Dr. Bob Sears' Alternate Reality or Everyone is a Pharma Shill

On 17 February 2011, Dr. Bob Sears appeared on The Dr. Oz Show; the topic was "What Causes Autism". Dr. Oz packed the audience with mainly those who believe autism is caused by vaccines thus setting up all of the legitimate panel members (paediatricians) to be on the defensive. It was a live viewing, however, of how "alternative" practitioners get to play by their own rules enticing the audience, leaving those who remain true to the facts appearing unsympathetic and cold. One particular statement that Dr. Bob made was rather sensational and undoubtedly meant to be:

"Most of the vaccine studies that show no link between vaccines and autism are funded by the pharmaceutical companies."

Audience applause then:

"In fact, if you look at the 23 major studies that have shown no link, 18 of them are funded by big pharma."

Yes, he really did say "big pharma". Needless to say, I found this claim rather intriguing so I asked Dr. Bob which studies was he referring to:

On the Dr. Oz Show about autism a couple of weeks ago, you stated that most studies exonerating vaccines as the culprit for autism were pharma-funded, 18/23 to be exact. I'm very curious as to which 23 studies you were referring to.

He kindly replied:

Not counting studies labeled as “commentary,” since that isn’t original research, I count 18 out of 23. There may be some studies I didn’t include here, but these are most of them:

Studies that compared children who received vaccines with mercury with children who did not and found no association between vaccine mercury and autism:

1.) Association between thimerosal-containing vaccines and autism, Hviid A, et al., JAMA 2003;290(13):1763-66. Pharma-funded. http://jama.ama-assn.org/content/290/13/1763.long

2.) Mercury concentrations and metabolism in infants receiving vaccines containing thimerosal: a descriptive study, Pichichero M, et al., Lancet 2002;360(9347):1737-41. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/12480426

3.) Thimerosal and autism? Nelson K and Bauman M., Pediatrics 2003;111:674-79. Commentary. http://pediatrics.aappublications.org/cgi/content/full/111/3/674

4.) On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes, Smith M. and Woods C. Pediatrics 2010;125(6):1134-41. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/20498176

Studies that show autism continued to increase even after mercury was removed from vaccines:

5.) Thimerosal and the occurrence of autism: negative ecological evidence from danish population-based data, Madsen K, et al., Pediatrics 2003;112:604-606. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/112/3/604?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=madsen&searchid=1&FIRSTINDEX=0&volume=112&issue=3&resourcetype=HWCIT

6.) Continuing increases in autism reported to california’s developmental services system, Schechter R, Grether, J., Arch Gen Psychiatry 2008;65(1):19-24.http://archpsyc.ama-assn.org/cgi/content/full/65/1/19

7.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al., Pediatrics 2006;118:e139-e150. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/118/1/e139

Studies that examined the rates of autism compared to the cumulative levels of mercury in vaccines and found no association:

8.) Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism, Price C. et al., Pediatrics 2010;126:656-64. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/20837594

9.) Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization database, Verstraeten T. et al., Pediatrics 2003;112:1039-48. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/112/5/1039

10.) Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines, Tozzi A, et al., Pediatrics 2009;123:475-82. http://pediatrics.aappublications.org/cgi/content/full/123/2/475

11.) Autism and thimerosal-containing vaccines: lack of consistent evidence for an association, Stehr-Green P., Am J Prev Med 2003;25(2):101-106. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/12880876

12.) Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the united kingdom does not support a causal association, Heron J, et al., Pediatrics 2004;114:577-83. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/114/3/577

13.) Early thimerosal exposure and neuropsychological outcomes, Thompson W, et al., N Engl J Med 2007;357:1281-92. Pharma-funded. http://www.nejm.org/doi/full/10.1056/NEJMoa071434#t=articleTop

14.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al., Pediatrics 2006;118:e139-e150. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/118/1/e139

Research comparing autism rates in children who did and did not receive the MMR vaccine and found no increased risk of autism:

15.) A population-based study of measles, mumps, and rubella vaccination and autism, Madsen KM, et al. N Engl J Med 2002;347(19):1477-82. Pharma-funded. http://www.nejm.org/doi/full/10.1056/NEJMoa021134#t=articleTop

16.) No effect of MMR withdrawal on the incidence of autism: a total population study, Honda H, et al., J Child Psychology and Psychiatry 46:6 (2005); 572-79. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/15877763

Research that duplicated Wakefield’s study and found no association between MMR and autism:

17.) Lack of association between measles virus vaccine and autism with enteropathy: a case-control study, Hornig M, et al., PLoS ONE 2008;3(9):e3140. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526159/?tool=pubmed

Studies showing no evidence of a temporal relationship between MMR vaccine and autism:

18.) MMR vaccination and pervasive developmental disorders: a case-control study, Smeeth L, et al., Lancet 2004; 364:963-69. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/15364187

19.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al., Pediatrics 2006;118:e139-e150. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/118/1/e139

20.) No evidence for a new variant of measles-mumps-rubella-induced autism, Fombonne E and Chakrabarti S, Pediatrics 2001;108:e58. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/11581466

21.) No evidence for links between autism, MMR, and measles virus, Chen W. et al., Psychological Medicine 2004;34(3):543-53. http://www.ncbi.nlm.nih.gov/pubmed/15259839

22.) Neurologic disorders after measles-mumps-rubella vaccination, Mäkelä A, et al., Pediatrics 2002;110:957-63. Pharma-funded. http://pediatrics.aappublications.org/cgi/content/full/110/5/957

23.) Association of autistic spectrum disorder and the measles, mumps, and rubella vaccine, Wilson K. et al., Arch Pediatr Adolesc Med 2003;157:628-34. Commentary. http://archpedi.ama-assn.org/cgi/content/full/157/7/628

24.) Vaccines for measles, mumps and rubella in children, The Cochrane Database of Systematic Reviews 2005; issue 4. Commentary. http://www.ncbi.nlm.nih.gov/pubmed/16235361

Studies that show no link between MMR and autism or gastrointestinal disease:

25.) MMR vaccine and autism: an update of the scientific evidence, DeStefano F., Thompson W., Centers for Disease Control, Expert Review of Vaccines 2004;3(1):19-22. Commentary. http://www.ncbi.nlm.nih.gov/pubmed/14761240

26.) Measles vaccination and antibody response in autism spectrum disorders, Baird G, et al., Arch Dis Child 2008;93:832-37. Pharma-funded. http://www.ncbi.nlm.nih.gov/pubmed/18252754

27.) Unintended events following immunization with MMR: a systematic review, Jefferson T. et al., Vaccine 2003;21(25-26):3954-60. Commentary. http://www.ncbi.nlm.nih.gov/pubmed/12922131

28.) A case-control study of measles vaccination and inflammatory bowel disease, The East Dorset Gastroenterology Group, Feeney M. et al., Lancet 1997;350(9080):764-66. http://www.ncbi.nlm.nih.gov/pubmed/9297995

Miscellaneous

29.) Immunization Safety Review: Vaccines and Autism, Immunization Safety Review Committee, Washington, DC: Institute of Medicine of the National Academies, 2004. Commentary. http://www.ncbi.nlm.nih.gov/books/NBK25344/

Research can be funded in numerous ways, for example, government institutions such as the NIH or CDC, special interest groups such as Autism Speaks or Autism Science Foundation, charitable/philanthropic organisations such as The David & Lucile Packard Foundation or Wellcome Trust and of course, industry such as pharmaceutical or agricultural companies. When Dr. Bob states, "funded by pharmaceutical companies", that has a very specific meaning, that the study was funded by pharmaceutical companies. Let's look at the funding sources for those he tagged as "pharma-funded":

1.) Association between thimerosal-containing vaccines and autism, Hviid et al.
Author Affiliations: Danish Epidemiology Science Centre, Department of Epidemiology Research (Messrs Hviid, Wohlfahrt, and Dr Melbye) and Medical Department (Dr Stellfeld), Statens Serum Institut, Copenhagen, Denmark.
Funding Statement: This study was supported by grant 11 from the Danish National Research Foundation and grant 22-02-0293 from the Danish Medical Research Council.

The Danish System is unique in that they have universal healthcare; Statens Serum Institut (SSI) is a public enterprise that operates under the Danish Ministry of Health. SSI has a division which develops vaccines and is essentially, a non-profit. SSI also has divisions which operate much like the CDC in the U.S. These divisions are where the authors of this study are employed. A comprehensive explanation of SSI's structure can be read here. This is not "big pharma" by any stretch of the imagination.

2.) Mercury concentrations and metabolism in infants receiving vaccines containing thimerosal: a descriptive study, Pichichero M, et al.
Author Affiliations: Department of Microbiology/Immunology, University of Rochester, Rochester, New York, NY, USA.
Conflict of Interest: None declared.
Funding Statement: The investigation was funded by the US National Institutes of Health (NIH), Bethesda, MD, under contract 1 AF-45248.

4.) On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes, Smith M. and Woods C.
Author Affiliations: University of Louisville School of Medicine, Division of Pediatric Infectious Diseases, 571 S Floyd St, Suite 321, Louisville, KY 40202, USA.
Conflicts of Interest: Drs Smith and Woods are or have been unfunded subinvestigators for cross-coverage purposes on vaccine clinical trials for which their colleagues receive funding
from Wyeth, Sanofi Pasteur, GSK, MedImmune, and Novartis; and Dr Woods has received honoraria for speaking engagements from Merck, Sanofi Pasteur, Pfizer, and MedImmune and has received research funding from Wyeth and Sanofi Pasteur.
Funding Statement: This study was conducted without funding from any company (e.g., vaccine manufacturer) or agency (e.g., the CDC). We conducted this study on our own after requesting and receiving the publicly available data that were used for the analyses. Our unrelated interactions with vaccine manufacturers have been appropriately disclosed for full transparency in accordance with our own ethical standards as well as formal guidelines from the Academy of Pediatrics and the University of Louisville.

This is what Dr. Bob had to say about the study when he was asked (he also copied a communication from Dr. Rosen included in the preceding link):

Major flaws by Dr. Bob Sears - posted on 5/25/2010
Let me first say I haven't read it yet. Too busy in office last few days. But here are three observations: 1 - they excluded kids with autism from the study (DUH! - that's the type of kids you'd want to include in this!)
2. Hugely funded by pharmaceutical companies - the list of conflict of interest is quite long. Publishing a study like this with pharma funding is 100% worthless - the only people who will believe it are those who don't mind conflicts of interest.
3. Here's a comment from one of a doctor in the AAP who heads up one of the AAP divisions: this is the letter he wrote the journal:

"Dear Sirs,

I read with great interest Smith and Woods article, "On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes." This issue is of paramount importance in clinical primary care practice today. However, I was dismayed by two factors within minutes of reading the piece. One, of perhaps lesser importance, in the Results Section, the numbers, simply put, do not add up. If all of the subjects are added as listed, a total of 1037 (not 1047) is obtained. Furthermore, the percentages are incorrect as listed. The final group (311) is in fact 30% of the incorrect total, not 20% as listed. It always concerns me and forces me to question the validity of the other findings when a mistake like this is notable. In any case, the finding that approximately 50% (depending on the true numbers) received an alternative vaccine schedule, even as long ago as 1993-1997 is of interest.

Of greater concern to me, personally, is the Financial Disclosure listings. It is very difficult in this day and age to review the authors' conclusions without considering their considerable potential biases given where their funding comes from. I believe every known vaccine manufacturer is listed on the payroll. Until we have well-done, conflict- free published research on this topic, both the public and skeptical physicians must continue to look for honest answers."

Dr. Bob didn't even read the study, let alone read the response that Dr. Rosen received about funding sources (self-funded) from the authors and absolutely no pharmaceutical funding. He doesn't even grasp that Dr.s Smith and Woods used the data set from Thompson et al. (13), which specifically excluded autism and explained why. This is just Dr. Bob being intentionally misleading so he doesn't have to confront any evidence that is antithetical to his "trademark alternative vaccine schedule".

5.) Thimerosal and the occurrence of autism: negative ecological evidence from danish population-based data, Madsen K, et al.
Author Affiliations: Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, Denmark
Institute for Basic Psychiatric Research, Department of Psychiatric Demography, Psychiatric Hospital in Aarhus, Risskov, Denmark
National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark
State Serum Institute, Department of Medicine, Copenhagen, Denmark
Funding Statement: The activities of the Danish Epidemiology Science Centre and the National Centre for Register-Based Research are funded by a grant from the Danish National Research Foundation. This study was supported by the Stanley Medical Research Institute. No funding sources were involved in the study design.

7.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al.
Author Affiliations: Department of Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada
Lester B. Pearson School Board, Montreal, Quebec, Canada
Conflicts of Interest: In the United Kingdom, Dr Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers, and to several government committees between 1998 and 2001. Since June 2004, Dr Fombonne has been an expert witness for vaccine manufacturers in US thimerosal litigation.
Funding Statement: None of his research has ever been funded by the industry.

8.) Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism, Price C. et al.
Author Affiliations: Abt Associates Inc, Cambridge, Massachusetts;
National Center for Chronic Disease Prevention and Health Promotion, Immunization Safety Office, and Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
Division of Research, Kaiser Permanente Northern California, Oakland,California;
Department of Psychiatry and Behavioral Sciences, Kaiser Permanente ASD Center San Jose Northern California Region, Stanford University, Palo Alto, California;
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts;
Southern California Kaiser Permanente, and Center for Vaccine Research, University of California, Los Angeles, California; and
Center for Health Research Southeast, Kaiser Permanente, Atlanta, Georgia
Funding Statement: This work was supported by a contract from the CDC to America’s Health Insurance Plans and via America’s Health Insurance Plans subcontracts to Abt Associates Inc; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School; Southern California Kaiser Permanente, and Center for Vaccine Research, University of California Los Angeles; and Division of Research, Kaiser Permanente Northern California.

Ironically, this is the study that Dr. Bob's colleague, Sally Bernard of SafeMinds participated in.

9.) Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization database, Verstraeten T. et al.
Author Affiliations: Epidemic Intelligence Service Program, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Vaccine Safety and Development Activity, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
University of Washington and Group Health Cooperative of Puget Sound, Seattle, Washington
Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, and Division of General Pediatrics, Children’s Hospital, Boston, Massachusetts
Kaiser Permanente Vaccine Study Center, Oakland, California
Funding Statement: None declared.

Ironically, this study group invited Dr. Bob's colleague, Lyn Redwood of SafeMinds to review the findings.

11.) Autism and thimerosal-containing vaccines: lack of consistent evidence for an association, Stehr-Green P. et al.
Author Affiliations: Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.
National Board of Health and Welfare (Tull), Stockholm, SwedenStatens Serum Institut (Stellfeld), Copenhagen, Denmark
National Centre for Register-Based Research (Mortenson), Aarhus, Denmark
National Immunization Program, Centers for Disease Control and Prevention (Simpson), Atlanta, Georgia, USA
Funding Statement: Financial support for the compilation of the data used in this investigation and the preparation of this report was provided by the National Immunization Program, Centers for Disease Control and Prevention. We are grateful to Victoria Romanus of the Swedish Institute for Infectious Disease Control, Ingrid Trolin of the Swedish Medical Products Agency, Anne-Marie Plesner and Peter Andersen of the Danish Statens Serum Institut, and Roger Bernier and Susan Chu of the Centers for Disease Control and Prevention for their contributions in the design and conduct of this investigation, and in the preparation and review of this manuscript.

12.) Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the united kingdom does not support a causal association, Heron J, et al.
Author Affiliations: Unit of Paediatric and Perinatal Epidemiology, Department of Community-Based Medical Sciences, University of Bristol, Bristol, United Kingdom
Funding Statement: Financial support for the establishment of the ALSPAC cohort was provided by the Medical Research Council, the Wellcome Trust, the UK Department of Health, the Department of the Environment, and DfEE, the National Institutes of Health, and a variety of medical research charities and commercial companies. Funding for this study was provided by the Department of Health (Ref VIE 134/1).

13.) Early thimerosal exposure and neuropsychological outcomes, Thompson W, et al.
Author Affiliations: From the Influenza Division and Immunization Safety Office , Centers for Disease Control and Prevention, Atlanta;
Abt Associates, Cambridge, MA;
Group Health Center for Health Studies, Seattle;
the Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston;
Kaiser Permanente Division of Research and Vaccine Study Center, Oakland, CA;
UCLA Center for Vaccine Research, Torrance, CA;
Southern California Kaiser Permanente, Los Angeles;
RTI International, Atlanta; and
Stanford University, Palo Alto, CA.
Conflicts of Interest: Dr. Thompson reports being a former employee of Merck; Dr. Marcy, receiving consulting fees from Merck, Sanofi Pasteur, GlaxoSmithKline, and MedImmune; Dr. Jackson, receiving grant support from Wyeth, Sanofi Pasteur, GlaxoSmithKline, and Novartis, lecture fees from Sanofi Pasteur, and consulting fees from Wyeth and Abbott and serving as a consultant to the FDA Vaccines and Related Biological Products Advisory Committee; Dr. Lieu, serving as a consultant to the CDC Advisory Committee on Immunization Practices; Dr. Black, receiving consulting fees from MedImmune, GlaxoSmithKline, Novartis, and Merck and grant support from MedImmune, GlaxoSmithKline, Aventis, Merck, and Novartis; and Dr. Davis receiving consulting fees from Merck and grant support from Merck and GlaxoSmithKline. No other potential conflict of interest relevant to this article was reported.
Funding Statement: Supported by the CDC.

14.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al.
Author Affiliations: Department of Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada
Lester B. Pearson School Board, Montreal, Quebec, Canada
Conflict of Interest: In the United Kingdom, Dr Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers, and to several government committees between 1998 and 2001. Since June 2004, Dr Fombonne has been an expert witness for vaccine manufacturers in US thimerosal litigation.
Funding Statement: None of his research has ever been funded by the industry.

15.) A population-based study of measles, mumps, and rubella vaccination and autism, Madsen KM, et al.
Author Affiliation: Danish Epidemiology Science Center, Department of Epidemiology and Social Medicine, Århus, Denmark;
Danish Epidemiology Science Center, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark; and
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta.
Funding Statement: Supported by grants from the Danish National Research Foundation; the National Vaccine Program Office and National Immunization Program, Centers for Disease Control and Prevention; and the National Alliance for Autism Research.

16.) No effect of MMR withdrawal on the incidence of autism: a total population study, Honda H, et al.
Author Affiliations: Yokohama Rehabilitation Center, Yokohama, Japan;
Institute of Psychiatry, London, UK
Funding Statement: None declared.

18.) MMR vaccination and pervasive developmental disorders: a case-control study, Smeeth L, et al.
Author Affiliations: Department of Epidemiology and Population Health;
Department of Infectious and Tropical Diseases ;
London School of Hygiene and Tropical Medicine, London, UK;
Department of Psychiatry, McGill University, Montreal Children’s Hospital, Canada;
and Institute of Psychiatry, Kings College, London, UK
Conflicts of Interest: L Smeeth, C Cook, L Heavey, L C Rodrigues, and P G Smith have no conflicts of interest. E Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers (for a fee), and to several government committees. A J Hall received a financial contribution from Merck towards research on hepatitis B vaccination in 1998. He is also a member of the Joint Committee on Vaccines and Immunisation (2002–present).
Funding Statement: The study was funded by the UK Medical Research Council. L Smeeth is supported by a Medical Research Council Clinician Scientist Fellowship.

19.) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations, Fombonne E, et al.
Duplicate of (14)

20.) No evidence for a new variant of measles-mumps-rubella-induced autism, Fombonne E and Chakrabarti S
Author Affiliation: Institute of Psychiatry, Department of Child and Adolescent Psychiatry, King’s College London, London, United Kingdom;
Child Development Center, Central Clinic, Stafford, United Kingdom.
Funding Statement: None declared.

22.) Neurologic disorders after measles-mumps-rubella vaccination, Mäkelä A, et al.
Author Affiliations: Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland.
Funding Statement: Dr Mäkelä was partially supported by a grant from Merck & Co.

26.) Measles vaccination and antibody response in autism spectrum disorders, Baird G, et al.
Author Affiliation: Newcomen Centre, Guy’s & St Thomas’ NHS Foundation Trust, London, UK;
Biostatistics Group, Division of Epidemiology & Health Sciences, University of Manchester, Manchester, UK;
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, UK;
Behavioural and Brain Sciences Unit, UCL Institute of Child Health, London, UK;
Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Oxford, UK;
School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK;
Chatswood Assessment Centre, Sydney, New South Wales, Australia;
National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, UK;
Virus Reference Department, Centre for Infections, Health Protection Agency, London, UK
Conflicts of Interest: MA and DB have given unpaid advice to lawyers in MMR and MR litigation. GB has acted as an occasional expert witness for the diagnosis of autism. AP receives royalties from SCQ and ADOS-G instruments. PBS has acted as an expert witness in the matter of MMR/MR vaccine litigation. All other authors have no conflicts of interest.
Funding Statement: he study was funded by the Department of Health, the Wellcome Trust, the National Alliance for Autism Research (NAAR) and Remedi. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation or writing
of the report. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication.

Of the 18 studies that Dr. Bob declared are pharma-funded, 1 (22) is partially funded by Merck, three studies (9, 16 and 20) don't have funding statements and 1 (19) is a duplicate of (14). That leaves 13 studies with no pharmaceutical funding whatsoever, confirmed. I already knew this so I offered Dr. Bob the chance to rectify his "mistake":

I really do wish to thank you for answering me. In doing so, I would like to extend you the courtesy of retracting your statements that, "Most of the vaccine studies that show no link between vaccines and autism are funded by the pharmaceutical companies" and, "In fact, if you look at the 23 major studies that have shown no link, 18 of them are funded by big pharma." before I write about this.

However, instead of making the honest gesture to retract his demonstrably false statements, Dr. Bob "clarifies":

Clarification by Dr. Bob - posted on 3/10/2011

A quote from the beginning of the Fombonne study:
Since June 2004, Dr Fombonne has been an expert witness for vaccine manufacturers in US thimerosal litigation.

The qualifications I use to determine if a study is pharma-funded is 1. The research is directly funded by pharma, or 2, the researchers involved have received money from pharmaceutical companies for services rendered, or 3. The researchers in the past have had other studies funded by pharma (I'm don't think this last one applies anywhere here, but I don't remember now).

Because Dr. Fombonne has been an expert witness in defense of the pharmaceutical companies, this creates a clear financial and professional conflict of interest.

I know that none of this would matter to some of you on this board, but I think it matters to most parents in general.

And this goes both ways. Some of the doctors who HAVE found a link between autism and vaccines in their research have testified AGAINST pharma on behalf of vaccine injury claimants. I also consider that a conflict of interest in their research.

But of course! Create an overreaching, blatantly dishonest, weasel-worded definition for what he meant; pure truthiness. He devises an alternate rendering in order to set up the premise should "big pharma" even fart in the general direction of an investigator, he can label their study as "pharma-funded". Even by his own tortured criteria, he can't claim that the three studies with no funding declaration are "pharma-funded" but yet he does. He doesn't even read these studies; he doesn't know how but only knows that they don't concur with his pre-conceived notions (and his bread and butter). How does he explain that these so-called "pharma-funded" studies' results are concordant with those that he hasn't deemed "pharma-funded"? He can't.

As for this statement:

And this goes both ways. Some of the doctors who HAVE found a link between autism and vaccines in their research have testified AGAINST pharma on behalf of vaccine injury claimants. I also consider that a conflict of interest in their research.

It's a right load of bollocks. His Vaccine Book is rife with "studies" by the Geiers, Wakefield, Classen, Goldman, Yazbak and Bradstreet, all with conflicts of interest, businesses that profit from "vaccine damage", and/or appearances as "expert witnesses" for petitioners in the NVICP. Why he still considers Andy (Wakefield) a close friend and stands behind his research, not to mention Dr. Bob's own flagrant conflicts of interest. As a DAN! doctor, he thrives on hawking "vaccines cause autism" and promoting fear about vaccines helps to keep his books, products and services selling. He clearly has a financial and personal investment in denying the legitimacy of any studies that don't support his paradigm.

Do some authors have conflicts of interest? Yes they do and their declarations allow the readers of their studies to properly assess their value and consider replication of other studies. Had Dr. Bob stated that some of these authors have conflicts of interest, he would have made a factual statement, but he also wouldn't have made the same impact on the audience and I believe he knows that, which is why he defers to truthiness. It is a predictable tactic for the deceptive "vaccine safety" party line pushers to take. Furthermore, he only includes about half of the list of studies that cannot find a vaccine-autism association; hand-picking only those he believes he can apply his crooked standard to.

It is also worth noting Dr. Bob's dishonest/incompetent labelling of studies 3, 23, 24, 25, 27 and 29 as "commentaries". Again, a word with a very specific meaning when referring to scientific publications. For example, Pediatrics defines commentaries as follows:

Abstract length: no abstract
Article length: 400 to 800 words
Commentaries are opinion pieces consisting of a main point and supporting discussion. These contributions usually pertain to and are published concurrently with a specific article; the commentary serves to launch a broader discussion of a topic. Commentaries may address general issues or controversies in the field of pediatrics.

Nearly all medical/scientific journals will have a commentary or editorial section and they are rather consistent. What Dr. Bob labelled as "commentaries" are actually reviews, systematic reviews or meta-analyses and only one actual commentary and it is positively cloddish that he either doesn't know this or is too morally bankrupt to care. A review, as the name implies is an article that provides a more generalised, critical review of a specific topic. They are almost always solicited and peer-reviewed in the same manner as original research. They are very useful, mostly written by top experts in their respective fields (the quality, of course, depends upon the quality of the journal) that provide a good overview although can still be subject to author bias. Systematic reviews and meta-analyses can be very powerful study designs as explained in this study module by The Cochrane Collaboration. I doubt Dr. Bob has the desire to actually learn something contrary to his witless dogma by reading this, but "systematic review" in the titles of the damn studies should have tipped him off. For him to try and pass off an Institute of Medicine - Immunization Safety Review as a commentary just begs for a rhetorical drubbing.

Dr. Bob is nothing more than a self-styled marketeer, a medico last. He has managed to parlay some business acumen, M.D. credentials and family name into a business that obfuscates his mediocre medical skills and complete oblivion of science. He is influencing public health and has absolutely no competence to do so.

Paediatricians need to be more proficient at countering his fabrications when both dealing with parents and confronting him in the media. Parents' fears can be acknowledged without being validated and sadly, paediatricians have to make an effort to undo the damage that the likes of Dr. Bob have done on their own time while he makes a living off of generating fear with patently false information.