In the Wakefield

Andrew Wakefield and his supporters (Image from depletedcranium.com)

Last week brought news (but, it should be noted, not “new” news) that the British Medical Journal is about to publish an article by journalist Brian Deer implicating defrocked British physician Andrew Wakefield in outright fraud related to his allegations of a link between vaccinations and autism.

In 1999, Wakefield and co-authors published a study in the prestigious British medical journal The Lancet which claimed a strong association between the use of combined mumps-measles-rubella (MMR) vaccine and autism.

Given the incidence of autism-spectrum disorders, which now approaches 1% in the U.S., and the emotional pain inflicted on autism sufferers and their “neuro-typical” family members, it’s obviously of keen interest to the medical community and the public at large to get to the bottom of the current upswing in diagnosed autism cases. Wakefield’s article generated a huge amount of interest.

Problem is, it’s all lies.

For a time after its initial publication in 1999, one could make the argument that Wakefield was misguided and not a con man. However, that time has passed. Deer’s work, and that of others, has conclusively shown that Wakefield perpetrated a fraud of incredible proportions.

Wakefield’s co-authors have all abandoned him. No one has been able to replicate Wakefield’s work. Seth Mnookin, whose upcoming book The Panic Virus is set to savage Wakefield further, has some criticisms of the way the BMJ announcement was handled, but not of their basic findings.

I am struck by the parallels between Wakefield and his British and American supporters, and the Tea Party movement in America. In both cases, there is an outright denial of objective facts and truth, in favor of an emotionally based appeal to fear. In both cases, there is an explicit or implicit conspiracy theory that underpins the claim of victimhood. For example, Wakefield has claimed Deer is a “hit man brought in to take me down” in the employ of Big Pharma and the Monolithic Medical Community when in point of fact there’s ample evidence that Wakefield himself perpetrated this particular fraud in order to financially benefit from a role as an expert witness in civil suits against Big Pharma.

Dose-Response Curve (Image from merckmanual.com)

There’s no doubt that mercury, in sufficiently high doses, can cause brain damage. No one disputes this. The technical aspect of the argument has to do with something called a “dose-response curve” where we plot the response (in this case, brain damage) versus the dose of the substance. Most people (incorrectly) assume that dose-response curves are linear. That is, if I consume 10 milligrams of mercury and it kills 100 brain cells, that if I consume 1 milligram of mercury it will kill 10 brain cells. That’s not the case for most substances. Note that at the left end of the curve pictured here, there is no effect whatsoever regardless of the dose. Probably something like this happens with mercury (actually the mercury salt thiomerosal) in vaccines, but as far as the low end of the dose-response curve, technical difficulties make this hard to test in animal systems. You would have to give millions of mice (for example) tiny doses to see any effect. In the absence of any evidence for an effect in humans, there’s really no reason to embark on such an expensive and time-consuming study.

Dr. Jen Gunter’s blog posted up an excellent article yesterday on whether “heavy metal poisoning” due to vaccines is reality or fantasy.

Humans are wired to associate events, even when no association exists. It’s a survival skill. (“I ate two of those purple berries from the bush over there, and a few hours later, I felt really sick. I hate that bush and all purple berries.”) It worked well in the primordial environment, but it steers us wrong in our complex modern world. (“Barack Obama gave a speech, and the stock market tanked. I hate Barack Obama and everything he stands for.”)

Is the Tea Party a good example of a Panic Virus?

About Monotreme

Monotreme is an unabashedly liberal dog lover, writer, and former scientist who now teaches at a University in an almost-square state out West somewhere. http://www.logarchism.com | http://www.sevendeadlysynapses.com
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21 Responses to In the Wakefield

  1. fopplssiegeparty says:

    Yes.

    And you have also now pissed off the scientific giant Jenny McCarthy.

  2. filistro says:

    But alarmism, paranoia and fact-free outrage are just so much more fun than logic and reason.

  3. mclever says:

    I’m not sure the Panic Virus applies to all Tea Partiers…

    The folks who thought, “Keep the damn guberment hands off my Medicare!” were definitely in the panic virus class. People who think Obama is the anti-Christ… Or people who think Bush was behind the 9/11 attack on NY…

    The real way to tell, is how they respond to evidence contrary to their “Panic Virus” belief. If a former-birther listens to Hawaii state officials and accepts their verification of Obama’s birthplace, then they’re not in the Panic Virus class. But if they persist in their birther beliefs despite reasonable evidence to the contrary, then they’d be the Panic Virus type…

  4. filistro says:

    Treme… Do you have any theories or speculation on the staggering increase in autism? When something so serious is approaching 1%, that’s nearing catastrophic. I’ve searched my memory and I can recall some kids back in my school days who were pretty odd ducks, but not anything approaching the level of handicap I see among students in my grandkids’ classes. Maybe back in the day, severely autistic kids just didn’t attend school? Still, there are a LOT more now.

    Is it environmental? Pollution in the gene pool? Mishaps during pregnancy? Why is this happening now?

  5. shortchain says:

    filistro,

    You left out the increased visibility of these disorders. I can tell you for certain that, when I was a child (back in the 50′s), there were weird kids who probably would now be identified as on the autism scale. Back then they were just held back for a year until they were bigger than their classmates. No further problems of being picked on for being different. Of age, they went into the Army and disappeared from civil society. No further problem in that regimented (in the non-metaphorical sense) environment.

  6. filistro says:

    SC… you think autism is not more prevalent, just more visible? I’m not sure.

    I think it’s somehow in the same category as peanut allergies. I suspect you and I are close to the same age, and when we were kids, nobody was allergic to nuts. We happily brought pbj sandwiches in our lunch, ate brownies chock full of walnuts and munched shelled peanuts in the park after school.

    Nowadays nothing that has ever been in the same room with a nut can be allowed to pass the school doors anywhere in the land, for fear some poor kid will get a whiff of it and drop dead. Nobody EVER dropped dead of nut allergies back in our nut-rich childhood.

    So whats’ going on? Are sunspots causing lethal mutations in our DNA, or what?

  7. shortchain says:

    filistro,

    And you know that kids who died suddenly back then didn’t die of anaphylactic shock? Having been the victim of medicine in that era, I have no faith that a correct post-mortem diagnosis would have been arrived at.

    BTW, peanut allergies (and many other allergies) appear to be largely a product of the ultra-clean environment infants are kept in today. Back when, we rolled in the dirt with the dogs.

    Ditto for asthma.

  8. filistro says:

    @shortchain… Back when, we rolled in the dirt with the dogs.

    LOL… I distinctly recall working in the garden when I was four or five, and wondering whether it was okay to eat a carrot I’d just pulled without washing it, and my grandma telling me in all seriousness that “every child should eat one pound of dirt a year to be healthy.” Being quite a methodical, scientific child, I immediately began trying to calculate how large a container would have to be to hold a pound of dirt, and whether I was getting my full allotment or needed to step it up a bit.

    What occurs to me now is… the garden was fertilized with dried manure from the winter corrals. No wonder I enjoy such robust health ;-)

    Come to think of it… it does seem to be the cleanest, most gently-reared children who are prone to allergies. Those tough little buttons who arrive at school with dirty faces, no jackets and freezing bare feet in rubber boots.. they’re NEVER sick.

  9. shortchain says:

    Here’s paper which documents the historical pattern of childhood mortality. You may find it useful.

    One of the things I note is that, over time, one of the largest and most persistent declines has been in parasitic and infectious diseases. It appears, thanks to recent scientific studies, that certain parasites and other biological agents have the capability of moderating immune system response. I make no claims here. This is merely an item of interest.

  10. filistro says:

    Oh come on, make a claim :-)

    Are you saying modern kids are lacking “certain parasites and other biological agents” that are actually necessary to their immune systems? Or am I misunderstanding you?

    Interesting article, BTW. I have bookmarked it to read more thoroughly, because on a quick once-through it reinforces a couple of my own much-less-educated theories. (I really like when that happens ;-)

  11. shortchain says:

    filistro,

    We all enjoy bias confirmation. Just don’t let it get to be a habit. “Necessary” — I won’t say that. I’ve gotten along just fine without hookworm, thanks very much. However, you may wish to check out this. It’s a very active area of research. You can buy worms by mail — there was a show on it on NPR’s “radio lab”.

    It seems to be no accident or coincidence that the kids who don’t show up scrubbed and spotless are healthier, although this does not seem to be widely accepted science yet.

    But if being dirty in childhood means healthier as an adult, I’ll probably outlive almost all my age-group.

  12. Monotreme says:

    fili,
    Sorry, things are crazy here. I just now got time to check in on this thread. Also, for some reason, it’s not showing up for me — I have to “ask” for it.

    Anyway, in answer to your question:

    Is it environmental? Pollution in the gene pool? Mishaps during pregnancy? Why is this happening now?

    my experience as a scientist is that when you have to ask the question this way, the answers are (respectively) yes, yes, yes, multifactorial.

    Seriously, though, when there are competing hypotheses for “why” a certain disease or mechanism exists, I usually look for a theory that encompasses all of them. I think there are environmental factors (of which over-vaccination may play a minor role in a small minority of susceptible individuals); there may be increased reproductive fitness in autistic individuals (that is, there may be more people with autism spectrum disorders who marry and have children); more older women are having children, and more IVF techniques are available; and we are getting better at recognizing and diagnosing autism spectrum disorders. So, all of the above, and a dozen or more other things I haven’t even mentioned.

    I agree that 1% is quite troubling. We need to look at this. One thing you didn’t mention is that we used to force children to interact with adults on a regular basis. Now, as an adult without children, I’m considered a little “odd” or “creepy” if I interact with children at the grocery, in an airport, or the like. Parents have become so afraid of the (exceedingly rare) abduction of their children that they are cutting off their children from all sorts of social interaction at an early age. So I also think that we are not “challenging” children with social interaction at an early age.

    Shortchain, at least among the scientists I interact with, the idea of too much cleanliness leading to autoimmune diseases is accepted fact. I will go dig up some references now.

  13. Monotreme says:

    http://scholar.google.com/scholar?q=hygeine+hypothesis&hl=en&btnG=Search&as_sdt=1%2C45&as_sdtp=on

    fili, you’ll like the article in this list called “Eat Dirt”:

    http://www.nejm.org/doi/full/10.1056/NEJMe020092

    Also note that multiple sclerosis has been (loosely) linked to pets in the household. In all these cases, one needs to do the cost-benefit. I think the chance of getting autism from MMR vaccination are much, much lower than the chance of dying from mumps (for example).

    As an aside, in the MS/pets article, notice how real scientists report their findings:

    These results suggest that exposure to house pets may sometimes be associated with subsequent M.S. Our findings should be interpreted with caution until they are confirmed by others.

    Compare and contrast this to Wakefield’s overblown and absurd claims.

  14. Monotreme says:

    In the interest of fairness, I would point readers to the recent Jenny McCarthy article:

    http://www.huffingtonpost.com/jenny-mccarthy/vaccine-autism-debate_b_806857.html

    Note, however, that she’s focused on the veracity of the autism/GI disorders link, which is well-established, and not on the veracity of the vaccine/autism link, which is extremely tenuous.

  15. Bart DePalma says:

    Mono:

    Humans are wired to associate events, even when no association exists. It’s a survival skill. (“I ate two of those purple berries from the bush over there, and a few hours later, I felt really sick. I hate that bush and all purple berries.”) It worked well in the primordial environment, but it steers us wrong in our complex modern world.

    Now apply the principle that correlation does not equal causation to the AGW faith.

    “Barack Obama gave a speech, and the stock market tanked.

    Actually, Obama gave approximately eleven speeches on the economy during this period and the stock market tanked every time without another alternative substantial economic event. (Thank you Michael for your constructive criticism which pushed me to test this hypothesis down to every speech Obama gave during the Jan-Mar 09 market dive.)

  16. Monotreme says:

    Barted:

    Now apply the principle that correlation does not equal causation to the AGW faith [sic].

    I did already.

  17. Mainer says:

    As one with experience in the educational system going back to 1970 and now 2 grandsons that are affected by Autism I can pretty much tell you that 1, it is sadly real 2, exploding at a very scarry rate, and 3 lacking in very many good treatment options.

    I have a back woods idea that I would love to have those on here much smarter than I in such matters consider. I am concerned that we have wandered into a world in which we are constantly exposed to toxins or chemicals of one sort or another. Given that maybe any one, two or seventy eleven of them will not by themselves adversley harm us what is the possibility that we are dealing with some thing that is reflective of many chemicals in our food chain or that are around us all the time that taken or being exposed to individualy would not have noticable harmful effect but in combination will in certain individuals cause what we are looking at with so many with Autism spectrum illness.

    I have a really bad feeling on this one that both sides of the family for these two great little guys have been military. Is there even a remote possibility that all of the shots we have had could now be causing what we are now seeing?

    School systems are already overwhelmed with this and it seems to be getting worse. With ADD and ADHD we at least had sollutions which now have been in place long enough that medical and educational programs have been honed and allow for the issues surrounding them to be controlled and worked around. I do not at present see those answers even on the horizon for those falling into the Autism spectrum.

  18. filistro says:

    @Mainer… I have a really bad feeling on this one that both sides of the family for these two great little guys have been military.

    That’s the sort of thing I’ve been wondering, too. What we need in order to determine causation is establish some kind of common thread.. but what if the cause is something SO COMMON that we can’t see it… because it’s part of everybody’s life?

    Like those vaccinations we has as kids that were so potent we all carry the scars to this day… or the super-strong birth control pills we took in the years when we were gestating the babies who are now the parents of these little wounded kids.

  19. dcpetterson says:

    The Market was tanking throughout that period, Bart. It even fell on days Obama did not< give a speech. I drank milk on all of those same days. You have furnished no mechanism, as has been said repeatedly. Give it up.

    Fascinating article, Monotreme. I need to dig into more thoroughly later. Well done.

  20. shortchain says:

    My understanding of the studies trying to find a statistically significant relationship between vaccinations and autism is that, except for the study by Wakefield, which was, apparently, fraud, they haven’t found any statistically significant relationship.

    Contrast this with the fact that, as NOAA has found, for the 34th consecutive year, the Earth’s average temperature was above average. 9 of the 10 warmest years in history have now occurred since 2001. You can check the statistics on those events under the null hypothesis, that it’s just a fluke. Now that’s what I call significance.

    Apropos of autism studies, did anybody else check out the report in the NYTimes about the brouhaha over a paper to be published on ESP?

    Here’s the thing: if you perform a bunch of tests, and 1 out of 20 of them shows a statistically significant result, are you then allowed to claim that the H1 hypothesis cannot be *rejected? (Note for the statistically challenged: this does not apply in the AGW situation, as we are only engaged in one, long experiment.)

    * — I say you can reject the H1 hypothesis in that case.

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