EBD Blog

As most readers probably know, the UK General Medical Council censured Dr. Andrew Wakefield for his research that supposedly shows a link between immunization with the measles-mumps-rubella (MMR) vaccine and autism. The Autism corner of the blogosphere has been rife with discussion (more than what I can up with keep). However, Liz Ditz has been maintaining a catalog of notes pro and con regarding the finding. For those who are interested, read Andrew Wakefield: Dishonesty, Misleading Conduct, and Serious Professional Misconduct: Blog Posts Critical of Verdict; Blog Posts Approving of Verdict

Also see theBBC news coverage, MMR scare doctor ‘acted unethically’ panel finds, and the UK Telegraph story, “GMC brands Dr Andrew Wakefield ‘dishonest, irresponsible and callous’.”

I want to note that readers should understand that the GMC investigation, though very important, did not expressly examine the scientific basis of Dr. Wakefield’s case. The findings discuss whether he was qualified to do the work and followed procedures in seeking approval for it. The scientific strength of the findings from the study in question have been examined extensively by well-qualified researchers and found wanting, though (see, for example, Hornig et al., 2008).

An individual who goes by the screen name C0nc0rdance posted a pair of videos to YouTube on 1 October 2009 that make a clear and compelling case for ignoring ill-reasoned arguments recommending that parents avoid vaccinating their children.

When we make risky decisions about our health, it’s always good to be in possession of all the facts, to let our brains, and not our hearts, make the decision. Your child is thousands of times more likely to die from a preventable disease you didn’t vaccinate them against than to develop autism from a vaccine you did give them. The case for autism and vaccines is solely based on weak correlations and emotional responses.

Continue reading ‘C0nc0rdance’s anti-vax takedown’

Over on Science-Based Medicine, John Snyder has an extended post that systematically analyzes the assertions of Robert Sears about vaccinating children. The title is “Cashing In On Fear: The Danger of Dr. Sears.” Highly recommended.

The spring 2009 issue of Stanford Medicine Magazine, a publication of the Stanford University School of Medicine, examines the turmoil swirling around vaccines. In “Hot Shots: Vaccines under the gun” one can read any of ten articles (not counting an introductory comment by Rosalyn Carter):

• The demonization of immunization: Shots get the once-over
• What is a vaccine? Immunization demystified
• Asking How: Vaccine Side Effects Probed
• When science gets hijacked: NBC News chief medical editor tells why she broke her silence
• Insourced to India: A vaccine for a scourge of the developing world
• Peet’s passion: The medical education of Amanda Peet
• Field yields: Can genetically engineered plants provide vaccines?
• Shoot it, don’t smoke it: An injectable tobacco-grown vaccine
• Golden needles: Vaccines for seniors
• Grow up: Can vaccines built for kids work in older immune systems too?

Few of the folks who ardently oppose vaccines will likely be swayed by the content provided here. However, this magazine provides an excellent broad-brush treatment of the topic for those who are curious, savvy, and vulnerable to reason.

Link to the issue on the Web. Flash of the electrons to Liz Ditz for alerting me to this excellent resource.

Probably someone’s done a much more sophisticated version of this analysis, but I fiddled with it just to see what I’d find. I took the number of children identified as having Autism by the schools in each US state (as a percentage of the state’s population) and correlated that with the number of children who are immunized in each state (also as a percentage). If vaccination ==> Autism, then states where vaccination rates are higher should have higher rates of Autism, and vice versa.

The relationship between the two variables is .071, which is not a significant correlation when one has 50 pairs of scores. In fact, for the a correlation to be significant at the convention level (p < .05), it would have to be > .275.

Sources:

• The 2006 U.S. Report to Congress on IDEA, Volume 2, p. 38.
• The H. K. Kaiser Foundation’s State Health Facts data on immunizations.

Please keep in mind that I’m not offering this analysis as anything profound. There are much stronger data showing a lack of relationship between immunizations and Autism. I just happened on the data and figured I’d entertain myself with analyzing them.

Over on Science-Based Medicine, Dr. David Gorski has an extended entry entitled “2009: Shaping up to be a really bad year for antivaccinationists.” Dr. Gorski, who has repeatedly written on the topic of putative causes of Autism, connects lots of dots in this piece.

For folks who are following press coverage of Autism, there are two items of potential interest in the New York (NY, US) Times. Under the headling “Book Is Rallying Resistance to the Antivaccine Crusade,” Donald G. McNeil, Jr., reports about the effects of Dr. Paul Offit’s book Autism’s False Prophets on efforts by some to dissuade people from vaccinating their children. According to a note appended to the story, another relevant article is pending: “Next week: In the Personal Health column, Jane E. Brody will write about efforts, so far fruitless, to find a cure for autism.”

Link to Mr. McNeil’s article.

It will be interesting to watch what happens if Dr. Sanjay Gupta becomes US Surgeon General and a chief advisor on public health policy for the Obama administration, as many news sources are reporting is likely to happen. Of special interest to those who are concerned about Emotional and Behavioral Disorders will by how Dr. Gupta addresses issues associated with Autism. Vaccines? Facilitated communication?

As Harold Doherty noted about a year ago on Facing Autism in New Brunswick, in his public career on the news-and-information source CNN Dr. Gupta has promoted discussion of some questions from his CNN pulpit. However, there is a lot more to Autism than providing a forum for people to brandish their often-ill-informed opinions about vaccines.

CNN is one of the world’s great communication and education organizations. People around the world listen to CNN and learn about the world from CNN. Hopefully Dr Gupta means it when he says he wishes to report on ALL aspects of autism. He might start by visiting the Long Island residential care facility where a middle aged woman who could not communicate at all was repeatedly abused by staff until outed by a conscientious co-worker and video recordings. The good doctor could also interview people with knowledge of the life of Tiffany Pinckney who died in Toronto from starvation and neglect while living in “the care” of her adoptive sister. Or he could talk to parents whose autistic children wandered into traffic to be lost forever or who have been restrained physically, left in a brick walled isolation room for hours, or simply sent home from school.

The list could continue: Parents who have taken out mortgages to secure financing for the private therapy their children desperately need but that schools will not provide. Promulgation of best-evidence interventions. Coordination of services across the disparate agencies that affect the services individual children receive. Respite care so that parents can catch their breath for a weekend. Etc. And we haven’t even begun to list medical, behavioral, or educational research needs. (Add other potential foci in the comments, please.)

As the holder of one of the most influential posts in public health, Dr. Gupta will need to wade into some difficult issues. He will have to go beyond simply making statements that solicit viewer interaction while avoiding alienating them, a strategy that serves one well in promoting discussions. Discussions are nice, but US health policy—about Autism and many other issues closely connected to Emotional and Behavioral Disorders—needs bold leadership informed by the best available science. Such leadership is likely to cause dissatisfaction among those who receive their wisdom from anecdotes told on popular mass media shows, give as much credence to evidence-based presentations as to an individual’s illogical assertion of correlation, and embed ad hominem attacks in their anonymous comments on discussion boards.

How would Dr. Gupta respond to questions posed by folks representing diverse views about Autism (see, e.g., Kristina Chew’s note about the participation of the Autism Self-Advocacy Network in discussions with the Obama administration)?

Review Mr. Doherty’s comments from his post about Dr. Gupta in January of 2008. For a sample of the interactions about Autism that have been engendered by Dr. Gupta’s work on CNN, see this discussion of vaccinations. Consider saying something about Dr. Gupta’s CNN pieces on FC.

Updates (of a more general nature):

• PZ Myers of Pharyngula—I’m not so sure about this pick;
• Orac of Respectful Insolence—Dr. Sanjay Gupta Surgeon General? Yawn.;
• Matthew Nisbet of Framing Science—Quick Thoughts on Sanjay Gupta and CNN Science;

More: Huffingtonpost post: Conyers: Obama Should Not Nominate Sanjay Gupta;
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