death and disability from vaccine-preventable diseases. Mind you, autism does not equal death for a child. But such is the mentality of the fanatic.

I wish that I could live in a fantasy world where there were no sacrifices for the good of the population, where no one in the absolute would have a reaction to a vaccine (no matter how mild). Unfortunately, such a world does not exist. However, there is this thing called science, and it prescribes the tools we can use to minimize the amount of suffering in humanity. With it, we’ve been able to cure diseases that used to kill people by the thousands (maybe millions) in centuries past. Sadly, there are those who have not benefited from the science and may have even been hurt by it. But such is life.

I’ll admit it: Wakefield’s research has been replicated over and over again

Calm down, will you? As long as you’ve been reading this blog and you think that I’m about to absolve Andrew Jeremy Wakefield? Not at all. I’m about to nail the (by my count) 145,345,364th nail in the coffin of his “MMR causes Autism” theory. See, the anti-vaccine “Wakefieldites” have been claiming that his “research” has been duplicated by other scientists. I put “research” in quotes because his paper is no research at all, from an epidemiological and even medical point-of-view. It was a fraud, but we’ll leave that for later.

Wakefield’s retracted paper has the following conclusion:

“We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue.”

My emphasis in bold.

That’s it. That’s their conclusion. Later on, the authors state that there is inadequate evidence to link the vaccine, that the onset of symptoms occurred after the vaccine, and that (as is the case in most research) further studies were necessary.

So, yes, further studies were done, and they all replicated Wakefield’s findings of no association. If you remember, it was Wakefield’s opinion that the MMR vaccine caused autism. Perhaps encouraged by the pay day coming with his patent for the single measles shot, or some other incentive altogether, Andrew Jeremy Wakefield decided to inject his opinion into this, even after the facts didn’t support his findings:

“Again, this was very contentious and you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.”

My emphasis in bold, again.

Read that last quote again, ladies and gentlemen. The anti-vaccine activists, all the harm they’ve done to herd immunity, all the anti-science and hate they spew, the cheering of murders in Pakistan of vaccine workers, all of that… All of that came from how Andrew Jeremy Wakefield felt, not from fact, not from evidence, not from anything tangible… Just how he felt.

We fight ’em. We fight ’em until we can’t.

Have you ever heard of the phrase “Beating a dead horse“? It goes a little like this:

It basically means that you keep at something that is futile, worthless, not worth doing. Unfortunately, there are people who keep beating a dead horse. Except that this “dead horse” is very serious, deadly even. The person doing the beating is Andrew Wakefield.

Yes, I know my policy is not to mention any names. But he’s just asking for it.

As it turns out, there is a new blog, Facebook group, and Twitter feed that beats the dead horse that the MMR vaccine causes autism, that Andrew Wakefield did not commit a fraud in his retracted Lancet “study” (it was a case series), and that anyone stating otherwise must be dragged to court in Texas to face the law (aka a “Strategic Lawsuit Against Public Participation“).

Warning: There is a picture of Wakefield and his wife in their posh living room. Wakefield is wearing no shoes and has a smug smile about his face. People have told me that they lost their lunch at the sight. You’ve been warned.

Anyway, I for one am glad that they are deciding to blog and post his every move. A threat to public health like the idea that the MMR vaccine should not be administered out of some fear of autism must be watched carefully, monitored. It must be countered.

And we will.

We will.

And I’m the pharma shill?

One of the continuing accusations that the anti-vaccine groups and their members keep launching at me when I go and comment on a news article about vaccines is that I am being paid off by “Big Pharma”. They write that I “must” be a pharma shill because no one in their right mind, after googling like a mother[expletive], would say that vaccines are good. Oh, no, no, no. According to them, anyone with half a brain would have figured out the conspiracy and not believe in the science behind vaccines.

The biggest deity in the anti-vaccine movement is Andrew Wakefield. You may remember him as the British physician who did a “study” on the association of the MMR vaccine and gut disease in children with autism. He then attributed the autism on the gut disease and the gut disease on the MMR vaccine. This caused a scare in Europe that has “attenuated” the interest in MMR vaccination. As vaccine rates dropped, cases and outbreaks of measles in the whole of Europe have been on the rise. Well, the “study” — which was actually just a case series with a few kids involved — the “study” turned out to be an elaborate fraud.

CNN reported the fraud this way:

“An investigation published by the British medical journal BMJ concludes the study’s author, Dr. Andrew Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study — and that there was “no doubt” Wakefield was responsible.
“It’s one thing to have a bad study, a study full of error, and for the authors then to admit that they made errors,” Fiona Godlee, BMJ’s editor-in-chief, told CNN. “But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data.”
Britain stripped Wakefield of his medical license in May. “Meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession,” BMJ states in an editorial accompanying the work.”

As their deity, anti-vaccine individuals defended Wakefield the best way they know: RABIDLY.

One such rabid defender follows a vaccine advocate across state lines to ask the same tired, conspiracy-filled questions over and over:

“You said that Dr. Andrew Wakefield said that the MMR vaccine causes autism. He never said that actually. He said that the safety data to back up the MMR vaccine’s use was inadequate and seven years later the Cochrane Review basically came to that same conclusion. What do you have to say to that?”

You know, if you’re going to go through the trouble of finding out where your target is going to speak, missing class, jumping on a train, and then stand in line to ask a question, you might want to not ask such stupid questions. I really hope this kid’s research skills get better because the best he can do is hassle scientists at talks and see monsters under the bed.

See, Andrew Wakefield did indeed state many times that the MMR vaccine causes autism. Anti-vaccine advocates like to twist words around. Just because he didn’t say “MMR causes autism” doesn’t mean he didn’t say it, you know, without saying it. But perhaps the best bit of evidence that he said it is his own patent application for a measles vaccine. Oh, yes, dear reader(s), Mr. Wakefield applied for a patent for his own version of the vaccine he so vilified.

And his cult followers have the audacity to say that I’m the one with the conflict of interest?

In the application, Wakefield attributes what he calls “Regressive Behavioural Disorder” to the MMR vaccine. Now, what the hell do you think he means by “Regressive Behavioural Disorder”? Does he mean an ingrown toenail? No. A sore throat? No. No. No. He [expletive] means “AUTISM”.

Page 3, line 9:

“I have also found that regressive behavioural disorder (RBD) in children is associated with measles, mumps and rubella (MMR) vaccination.”

Let that sink in for a second.

Ah, all sunk in? Now, how will you respond next time someone says to you that Wakefield didn’t say that MMR causes autism? I hope you respond by waving this patent application in the face of the Wakefieldite. Because not only are they endangering public health by scaring people away from MMR immunization by citing a fraud of a “study”, they seem to be outright lying when they say that he didn’t say what he says right there in his own words.

Not only that, dear reader(s), Wakefield had a clear conflict of interest in publishing his “study”. The patent application above is from 1997. His paper in The Lancet was published in 1998. All this time, he knows that he has an interest in the MMR vaccine falling out of favor so that his vaccine can take over, and he and his proxies still have the audacity to say that he was doing this out of his desire to help children with autism? Really?

I’ll leave you with a bit of advice. You know how you’ll be able to recognize Wakefieldites when you see them? They’ll be the ones walking into the room with their testicles on a wheelbarrow… Because it takes a really big pair of brass ones to say what they say with a straight face in light of the evidence.