Anti-Vaccine Nonsense on Facebook

An anti-vaxx post is circulating on Facebook that is completely unoriginal but is being disseminated by someone unknown to me and the content is humorously paranoid and wrong.

 This information is by a man who calls himself Dr. Michael Gaeta and fancies himself "a visionary educator, clinician, writer and publisher in the field of natural healthcare." He calls himself doctor, no doubt to pad his credentials but he is really an acupuncturist who "graduated" from a woo college in New York.  There is no recognised profession as "Doctor of Acupuncture" from any accredited institution or recognised organisation.  As such, Mr. Gaeta has not undertaken the requisite studies to allow him to be competent in matters surrounding vaccinology, considerably more complicated and attested than poking needles into "meridians".  Nothing more than a certification squatter really.

Of particular interest with regards to Mr. Gaeta and his "seminars" is his invocation of "an impeccably-credentialed, pro-vaccine PhD immunologist."  Who, of course, "confirmed what I and others have been saying for years."  She can be heard on an audio file but here is the text of her statements:

Q. So the science seems fairly clear that for the first year of life, probably, that the immunization is not stimulating the kind of response we expect it to stimulate.
A. True.
Q. So what’s the rationale for continuing to do that if it’s not doing what it’s supposed to be [doing]?
A. The vaccines are given at pediatric wellness visits, and the idea is that you are training the parent to bring their child in at all the pediatric wellness visits, and that it’s only the year visit that actually is truly important. But that for most parents you are not going to get them to bring their kid in if they don’t come in at two months, four months, and six months. And so it’s actually more of a training thing.
It’s interesting, I was on the phone with [?] county public health last week, with one of their vaccine nurses. She was like, ‘Oh, you’re talking about vaccines? Make sure you tell them they have to do that year shot because the first three [the 2, 4 and 6 month shots] don’t work.’ I was like, ‘Yeah, I know.’ [laughter].

This is Mr. Gaeta's summary of her talk:

The first was that it is pointless to administer drugs intended to stimulate antibody production to babies who are too young to produce antibodies. Infants in their first year mostly depend on generalized, non-specific immunity, including (hopefully) immunoglobulins from breast milk, to protect their young bodies from infection. They do not produce antibodies of their own until about age one. Despite this basic fact, the medical establishment insists administering a total of 19 shots, containing 24 vaccines, to infants on the 2, 4 and 6 month pediatric visits (Source: cdc.gov). Somehow, the basic facts of human physiology and development do not apply to vaccines.

Of course it is demonstrably false that,  "So the science seems fairly clear that for the first year of life, probably, that the immunization is not stimulating the kind of response we expect it to stimulate." and , "The first was that it is pointless to administer drugs intended to stimulate antibody production to babies who are too young to produce antibodies. Infants in their first year mostly depend on generalized, non-specific immunity, including (hopefully) immunoglobulins from breast milk, to protect their young bodies from infection. They do not produce antibodies of their own until about age one."

These statements alone should be a glaring tip-off that the speakers don't know what they are talking about.  Mr. Gaeta is an acupuncturist so it is a given he is clueless about immunology and his "impeccably-credentialed, pro-vaccine PhD immunologist" either is not so impeccably-credentialed and/or has tired of languishing in obscurity and ineptness and jumped onto the anti-vaxx bandwagon for attention.  It is demonstrably false that infants don't produce antibodies until one year old.  All a layperson needs to do is look at a package insert for clinical trial summaries on infants less than one year old to see that there is antibody response.

It is well-known, although not to Mr. Gaeta and Mizz Impeccably-Credentialed PhD Immunologist, that:

Neonates develop the capacity to respond to foreign antigens before they are born. B and T cells are present by 14 weeks’ gestation and express an enormous array of antigen-specific receptors.5 Although the fetal immune system has the potential to respond to large numbers of foreign antigens, few foreign antigens are present in utero, and cells of the immune system are, therefore, primarily “naıve” at birth.

That is from: http://www.pediatrics.org/cgi/content/full/109/1/124 One can always look it up the references in the literature for that statement or even look it up in the many textbooks available.  I guess Mizz Impeccably-Credentialed PhD Immunologist slept during that portion of her education.  It is also untrue that paediatric well visits are "to train" parents.  If that is the case then every public health programme in the world is in on this great hoax.  Many infant vaccines are not fully effective until the full series are given, infants are particularly susceptible to complications from some of the vaccine preventable diseases thus are generally given from two to six months old.

Mizz Impeccably-Credentialed PhD Immunologist then invokes a nameless "public health vaccine nurse" in an appeal to authority and popularity.  This somehow induces laughter with the audience of "health professionals" which Mr. Gaeta claims he gives his seminars to.  But a glance at his testimonials reveals that the "health professionals" in attendance are also primarily sCAM practitioners such as chiropractors, naturopaths and nutritionists.  It is no small wonder that such a group would lap up unqualified, completely fallacious statements because they are notoriously anti-vaccine and such claims massages their confirmation bias.

What good is a great vaccine hoax messenger without the whiff of intrigue:

You can listen to an audio file of an exchange between an attendee and the immunologist about this question. She declined to be identified in my presentations, including this post, perhaps because she knows that anyone who speaks the truth about vaccines is savaged by the medical establishment and their compliant lapdogs in the mainstream media. It is professional suicide for anyone in conventional medicine to question the unquestionable (yet unproven) assumptions about vaccines: that they are effective, safe and necessary. I have stopped lecturing publicly on this subject for the same reason, because the attacks in recent years have become particularly vicious; and because my main message in my teachings is about personal responsibility, innate wholeness and opening to the largeness of who we are, not just vaccines.

I guess it has become fashionable to be persecuted by The Man™ and lends believability to the poor down-trodden speaker-of-the-truth.  But no, Mr. Gaeta and Mizz  Impeccably-Credentialed PhD Immunologist are free to make fools of themselves in any venue that will have them without any fear of retribution from the New World Order.

Of course it won't go unnoticed the response to this tosh that Dr. Bob Sears had:

This is interesting info. I agree that the general medical teaching on immunology is that infants don’t have much of their own immune system during the first year of life, and they rely heavily on the immunity they gain from mom through th...e placenta and from breastmilk. I don’t know whether babies actually don’t make ANY antibodies during this time, OR if they simply have a lower capability to do so. This immunologist seems to say that they don’t make any? My understanding is that it isn’t that they don’t have any immune system or can’t make any antibodies, but rather that these abilities are immature and lower than what it will eventually be, but that there is still some capability there.
What seems to contradict what this immunologist is saying is that the vaccine product inserts do provide data on antibody responses to vaccines, showing that infants do generate antibodies in response to the vaccines, and that the response increases after each dose.
Do you know if this immunologist addresses that specific issue? I’d be curious.

He almost gets it right but blunders with, " I agree that the general medical teaching on immunology is that infants don’t have much of their own immune system during the first year of life, and they rely heavily on the immunity they gain from mom through the placenta and from breastmilk."  What is so profoundly laughable, if not frightening about his response is that he wrote two books about paediatric vaccines and touts himself as a "vaccine expert" and doesn't really know how to answer the question.  I attribute this to part incompetence and part insecurity to disagree with a fellow anti-vaxxer.  It is a fringe science variant of "honour among thieves" and to quote Dr. James Laidler,  "Utter nonsense treated like scientific data, people nodding in sage agreement with blatant contradictions, and theories made out of thin air and unrelated facts—"

Dr. Bob is Really Only Doing it for the Worried Parents

not because of any own concerns over vaccine safety. The Sears' website has been modified again, and here is Dr. Bob himself, explaining the origin of his alternative vaccination schedule. It is really all about parental concerns (not about his own flirtations with the anti-vaccine crowd, or the fact that his "alternative" schedule almost doubles the number of office visits for vaccine purposes at $75 to $200 dollar a pop). Good to know, right?

Immunity

I came across this on Ratbags.com - a very short movie by Jasmine Marosvary - this made me think of Nelyn. I met his mum Lynne on ivillage some years ago. The first mother my age, who had lost a child to a vaccine preventable disease. Lynne was lobbying for the licensing of pertussis vaccine for adults, which has since happened. Vaccination saves lives:

And another SSPE case: Angelina is dying

I had seen girl previously on a board, but the parents had not gone public until now, after Natalie's death.

Angelina caught measles in 2006 from an adult, when she was 7 months old. She recovered well - this is her before SSPE broke out:



This is her now:



Gina, Angelina's mum says (my translation):

"In February of this year, we noticed pronounced problems with our daughter. She kept falling off her bike, and had speech blockades. When this was getting worse, we went to the clinic. The diagnosis SSPE was a shock for us. Our child became dependent on care within 8 weeks. She cannot walk nor speak and needs to be tube fed. She would have entered school this year. This blow of fate is very hard for us all."

According to Sean Monks, spokesperson of the German Association of Pediatricians, this is the third case of SSPE from measles infection in infants in 2006 - in 2006 a total of 313 infants with measles were reported to the RKI (German CDC equivalent) in Berlin. One of these children died in 2007, another has been suffering from SSPE since 2009, and now Angelina is the third victim from that year.

Importantly, this shows that the risk of SSPE is much higher than previously thought. Overall risk for SSPE had recently been adjusted to about 1 in 11'000 notified cases of all ages, and "at least" 1 in 2'000 for infants (German pdf). From 2005 to 2010, 27 patients died of SSPE in Germany, although measles incidence had been sinking to reported numbers under 2000/year for some time. The current cluster of SSPE cases indicates that the risk of SSPE for infants who contract measles lies closer to 1 in 200.

Research has not yet identified the causative mutation for SSPE (see for example here) nor found strains with a particularly high risk of causing SSPE which could explain this high incidence. What is clear is that all cases in which measles virus has been amplified from the brain of SSPE victims, it was the wild type rather than the vaccine virus, and that with increasing vaccination coverage, SSPE incidence sank (see for example here and here, for review here).

The only way to prevent more SSPE cases is to vaccinate your child against measles (2xMMR) and to check your own immunity if you are unsure of your history of measles/measles vaccination. Your immunity protects those too young or too sick to be vaccinated. Your decision not to vaccine could cost lives, not necessarily yours.

Testing Anthrax vaccines in children?!

I came across this piece in the Washington Post today:

Possible study of anthrax vaccine’s effectiveness in children stirs debate

Apparently, a "key working group of federal advisers" endorsed testing in September, to see whether the anthrax vaccine would safely protect healthy children against a bioterrorism attack.

What bioterrorism attack? The possibility of the use of anthrax by (foreign) terrorists was one of the fears addressed post 9/11. However, the only documented use of anthrax in the United States with the intention to harm in the past 10 years happened a week after the 9/11 attacks, when "letters containing anthrax spores arrived at several media offices and two Senate offices, killing five people and sickening 17 others. The FBI eventually concluded that the letters were mailed by Bruce Ivins, a disgruntled scientist at Fort Detrick in Maryland who committed suicide in 2008, although some experts question the FBI’s findings."

As a consequence of the anthrax bioterrorism fears, 2.6 million US military personnel were vaccinated with the anthrax vaccine, and the federal government has spent $1.1 billion to stockpile the vaccine to protect Americans in the event of an attack. This is in addition to treatment option by antibiotics.

The Washington Post reports:

Unlike with measles, mumps and other diseases, the chance that children will be exposed to anthrax is theoretical, making the risk-benefit calculus of testing a vaccine on them much more questionable.

“It’s hard to believe that it’s something that makes a great deal of sense,” said Joel Frader, a pediatrician and bioethicist at Northwestern University’s Feinberg School of Medicine. “It would be difficult to justify testing it on kids simply on the hypothetical possibility that there might be an attack.”

In addition to these ethical considerations, I have several other concerns, this paper sums one up well:

In response to the attacks on Sept 11, 2001 (9/11), and the related security concerns, the USA and its coalition partners began a war in Afghanistan and subsequently invaded Iraq. The wars caused many deaths of non-combatant civilians, further damaged the health-supporting infrastructure and the environment (already adversely affected by previous wars), forced many people to migrate, led to violations of human rights, and diverted resources away from important health needs. After 9/11 and the anthrax outbreak shortly afterwards, the USA and other countries have improved emergency preparedness and response capabilities, but these actions have often diverted attention and resources from more urgent health issues. The documentation and dissemination of information about the adverse health effects of these wars and about the diversion of resources could help to mitigate these consequences and prevent their recurrence.

Given the publicly available data, there is only a "theoretical" anthrax threat to US children. The current disease burden for them, for all we know, is zero. Anthrax vaccine trials and/or general vaccination programmes for children would be a very hard sell to the general public and would significantly support anti-vaccine sentiments. Ultimately, it would detract funds from essential health care research and provision in areas of actual need (i.e. where a measurable disease risk and burden exists), and it may erode vaccination compliance for the essential childhood vaccinations (measles, anyone? Pertussis?).

Follow up on my post about Natalie and SSPE

There were two reactions to my post about Natalie's entirely preventable death from SSPE that I had put up yesterday.

One that invariably came from pro-vaccine minded parents, which was "oh, how horrible, the poor child/parents" and sometimes included "can we go after those vaccine-refusing parents"

and one that invariably came from anti-vaccine minded parents, which was "oh, how horrible, how can you call our children potential murder weapons" and sometimes included "you must be paid to post this" pharmashill accusations.

So here are some clarifications:

I don't know much about the parents who took their unvaccinated 11 year old to that pediatrician's practice. I can say with some conviction that neither Andrew Wakefield nor Jenny McCarthy had anything to do with their decision, since this happened in Germany in 1999 and their son was 11 then, so their anti-vaccine decision must have happened 10 years earlier, when neither Wakefield nor McCarthy were a topic (and they never really became one in Germany anyway). We don't know what made them not vaccinate. I am pretty sure they did not intend this to happen.

There is no provision to sue these parents in German law. The new Infektionenschutzgesetz was passed after this all got started and it only regulates intentional transmission of reportable infectious diseases. I think it would be very difficult to prove intent here. Also, I don't know about Natalie's parents, but Micha's family are devout Christians. While they are obviously sad and burdened, they do not seek punishment for that other family.

I posted a link to this blog on Mumsnet and that caused quite an upheaval amongst non-vaccinating parents. There was a lot of profanity (seemingly caused by the -wrong- assumption that I was addressing people directly, while being fully aware of the children's medical histories), but I am accepting this:

A lot of non-vaccinating parents made their decision after careful thought and deliberation with their health professional. They are aware of the risks of their non-vaccine decision and they are not necessarily comfortable with those risks. However, for them, the risks of not vaccinating outweighs the risks of vaccinating their children. To be told that they are turning their kids into potential murder weapons and to scare them with what is certainly a) a very unlikely and b) the most catastrophic outcome of a family not vaccinating deals them an unfair blow and it is not really helpful. This was not my intention and I have apologised to one mum there and hereby do to any parent in the above situation here.

That said: if you are thinking about not vaccinating your child and you are currently weighing the pros and cons: have a look at my previous blog and previous post on this situation and weigh this into your decision.

So predictable - so sad, Natalie dies of SSPE

We had previously reported the case of Natalie, one of the children who contracted measles from an unvaccinated preteen in their pediatrician's practice in 2000. Natalie was 11 months old at the time. She came down with SSPE in 2007 (that is actually the average time lag between measles infection in infancy and the development of this fatal measles complication), she deteriorated, fell into a "wake coma" and now passed away due to organ failure.




Micha, one of the other babies infected by the same 11 year old is still dying... Measles vaccination and the resulting herd immunity for babies saves lives. Vaccine refusers turn their children into potential murder weapons.

Polio in China

As of 13 September 2011, nine cases of polio have been reported in the Xinjiang region.  There has been one death.  All of the cases had wild-type polio 1 (WPV-1) which originated from Pakistan.  Xinjiang shares a border with Pakistan where polio is endemic, along with other neighbouring countries, India, Afghanistan and Tajikistan that are also polio-endemic.

Four children between the ages of four months and 2 years were infected in July, data for the other five are unknown but appear to be all infants, including the one fatality.  This is the first outbreak of polio in China since 1999, when an importation from India was identified.  The last indigenous case was in 1994.  An intense surveillance and vaccination programme has been launched in the region in hopes that the spread can be contained.  However, given that paralytic polio occurs in ~1% of polio cases and of that, 5-10% result in death and there were at least four cases of paralysis and one death, it is more than likely that hundreds, if not thousands of cases have gone undetected.

This outbreak demonstrates the vulnerability of populations who are not adequately vaccinated and the relative ease at which an infectious disease can cause an outbreak even in a country previously certified as polio-free.

Lessons From the MMR Scare

That was the title of Fiona Godlee's webcast from the National Institutes of Health, Fogarty International Center, Tuesday, 6 September 2011.  Dr. Godlee is the editor-in-chief of the British Medical Journal (BMJ) and published the three part series by Brian Deer exposing the fraudulent research of Dr. Andrew Wakefield.  Her talk can be viewed in its entirety here.

She reviewed the key points of Mr. Deer's protracted investigation of Dr. Wakefield's MMR research and the painstaking measures the BMJ took to review and validate Mr. Deer's reports.  She raised concerns of fraud in science and what medical/scientific journals could do to prevent such an occurrence from happening again.  She also discusses the role of the media and their contribution to the legitimising of Dr. Wakefield's, now retracted, Lancet report.  Dr. Godlee also makes an intriguing proposition for improving public health communications by entreating investigative journalists to work with epidemiologists.  We have already seen the success of solid science reporting by the likes of Brian Deer and Seth Mnookin so it is a feasible proposition.

Dr. Godlee provides an honest and thorough analysis of fraud in science/medicine and public health communications deficits along with some criterion to prevent fraudulent scientific reporting.  All in all, an informative talk and interesting points made during the question and answer session.  Jake Crosby from the Age of Autism made an embarrassing showing by introducing himself as "Jacob Crosby from the George Washington School of Public Health and Health Services", not disclosing himself as a student and implying he represented the school as faculty or staff.  Not to mention, I doubt the George Washington School of Public Health and Health Services sent Mr. Crosby as their representative, but rather, he attended as Age of Autism's lackey.  Mr. Crosby also missed the point of a "question and answer" session and launched into a churlish diatribe of fraud allegations against Brian Deer which can be viewed at the 54:04 mark on the webcast.

Death isn't everything, part 3: measles in Minnesota

This is Mahi Abdalla on his mother's lap (photo Jim Gehrz, Startribune.com). His family took him from Minnesota to Kenya where he contracted measles. He had been unvaccinated, because he was only 9 months old when he left the country. He spent three weeks in the hospital, two of those on a ventilator, due to measles pneumonia.



The US has seen over 175 measles cases this year; in the 1989-1991 epidemic, the death rate was just over 1 in 400 reported cases (123 acute deaths, at least 11 due to SSPE). Mahi was "lucky" with this severe but not fatal course of measles - it is only a question of time when the US will see their first acute measles fatality since measles were thought eradicated from the Americas. SSPE as a late consequence of measles usually in the first couple of years of life is still looming over the heads of the babies and toddlers who contracted measles this year. Sad...

Death isn't everything: part 2

Chloe Holmes lost most of her fingers as a toddler due to septicemia caused by chicken pox - she has now been fitted with a bionic hand:



contrast that with this: FB Group "Find a Pox Party in your area"

Measles: big deal

I am still working on the reference for a couple of longer blog posts, but since measles cases in the US have crossed the 150 mark, more than in almost two decades, I thought I'd post a quick reminder that "death isn't everything" (hat tip to Bad Astronomy)



Constrast her account with this - a call for a measles party!

The effects of anti-vaccine lobbying

Worth watching from beginning to the end. In particular, listen to Viera Scheibner, the "Grande Dame" of anti-vaccine activists - children are staying unprotected and are dying because of that kind of "expertise"! It is mind boggling. Watch - this is the anti-vaccine lobby rolling out their "best":



personal footnote: my 30 year old niece, healthy, top fit, half marathon runner, has been coughing for 102 days from whooping cough (and counting) now. This is not a harmless disease and it has the nickname "100 Tage Husten" (100 days cough) for a reason.

oh look - vaccines resurrected on Ask Dr. Sears site

at least somewhat - as promised by Matt Sears to Seth Mnookin, "Vaccines" are back on the Ask Dr. Sears website:



The content is still a bit disappointing, cannot say the info is "updated". It consists of links to old "The Vaccine Book" (dead link) blog posts, mostly sans comments (big shame, since there were some beautiful ones in there by SM and me). This is not really suitable as an info site (yet) especially since posts don't have date stamps or corrections (no, the return of single measles, mumps and rubella vaccines is not planned for 2011, at least not according to Merck). The "purchase the vaccine book" link works (not surprisingly). I would advise against it.

Keeping Track of Your Child's Vaccinations

One of the topics that come up often on the boards is shoddy book-keeping of the doctor's office, posts like

"My child is two years old and I am sure we had done all first year vaccines, but now we got called back for XYZ shots"

"I got a letter from the State saying that my child is not up to date, but s/he is"

"my child got his/her 4th DTaP at 12 rather than at 15 months and now we have to go back for a 5th, because the 4th doesn't count" *

"my child got his/her MMR too early and now it doesn't count" *

All of these are real life examples (2 from Dr. Bob's old board, 1 from Babycenter) and they illustrate one thing very clearly:

You have to keep a record of the vaccines your child get!

Now in an ideal world, your pediatrician hands you a vaccination schedule on your first well visit, including all info on the first vaccines, so you can read up ahead of time. S/he'll discuss with you whether you have any questions before the first shots and each time your baby is vaccinated, the little sticker on the vaccine vial that has vaccine name and lot number goes into a booklet like this:




that you get to keep. I have encountered such "best practice" with our second child - our first had 3 cards, one for each country she got vaccinated in, until we combined them into one. It is surprising, however, how often parents do not automatically get vaccination records to take him with them.

However, you need such records, so if you move or change doctors, you have proof of which vaccinations your child has had. These "Yellow Cards" exist world wide (the upper picture is an Ugandan one filched off the web, my daughter has one from California, my son one from Germany), they have been around for a really really long time - I have one, my original one is white though and I recently found my mum's and grandma's (proper record keeping during WWI and WWII, although mainly for smallpox).

It is even more important to keep your records if you are on an "alternative" schedule (for any reason - the European schedule my daughter had been vaccinated on for her first 9 months was very much "alternative" to what was recommended/required in the US).

As soon as your child is born, you can make up a vaccination schedule for him/her - the CDC has a handy tool, or find your country's National schedule and do it by hand. If you want to diverge from what is recommended, highlight this on the schedule. Take the schedule in to your doctor's appointment to double check you have done it right. Ask for the yellow card and then keep track of all shots. Also make sure that all vaccines are actually available in the combination that you want to give them - there are still parents out there who want to give monovalent measles, mumps and rubella, but they are no longer made by Merck - there are also periodic shortages in vaccines (in recent years for example the monovalent hib).

It needs a little planning, but it is very valuable, and, ultimately, your responsibility.


* that is actually a topic for another post

Bob for hire...suggested topic "Vaccine Myths and Questions"

Hat tip to Liz Ditz, who found out that if you are on Dr. Bob withdrawals after his recent disappearance from the new Ask Dr. Sears website, you can still hire him to speak at your event (birthday party maybe?!):



The site advertises Dr. Bob Sears:

Acclaimed Pediatrician & Vaccine Expert
Once considered a routine and mandatory part of pediatric health care, vaccines are now constantly surrounded by debate and controversy. Parents are bombarded with well-intentioned medical advice from family, friends, advertisers, and even pediatricians who mean well but might be too busy to provide all the answers an anxious parent needs.

Dr. Robert Sears, M.D., F.A.A.P. one of the most trusted names in childcare today (1), provides clear, concise answers to the countless questions parents have about vaccines (2). He offers the most up to date information in the latest addition to the Sears Parenting Library, The Vaccine Book (3).

"Dr. Bob," as his young patients call him, has studied every article, vaccine product insert and case study available (4). Nine years spent in private practice have taught Dr. Bob what questions and concerns parents have, what aspects of vaccines they don't understand and which topics need more clarification - all so that he can sift through the noise to give parents the peace of mind they need when making sure their child is well cared for (5).

Dr. Bob does not tell parents which decision is right for them, he simply gives them the information and the tools they need to make the right decision for their particular child and situation (6).

Dr. Bob is a board-certified pediatrician in practice with his father, William Sears, M.D.. and the co-author of several books in the Sears Parenting Library (7). He lives in Dana Point, California.

At the podium, Dr. Bob discusses vaccine myths and questions, vaccine ingredients (which harmful ingredients are still in vaccines and what parents need to know to protect their children), and the current vaccination schedule. Dr. Bob presents his own alternate vaccination schedule that is more effective and less likely to create harmful side effects than the current one (8). (my footnotes)

(1) actually, I would doubt that - Sears maybe, but that is Sears the elder, or Sears the brand, not Bob.

(2) I wish I had saved more of his posts from his board. Dr. Bob often either didn't answer, or totally hand waved his replies. He often suggested that parents with children with ASD, AD(H)D, or sensory and/or speech issue not be vaccinated at all, without a clear rationale (gut feeling, extracted rectally?).

(3) The Vaccine Book appeared in 2007.

(4) I wonder why he would still make totally outlandish claims then. Recently, he told the mother of a 7 months old ex-preemie to rely on maternal immunity after measles exposure, which isn't really a testimony to his knowledge in the field.

(5) Except when they go abroad and bring back measles, that is...

(6) Yes, right, he instead pulled the "I tend not to vaccinate in this kind of situation, but of course it is totally your choice..."

(7) ...books which are no longer mentioned in his family's web shop.

(8) Bob's alternative schedule has never been tested for efficacy or safety. On his board, he appeared generally unaware of studies on alternative schedules (e.g. the Swedish schedule). His ideas on MMR efficacy were totally evidence-free.

"suggested topic" for a talk by Dr. Bob Sears is:

Vaccine Myths and Questions:
What's True, What's Hype, and What You Need to Know

I need a new irony meter...

The MASTERPLAN - The Hidden Agenda for Global Scientific Dictatorship

Oh * my * word - I just stumbled across the below (hat tip to Omri)



Scientific World Domination is looming, and the only people to open our eyes and prevent the worst (e.g. getting sprayed with toxins by Chemtrails, or our children getting poisoned by fluoridated drinking water) are the 9/11 Truthers. They advertise

Dr. Andrew Wakefield has pioneered research into the possible links between the MMR vaccine and autism and has been victimised ruthlessly by his own profession, including being struck off by the General Medical Council in the UK for daring to speak out, despite other researchers, both before and after his evidence was published, now showing the same links between the MMR vaccine and autism. (my bold)

The bold is, of course, as bold as it is wrong.

I am not sure whether I should laugh or cry - the decline of Andrew Wakefield into this scene, down (I guess) from the Anti-Vaccine movement, deeper into the anti-science realm of conspiracy theorists is both consequential and kind of sad.

Off to stroke my cat...

Oh the Irony - Vaccine Exemption and Disease: Rubella

The CDC published the Vaccination Coverage Among Children in Kindergarten United States, 2009/10 School Year in the June 3 issue of its MMRW today. Some media outlets picked up the news that Washington has highest vaccine opt-out rate in country. Over 6% of Kindergartners have an exemption for one or more vaccines. While that doesn't seem much at first glance, it does push vaccination coverage at an age where kids are very likely to spread disease under the level that is assumed to be needed for herd immunity. Ironically, in the same issue of the MMWR, the CDC reports two cases of rubella in Washington, one imported, one indigenous.

Rubella?!

Honestly? I wonder what sort of false eco-nostalgic ideals Washingtonians are striving for, but is it really those times when hundreds (thousands in epidemic years) of babies per year contracted rubella in the womb and died in utero, or were born with horrendous malformations, deaf, blind, with heart defects?!

Vaccine exemptions lead to disease outbreaks - this is a small example. I wonder how many larger and much more catastrophic examples it will need for some parents to clue in?

Unanswered question

So following my recent post about that paper by Miller and Goldman, which crudely correlates numbers of recommended vaccines with infant mortality rates in the US and any country with a lower IMR, I got mail. Gary Goldman wanted to discuss my criticism with me and explain why they were still right. He actually wanted me to call him, which I was initially tempted to do, but eventually didn't because I was put off by the twisting and turning email conversation. He did request that I keep our exchange private, however, he stopped writing me, so I thought I'd just bring one argument up here and see whether he will answer.

me on 13 May - I (for Germany) and the devine Prometheus (for the US) had asked this earlier:

I see that you are avoiding the most obvious question: why are there fewer and fewer infant deaths when more and more vaccines are given? I gave you the German numbers, where infant mortality dropped by 80% while the number of scheduled vaccines tripled. Every country I look at has the same temporal trend, although in the US it is not as pronounced as in Europe, most likely because of your crappy health system. I would really like to know what your thoughts on this are.

No response to that by Gary on the same day (while was responding to other points)

Me, in response, still 13 May (his points in italics):

I notice you are still avoiding the historical question and if I may make a prediction - you are going to avoid answering this question forever. I would really be interested in your reasoning.

14 May, Gary, at the very bottom of a looong email elaborating on a number of points entirely unrelated to any of my questions:

I am not able to address the specific historical factors concerning infant deaths in Germany upon which you rely to support your contention that no correlation exists. I have seen data where 90% of disease mortality declined prior to vaccinations and this was largely attributed to improved sanitation, nutrition, and water. Other
studies, more longitudinal, and in other populations are reasonably necessary to support the present trend we report.

Now this is really irritating, because we were talking the past 30 years, not "pre all vaccines". Therefore, me, a day later:

Dear Gary,

I should maybe specify

I am not able to address the specific historical factors concerning infant deaths in Germany upon which you rely to support your contention that no correlation exists.

Germany is, of course, not the only country in which infant mortality plummeted over the past 30 years, it did so in every developed country I looked at.

I have seen data where 90% of disease mortality declined prior to vaccinations and this was largely attributed to improved sanitation, nutrition, and water.

Yes, all anti-vaccine protagonists like to refer to such curves. However, I am not talking about disease mortality, and I am talking a period of 1981 to 2011, when sanitation, nutrition and water were not a problem at all in Germany (or any of the other developed countries in which infant mortality dropped over the same time period).

Other studies, more longitudinal, and in other populations are reasonably necessary to support the present trend we report.

But Gary, we already know that infant mortality plummeted while the number of vaccines was significantly increased. I don't think that the kind of crude and error/bias ridden correlation that you have published advance the field at all, or reasonable raises new questions.

What about you? What experiences have you had that have shaped your thinking and views?

Misrepresentation of scientific evidence and dodging of straight forward questions by anti-vaccinationists for example - you wrote many many words, totally side tracking - we were talking German vaccination schedule and how it is not what you wrote about - you have similar misrepresentations for other countries as well - then you write about varicella, which is a second year vaccine - this was not the topic at hand - and you come with "sanitation" when we are talking 1980ies Germany - that is rather lame, you know.

So, given that Germany had great sanitation in 1981 and we are talking infant mortality, not disease related mortality, and they had 9 recommended vaccine doses and 10'000 infant deaths then, while they have 21 to 28 recommended doses and under 2000 infant deaths now, how would number of recommended vaccines correlate with infant mortality at all? Can you give me even an idea, a reasonable notion how your idea would match, umm, reality?

Thanks

Catherina

I had to wait two days to get a response, signed by Miller and Goldman:

Dear Catherina,

Infant mortality rates in all developed nations, including Germany, were much higher in the 19th and early 20th centuries and have continued to decline mainly due to improvements in nutrition (including breastfeeding advocacy), sanitation, and access to healthcare. [This information is not a conspiracy of "anti-vaccine protagonists" as you suggest; it is well-documented in the medical and historical literature.] For example, nearly 300 per 1,000 German infants died in the mid 1800s. By 1950, the German IMR had dropped to 52/1,000—an 83% decline. By 1960, the German IMR had dropped another 33% to about 35 infant deaths per 1,000 live births. These dates and declines in IMR preceded the extensive increases in compulsory vaccinations required of German infants.

Furthermore, Germany’s IMR declined at a rate of 3% annually from 1960 to 1979 during a time when few infant vaccines were required. This rate of decline was much faster than the 2.4% annual "plummet" from 1980 to 2009 during a period when more infant vaccines were required.

Additionally, Germany and other developed nations continued to make medical advances at reducing neonatal mortality during periods of increasing vaccine requirements. For example, from 1970 to 1979 there was a 41% decline in U.S. neonatal mortality. From 1980 to 1989, there was an additional 27% decline in neonatal mortality. Neonatal mortality (deaths in the first 28 days of life) usually accounts for more than 50% of all infant deaths. From 1990 through 2010, neonatal mortality in Germany represented about 68% of all infant mortality. During that period, Germany’s neonatal mortality rate had declined by 55%. Such improvements to the neonatal mortality rate greatly reduce the infant mortality rate yet are unrelated to the number of vaccines administered to infants.

Sincerely,
Neil Z. Miller
Gary Goldman, PhD

So here is my question that I have not gotten an answer for in the past 2 weeks:

Dear Gary,

so if I understand you correctly, infant mortality is dependent on all sorts of factors (hygiene, nutrition, sanitation, access to health care) and still declining, but just not as fast as it would be if we didn't vaccinate. Despite all these factors, which obviously vary tremendously between countries, you decided to only crudely correlate vaccines to infant mortality?

Thank you for clarifying

Catherina

Vaccines dumped from new Ask Dr Sears website?

I just caught a glimpse of the new Ask Dr. Sears Website. It was terrible slow loading when I first saw it, but the the landing page was all re-structured and modern in nice greens and oranges (I like that, very purdy).



Since we have been posting on the vaccine discussion board (justthevax passim), I thought I should take a stroll through the new page and have a look what the vaccine area looks like now. Well, this morning, there was none. While the "all categories" page did not load all too well, both on the left category bar



and on the middle all categories bar, there were no vaccines.



but they certainly had been there on the old page.



UPDATED TO ADD - indeed, no "Vaccines Area" - the search for "vaccines" only leads to Dr. Bob, not to further info (bites tongue):

closeup

I wonder whether this is going to be amended, or, whether in a year of pertussis and measles outbreaks that have cost 10 infants in the Sears' home state of California their lives, and have put many kids in hospital, the Sears have decided to drop this potentially contentious part of their web presence.

In any case - since the Sears' vaccine book discussion board has now disappeared, I hope you do have a good doctor and I can recommend our forum and, if you want a bit of a mixed audience, also the Immunization Discussion forum on Babycenter - see you there!

Infant mortality and vaccines

ETA 1.4.16: Gary Goldman and Neil Miller failed to disclose their conflicts of interest to Human and Experimental Toxicology.  The corrigendum is here.

oh goodness, here I wanted to go to bed early and then I stumbled over this latest "peer reviewed" paper in a journal "indexed by the National Library of Medicine" (see the anti-vaccine faction gloating at those fantastic quality indicators) and "proving" with an correlation co-efficient of 0.992 and a p of 0.0009 (so "sciencey") that:

Nations requiring the most vaccines tend to have the worst infant mortality rates

Authors of this little gem, in the journal Human & Experimental Toxicology, with the impressive impact factor of 1.307 and a proud ranking of 58th of 77 in the area of Toxicology (yes, that would put them into the bottom quarter) are Think Twice's own Neil Z. Miller and Medical Veritas' Gary S. Goldman. I wonder why Miller and Goldman didn't publish their paper in Medical Veritas (here is the link to the journal, please don't go blind), seeing that item 7 in their mission is: "Create a movement to address the adverse vaccine reactions and vaccine-related injuries afflicting children and adults". I guess that is because parents have clued in that "peer review" and being indexed on PubMed is a quality measure (although very obviously no guarantee for quality).

In any case - Miller and Goldman took a list of countries and looked at the number of vaccines they schedule for infants and they also looked at infant mortality. And then they correlated one with the other, a fail safe way to find causal relationships: Storks deliver babies p=0.008.

There are a number of things wrong with this procedure - first of all, the way Miller and Goldman are counting vaccines is completely arbitrary and riddled with mistakes.

Arbitrary: they count number of vaccines in US bins (DTaP is one, hib is separate) and non-specific designations (some "polio" is still given as OPV in Singapore), rather than antigens. If they did that, Japan, still giving the live bacterial vaccine BCG, would immediately go to the top of the list. That wouldn't fit the agenda, of course. But if you go by "shot" rather than by antigen, why are DTaP, IPV, hepB and hib counted as 4 shots for example in Austria, when they are given as Infanrix hexa, in one syringe?

Mistakes: The German childhood vaccination schedule recommends DTaP, hib, IPV AND hepB, as well as PCV at 2, 3 and 4 months, putting them squarely into the 21 - 23 bin. The fourth round of shots is recommended at 11 to 14 months, and MenC, MMR and Varicella are recommended with a lower age limit of 11 months, too, which means that a number of German kids will fall into the highest bin, at least as long as you count the Miller/Goldman way.

Then, they neatly put those arbitrarily counted doses into bins. Binning (i.e. grouping numbers before correlating them to something) always makes me suspicious. I don't have the time to check each country's vaccination schedule - I assume there will be mistakes in many claims, but I am guessing that if we plotted the infant mortality against the actual number of recommended vaccines, the correlation would be less good than engineered in this paper, i.e. the dose count above is probably not all that "arbitrary".

Then I noticed that the authors totally ignore historical trends. For example, in the early 1980ies, Germany's infant mortality was about 5 times as high (10000 infants died per year) than it is today (2000 died in 2009 with approximately the same birth rate), however (in Miller's and Goldman's twisted logic), the vaccination schedule contained far fewer vaccines in the first year (essentially just DT and polio, since the whole cell pertussis was not given between 1974 and 1991, the aP not yet introduced, the MMR given in year 2, no hib, nor hepB, nor PCV given either), while Germany was already very much a "developed country".

ETA: a similar point is made by Prometheus on Science based Medicine for the declining infant mortality rate in the US.

If I believed that one factor could ever explain something as complex as infant mortality, I would go and look at the relationship of maternity leave:

Japan, for example, generally gives 14 weeks at an average of 40% of a woman's salary and mothers are also entitled to childcare leave for their new baby's first year. Childcare laws dictate that in the first year of her baby's life, a mother may take two 30-minute breaks per day to care for her child (anyone else think breastfeeding?). She may also take time off any time during the baby's first year with one month's notice.

In Sweden, all working parents are entitled to up to 16 months of paid parental leave, Norway is similarly generous. Read the table and weep, US American parents!

In the bottom countries, the USA gives 0 months of parental leave, the FMLA offers some (up to 12 weeks) generally unpaid leave under very specific conditions. Heck - Botswana and Chad have better rules. Australia has 18 weeks (not months, like Norway) at minimal wage, but then, Canada, third worst in infant mortality has up to a year of parental leave at almost $2000 a month and that is where my crude correlation fails (although, if I binned some countries...a cunning plan).

ETA: Dr. Gorski picks up on some other flaws of this study - read his post.

In general, several large studies/meta-analyses NOT cited by Miller and Goldman, have indicated that if vaccines have anything to do with infant death, then as a protective factor, as this German study and meta-analysis and this large study from the UK.

To prevent SIDS (specified 10 May after comment):

put your baby "back to sleep"
do not smoke
breastfeed if at all possible (easier in countries with 18 months of paid maternity leave)
avoid loose bedding and soft mattresses or sofas
do not bed share when intoxicated, or smoker, or taking medicine that may make you drowsy, but keep your baby in your room
keep the sleep environment cool and don't overdress your baby

That is it.

Still no independent confirmation of Wakefield's claims

One of the things that anti-vaccines groups desperately want to have, is the scientific support for their claims. A lot of parents know that rigorous studies, peer reviewed, published in scientific journals and indexed on Pubmed are the standard in discussions about medical care. Therefore, the anti-vaccine brigade are trying to maintain that, really, countless scientific studies across the globe have shown that vaccines are bad for you.

The anti-vaccine, pro-any-conspiracy theory website Whale.to (the citation of which automatically invokes Skopie's Law), provides a neat shopping list that staunch supporters of the long debunked “MMR causes inflammation of the gut which somehow causes autism and Andrew Wakefield is really a hero” notion can use to spam evidence based discussions, as recently seen on the Shot of Prevention blog where Marsha McClelland of the “We the People United for Vaccine Education Misinformation” Yahoo group copied and pasted in support for Andrew Wakefield.

She “writes”:

In the years after his initial controversial finding, linking the MMR vaccine to Crohn’s disease and autism, he published another 19 papers on the vaccine-induced disorder.
All were peer reviewed. However, strangely enough, none of these 19 papers are ever discussed in the media. The only study that keeps seeing the light of day is the original study from 1998, along with the original questions about conflicts of interest, which he explains in great detail in this interview. (my comment - that refers to the Mercola interview with Andrew Wakefield).

Note the buzz word “peer reviewed“ – also note the fundamental misconception that anyone would give a toss whether Wakefield believes that Wakefield was correct.

She goes on:

This is very interesting indeed, because not only has he continued his own studies, but since then, a large number of replication studies have been performed around the world, by other researchers, that confirm his initial findings.
It’s been replicated in Canada, in the US., in Venezuela, in Italy [but] they never get mentioned. All you ever hear is that no one else has ever been able to replicate the findings.

That – Martha and friends – is because no one (apart from Wakefield and his buddies) has ever been able to replicate Wakefield’s claims. I had previously looked at 5 studies supposedly „independently“ replicating Wakefield, but this list was 28 citations long (I guess the length is supposed to duly impress AND to keep anyone from checking). To quote Kenneth Branagh: “There is safety in numbers”. Luckily, both Chris and Liz Ditz were bothered enough to spend their valuable time to debunk the list (THANK YOU!) – I have created a synthesis of their and my previous searches and comments to create the “one stop copy and paste resource for the evidence minded”. Links add extra depth - sorry about the length, it may exceed the number of characters allowed for blog comments...

To summarize re-using Martha’s words: you may have been tricked into believing that Andrew Wakefield’s claims had been independently verified in 28 publications from 5 different countries. I’m afraid that is false. For those of you who have swallowed this type of reporting hook line and sinker, the below debunks each of the 28 studies from around the world that have been cited in his support.

1. The Journal of Pediatrics November 1999; 135(5):559-63 =
Horvath K., Papadimitriou J.C., Rabsztyn A., Drachenberg C., Tilden J.T. 1999. Gastrointestinal abnormalities in children with autism. J. Pediatrics 135: 559-563.

This study did not look for measles virus. Instead it looks at gastrointestinal (GI) malabsoption as an underlying mechanism for autism. It does not appear to have controls with autism & without GI symptoms OR controls without autism & with similar GI symptoms. Most children with autism & GI symptoms had upper GI problems such as reflux
This in no way “replicates” or “supports” Wakefield’s “findings”, which have been shown repeatedly to have been manufactured or the result of laboratory contamination.

2. The Journal of Pediatrics 2000; 138(3): 366-372 =
Furlano RI, Anthony A, Day R, Brown A, McGarvey L, Thomson MA, Davies SE, Berelowitz M, Forbes A, Wakefield AJ, Walker-Smith JA, Murch SH. Colonic CD8 and T cell filtration with epithelial damage in children with autism. J Pediatr 2001;138:366-72.
This paper claims to have "confirm[ed] a distinct lymphocytic colitis in autistic spectrum disorders", which is something that no other research groups find and has been the center of the recent GMC hearings against Wakefield. The extreme "engineering" towards a specific gut pathology has been summarized by Brian Deer.
Note the emergence of a theme: Wakefield is a co-author and no fewer than 7 of this paper's authors are also authors on the retracted paper in The Lancet; this paper cannot be said to independently ”replicate” or “support” Wakefield’s “findings”.

3. Journal of Clinical Immunology November 2003; 23(6): 504-517 =
Ashwood P, Anthony A, Pellicer AA, Torrente F, Wakefield AJ. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology. Journal of Clinical Immunology, 2003;23:504-517.

Again, this paper seeks to further claim "a pan-enteric mucosal immunopathology in children with regressive autism that is apparently distinct from other inflammatory bowel diseases", but we know that Wakefield et al. are the only researchers who have "found" this in the past 15 or so years.
Same theme: Wakefield (and Anthony) is a co-author; cannot be said to support his own work.

4. Journal of Neuroimmunology 2005
A meaningless citation as this would be a whole volume of a journal - this happens if you just copy and paste without any regard to the content. Supports nothing except maybe the notion that the anti-vaccine folk cannot cite biomedical literature properly.
If you go back to whale.to, John was kind enough to link to to the paper, which is
Ashwood P, Wakefield AJ. Immune activation of peripheral blood and mucosal CD3+ lymphocyte cytokine profiles in children with autism and gastrointestinal symptoms. J Neuroimmunol. 2006 Apr;173(1-2):126-34.

doesn't mention MMR, instead, the authors start from their own wrong premise "Gastrointestinal pathology, characterized by lymphoid nodular hyperplasia and entero-colitis, has been demonstrated in a cohort of children with autistic spectrum disorder (ASD)." and continue to find "In both peripheral blood and mucosa, [intracellular] CD3+ TNFalpha+ and CD3+ IFNgamma+ were increased in ASD children" ,
has Wakefield as senior author, therefore no independent replication of his results.

5. Brain, Behavior and Immunity 1993; 7: 97-103 =
Singh VK, Warren RP, Odell JD, Cole WP. Antibodies to myelin basic protein in children with autistic behavior. Brain, Behavior and Immunity 1993;7:97-103

Found some but not all children with autism had specific antibodies to myelin basic protein (MBP). Study did not look for measles virus, nor did study look for mumps or rubella virus or administration of the MMR.
It precedes the Lancet paper and in no way ”replicates” or “supports” Wakefield’s claims.

6. Pediatric Neurology 2003; 28(4): 1-3 Citation not found.
According to whale.to, this is
Singh VK, Jensen RL Elevated levels of measles antibodies in children with autism Pediatric Neurology 2003; 28(4): 292-294.

To the best of our knowledge, this study has not been replicated, and the findings refuted by several other studies, such as Baird G, Pickles A, Simonoff E, Charman T, Sullivan P, Chandler S, Loucas T, Meldrum D, Afzal M, Thomas B, Jin L, Brown D. Measles vaccination and antibody response in autism spectrum disorders. Arch Dis Child. 2008 Oct;93(10):832-7.
This study does not support Wakefield’s claims.

7. Neuropsychobiology 2005; 51:77-85 =
Jyonouchi H, Geng L, Ruby A, Zimmerman-Bier B. Dysregulated Innate Immune Responses in Young Children with Autism Spectrum Disorders: Their Relationship to Gastrointestinal Symptoms and Dietary Intervention. Neuropsychobiology. 2005;28:51 77-85

This study did not look for measles virus but evaluated inflammatory response to specific dietary proteins.
In no way ”replicates” or “supports” Wakefield’s “findings”

8. The Journal of Pediatrics May 2005;146(5):605-10 =
Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders. J Pediatr.2005;146(5):605-10.

This study did not look for measles virus. Instead, the study evaluated inflammatory response to specific dietary proteins.
In no way ”replicates” or “supports” Wakefield’s “findings”

9. Autism Insights 2009; 1: 1-11 citation not found on PubMed, but this refers to Krigsman, A. , Boris, M., Goldblatt, A., Stott, C. Clinical presentation and histologic findings at ileocolonoscopy in children with autistic spectrum disorder and chronic gastrointestinal symptoms Autism Insights 2010:2 1-11.

Arthur Krigsman was a colleague of Andrew Wakefield at Thoughtful House, Wakefield and Carol Stott (a contributor to this paper) are editors of the vanity press journal Autism Insights (previously discussed on LBRB. Not very likely that this "peer review" was very tough.
In no way ”replicates” or “supports” Wakefield’s “findings”

10. Canadian Journal of Gastroenterology February 2009; 23(2): 95-98 =
Galiatsatos P, Gologan A, Lamoureux E, Autistic enterocolitis: Fact or fiction? Can J Gastroenterol. 2009:23:95-98

Case report, featuring two adult patients with gastrointestinal problems and ASD diagnoses. The authors call for “more investigations” in their discussion.
In no way ”replicates” or “supports” Wakefield’s “findings”

11. Annals of Clinical Psychiatry 2009:21(3): 148-161 =
Singh VK. Phenotypic expression of autoimmune autistic disorder (AAD): a major subset of autism. Ann Clin Psychiatry. 2009 Jul-Sep;21(3):148-61.

This paper makes assertions that are not supported by the evidence base in the paper. It is mainly a summary of research, with no mention of what children were looked at. Chris found the actual paper (https://www.aacp.com/Pages.asp?AID=7937&issue=&page=C&UID=), and among the data used it included a Wakefield paper = not independent. Also included in the references are papers from questionable journals like Journal of American Physicians and Surgeons and Medical Veritas, which all suddenly makes sense if you see that Singh is associated with these folk that tick the "our treatment heals everything" quack box (see one Singh study on PTSD).
This looks like it would support a connection between MMR and autism, but since no-one has independently reproduced this and the author stands to make money off the claims this review has to be viewed with extreme reservations.

12. Journal of Child Neurology June 29, 2009; 000:1-6 =
whale.to provides the pre-print, hence the missing volume and page numbers:
Genuis S.J., Bouchard, T.P. Celiac Disease Presenting as Autism, J Child Neurol January 2010 25(1):114-119

This paper proposes that many children with autism have celiac disease, that this causes micro nutrient deficiencies and that the behaviour of the children improves when you put them on a gluten free diet. No MMR mentioned.
Does not support Wakefield's claims.

13. Journal of Autism and Developmental Disorders March 2009;39(3):405-13 =
Nikolov RN, Bearss KE, Lettinga J, Erickson C, Rodowski M, Aman MG, McCracken JT, McDougle CJ, Tierney E, Vitiello B, Arnold LE, Shah B, Posey DJ, Ritz L, Scahill L. Gastrointestinal symptoms in a sample of children with pervasive developmental disorders. J Autism Dev Disord. 2009 Mar;39(3):405-13.

This study did not look for measles virus, nor did study look for mumps or rubella virus. Study evaluated children previously diagnosed with pervasive developmental disorders (PDDs) for gastrointestinal (GI) symptoms. 22.7% were found to exhibit GI symptoms, but were otherwise no different from subjects without GI problems in demographic characteristics, measures of adaptive functioning, or autism symptom severity.
In no way ”replicates” or “supports” Wakefield’s “findings”

14. Medical Hypotheses August 1998;51:133-144. =
Bolte, ER Autism and Clostridium tetani Medical Hypotheses August 1998;51:133-144.
Speculative paper presenting the hypothesis that autism symptoms are caused by a subacute, chronic tetanus infection
In no way ”replicates” or “supports” Wakefield’s “findings”

15. Journal of Child Neurology July 2000; ;15(7):429-35 =
Sandler RH, Finegold SM, Bolte ER, Buchanan CP, Maxwell AP, Väisänen ML, Nelson MN, Wexler HM. Short-term benefit from oral vancomycin treatment of regressive-onset autism. J Child Neurol. 2000;15:429-435

This study did not look for measles virus. Instead, this study evaluated 11 children’s response to a specific antibiotic. Gains faded following cessation of antibiotic.
In no way “replicates” or “supports” Wakefield’s “findings”

16. Lancet. 1972;2:883-884 =
Walker-Smith J, Andrews J. Alpha-1-antitrypsin, autism, and coeliac disease. Lancet. 1972 Oct 21;2(7782):883-4.

This is a "letter to the editor" published decades prior to the Wakefield Lancet paper and can hardly be said to “replicate” the latter. Walker-Smith and Andrews report on the investigation of alpha-1-antitrypsin levels in 8 children with autism vs in children with untreated and treated celiac disease and control children and finds levels in children with autism and celiac disease are similar. This has little to do with Wakefield or the MMR (it also predates the introduction of the MMR), however, Dr. Walker-Smith is a co-author of the retracted study in The Lancet.
In no way “replicates” or “supports” Wakefield’s “findings”

17. Journal of Autism and Childhood Schizophrenia January-March 1971;1:48-62 =
Goodwin MS, Cowen MA, Goodwin TC Malabsorption and cerebral dysfunction: a multivariate and comparative study of autistic children. J Autism Child Schizophr. 1971 Jan-Mar;1(1):48-62.

A paper published decades previously cannot be said to “replicate” a later paper, the paper predates the introduction of the MMR vaccine in the US, the authors are not concerned with vaccination at all, but is mainly concerned with finding distinguishing features between childhood autism and adult schizophrenia using a number of challenges and physiological measurement. One minor in their discussion is that "malabsorption" would lead to autistic behaviour, so more in the sense of paper 12.
In no way “replicates” or “supports” Wakefield’s “findings”

18. Journal of Pediatrics March 2001;138:366-372.

Same paper as #2 above. Wakefield and 6 others from the Lancet paper are co-authors; cannot be said to support their own work.
In no way ”replicates” or “supports” Wakefield’s “findings”

19. Molecular Psychiatry 2002;7:375-382. Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. Enteropathy with T cell infiltration and epithelial IgG deposition in autism. Molecular Psychiatry. 2002;7:375-382.

Gosh, we know these guys – it’s Andy Wakefield and his colleagues from that paper in The Lancet, this time claiming IgG deposit in gut samples indicative of an autoimmune gut pathology and call me cynical, but I don't believe any of this, because it has only ever been seen by this group.
In no way ”replicates” or “supports” Wakefield’s “findings”

20. American Journal of Gastroenterolgy April 2004;598-605.=
Torrente F, Anthony A, Heuschkel RB, Thomson MA, Ashwood P, Murch SH. Focal-enhanced gastritis in regressive autism with features distinct from Crohn’s and Helicobacter pylori gastritis. Am J Gastroenterol. 2004;99:598-605

Murch SH, Anthony A, Thompson MA, Torrente F and Ashwood P were previous co-authors with Wakefield A. Again, there are no independent groups reporting similar findings and this does not look at MMR or any vaccine anyway.
In no way ”replicates” or “supports” Wakefield’s “findings”

21. Journal of Clinical Immunology November 2003;23:504-517 =
Ashwood P, Anthony A, Pellicer AA, Torrente F, Walker-Smith JA, Wakefield AJ. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology. J Clin Immunol. 2003 Nov;23(6):504-17.

We totally get it by now – Wakefield and Wakefield’s colleagues confirm their own results.
In no way ”replicates” or “supports” Wakefield’s “findings”

22. Neuroimmunology April 2006;173(1-2):126-34 =
Ashwood P, Wakefield AJ. Immune activation of peripheral blood and mucosal CD3+ lymphocyte cytokine profiles in children with autism and gastrointestinal symptoms. J Neuroimmunol. 2006;173(1-2):126-34.

same as number 4.

23. Prog. Neuropsychopharmacol Biol Psychiatry December 30 2006;30:1472-1477 =
Shinohe A, Hashimoto K, Nakamura K, Tsujii M, Iwata Y, Tsuchiyaa KJ, Sekine Y, Suda S, Suzuki K, Sugihara G, Matsuzaki H, Minabe Y, Sugiyama T, Masayoshi Kawai M, Iyo M,Takei N and Mori N Increased serum levels of glutamate in adult patients with autism- Progress in Neuro-Psychopharmacology and Biological Psychiatry Volume 30, Issue 8, 30 December 2006, Pages 1472-1477

Study of adults with autism on blood levels of amino acids, to assess whether altered glutamatergic neurotransmission was likely in autism. Study did not look for measles virus, nor did study look for mumps or rubella virus or anything connected with the gut.
In no way “replicates” or “supports” Wakefield’s “findings”

24. Clinical Infectious Diseases September 1 2002;35(Suppl 1):S6-S16 =
Finegold SM, Molitoris D, Song Y, Liu C, Vaisanen ML, Bolte E, McTeague M, Sandler R, Wexler H, Marlowe EM, Collins MD, Lawson PA, Summanen P, Baysallar M, Tomzynski TJ, Read E, Johnson E, Rolfe R, Nasir P, Shah H, Haake DA, Manning P, Kaul A. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.

Stool samples from children with regressive autism were compared to samples from children without autism; differences in stool flora were found. The study did not look for measles virus, nor did it look for mumps or rubella virus. Study did not evaluate changes in gut structure.
In no way “replicates” or “supports” Wakefield’s “findings”

25. Applied and Environmental Microbiology, 2004
Another of those citation snafus -
Song Y, Liu C, Finegold SM. Real-time PCR quantitation of clostridia in feces of autistic children. Appl Environ Microbiol. 2004 Nov;70(11):6459-65.

This study describes how to do PCR for specific bacteria on stool samples of autistic and non autistic children.
In no way “replicates” or “supports” Wakefield’s “findings”

26. Journal of Medical Microbiology October 2005;54:987-991 =
Parracho HM, Bingham MO, Gibson GR, McCartney AL. Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children. J Med Microbiol. 2005 Oct;54(Pt 10):987-91.

More in the same vein: This study compared fecal flora for children with autism with two control groups: siblings without autism and unrelated children without autism. Minor differences were found. The study did not look for measles virus, nor did study look for mumps or rubella virus. Study did not evaluate changes in gut structure.
In no way “replicates” or “supports” Wakefield’s “findings”

27. Archivos venezolanos de puericultura y pediatría 2006; Vol 69 (1): 19-25. = González LG., López K, Navarro DC, Negrón L, Flores LS, Rodríguez R, Martínez M, Sabrá A. Características endoscópicas, histológicas e inmunológicas de la mucosa digestiva en niños autistas con síntomas gastrointestinales [Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms] Archivos Venezolanos de Puericultura y Pediatría Enero-Marzo 2006, Volúmen 69, Número 1 Arch Venez Pueri Pediatr 2006 69(1):19-25. 1.

The authors cannot replicate Wakefield’s 1998 “findings” of a distinct autistic enterocolitis, although they do report a higher incidence of gastrointestinal problems in their autistic group. 2. It appears that the Gonzalez paper was funded by Thoughtful House, under Wakefield’s leadership as previously shown
In no way “replicates” or “supports” Wakefield’s “findings”

28. Gastroenterology. 2005:128 (Suppl 2);Abstract-303 =
Balzola F, Daniela C, Repici , Barbon V, Sapino A, Barbera C, Calvo PL, Gandione M, Rigardetto R*, and Rizzetto M .

This is a meeting abstract that has never been published as a peer reviewed study since 2005. Nine adult males with autism and GI symptoms were evaluated for GI disease. Study did not look for measles virus, nor did study look for mumps or rubella virus. Study did not evaluate changes in gut structure.
In no way “replicates” or “supports” Wakefield’s “findings”

Numbers: of 28 studies 2 were duplicates, 3 were only retrievable because of the links on the whale.to page, 13 were written by Wakefield and/or Lancet co-authors and/or Thoughful House colleagues (counting two duplicates), 3 predate the Lancet paper by years or even decades and not one independently replicates Wakefield’s claims, made in the retracted Lancet paper, the associated press conference and in many statements since.

Death by measles

I just found the news that a young man died of measles in Germany this Spring. Germany has had more than 390 measles cases since the beginning of the year, mainly in the Southern most federal states (Bundesländer) of Bavaria and Baden-Württemberg.

In March 2011, a 26 year old man, undergoing treatment for a non life threatening tumour contracted measles and died. While in hospital, he infected at least one further patient as well as several unvaccinated medical staff, including doctors. Dr. Martin Terhardt of the Professional Association of Pediatricians (Berufsverband der Kinder- und Jugendärzte (BVKJ)) states the obvious:

"It is unacceptable that unvaccinated personnel exists in hospitals. When unvaccinated doctors or nurses have access to intensive care, it becomes very dangerous, both for the personnel themselves and for the patients. Patients who are being treated in intensive care are often immuno-compromised - an additional infection therefore has to be avoided at all cost. Doctors and other medical care personnel must have adequate protection through immunization. The fact that a patient with measles could cause an outbreak amongst medical personnel is absurd."

Measles transmissions in a medical care setting seem to have become the norm rather than the exception (see California and Arizona 2008). In the light of the current strong measles activity in Europe (with world wide exports), everyone, especially care professionals, should check their immunization status and get boosters if necessary to avoid transmission (especially to vulnerable babies and immuno-suppressed).

Pertussis Closes Waldorf-Based Private School in Virginia

A whooping cough outbreak hitting more than half (23 of 45) their pupils has led to the closure of that small private school for a week. The local Health Care Director unambiguously stated that lack of vaccinations caused this outbreak and that the children who were affected were unvaccinated (7 adult contacts also got the disease).

This outbreak is demonstrating two things - disease outbreaks happen in "pockets" of unvaccinated children, and, those "pockets" are often found in Waldorf/Steiner oriented institutions (for a comprehensive critical introduction into Anthroposophy, read the three part series on DC's Improbable Science blog). Indeed, the last whooping cough outbreak I personally saw was in the Steiner Kindi in two streets down from where we lived in Germany. The daycare director interpreted the outbreak as "the children seeking disease, because they needed a break" and proposed to close the Kindi for three weeks (a plan curbed by the working moms whose children attending the facility had been vaccinated and were just fine). What a break that was, with several children needing a 3 week residential rehab to learn how to breathe normally again... I'd rather pay money for a break than health, but that may be just me.

Similarly, quite impressive measles outbreaks in (mostly German speaking) countries have started in Steiner schools and Kindergartens and were sometimes specifically centered around Anthroposophical doctors with an anti-vaccine vaccine-critical outlook. Steiner himself deemed rashy diseases, like measles and Scarlet fever, which in his life time each killed a large percentage of the annual birth cohort, important for the development of proper karma and the shedding of bad miasms (don't ask - read link above, it is weirder than you think and weirder than you would expect any contemporary parent to believe and doctor to peddle).

The good news is that school and parents are complying with the suggested quarantine and/or treatment measures to limit transmission. Hopefully, some of them will research the "crunchy, holistic" philosophy behind their school and their vaccine refusal a bit more carefully, too.